‘New to me’ – changing patient understanding of psoriasis and identifying mechanisms of change: The Pso Well® patient materials mixed methods feasibility study

Summary

Background

Psoriasis is an inflammatory, long-term condition (LTC) involving co-morbidities, unhealthy lifestyle and significant life impact. Patients' understanding of psoriasis is limited and support lacking. The Common-Sense Self-Regulatory Model emphasises the role of illness/treatment beliefs on coping/self-management. New 'Pso Well^®' patient materials informed by the model addressed: psoriasis as a LTC; medications management; and lifestyle behaviours.

Objectives

To investigate whether Pso Well^® materials: 1) broaden understanding of psoriasis without increasing anxiety; 2) are acceptable and; 3) comprise features that appear to effect change.

Methods

The Revised Illness Perceptions Questionnaire (IPQ-R modified) and the Hospital Anxiety and Depression Scale (HADS) were administered in patients pre-/post-intervention. Numerical Rating Scales (NRSs) assessed perceptions of change in understanding/anxiety. Qualitative interviews explored acceptability and perceived 'active ingredients'.

Results

Fifty five patients completed pre-/post-intervention questionnaires (56% female; median age 59 years). Post-intervention, a large effect size was indicated in two IPQ-R domains: illness coherence (t [55] = -3.48, p=.001 [two-tailed], eta² =0.19) and personal control (t [55] = -2.98, p=.004 [two-tailed], eta² =0.14); and a medium effect in one: treatment control (t [55] = -2.08, p=.042 [two-tailed], eta² =0.08). HADS scores did not change. For NRSs, 80% of participants reported increased understanding of psoriasis and no increased anxiety. Interviews with 19 patients indicated materials were acceptable/usable. Factors reported to broaden understanding/promote engagement with self-management included: linking of related disease aspects; personally relevant content; and high quality design.

Conclusions

High quality, theory-based psoriasis materials are acceptable to patients and can improve understanding/sense of control without increasing anxiety.

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