70% recognize psoriasis as a complex condition but managed it as a skin problem

[Fred]

This is another one of those interesting articles that looks at psoriasis from the side of the people that treat us, it suggests that 70% of practitioners recognized psoriasis as a complex condition but managed it as a skin condition.

Quote:

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Objectives:
Individuals’ illness representations, including beliefs about psoriasis (a complex immune-mediated condition), and their emotional responses to the condition guide self-management behaviour. It is also plausible that health care providers’ illness representations guide their own management of psoriasis. Patients commonly report poor health care experiences related to psoriasis, and the role of health care providers’ beliefs, emotions, as well as their knowledge, experiences and behaviours (‘personal models’) in this is unexplored. This study aimed explore health care providers’ personal models of psoriasis.

Design and methods:
Qualitative analysis of 23 semi-structured interviews with health care professionals providing care for psoriasis patients was performed. Purposive sampling achieved maximum variation regarding participant discipline, level of experience, gender and age. The self-regulatory/common sense model informed data collection and initial data analysis. Principles of framework analysis were used to generate predetermined and emergent key issues related to practitioners’ personal models.

Results:
Three types of personal model emerged. Sophisticated–Linear Model: 70% of practitioners recognized psoriasis as a complex condition but managed it as a skin condition. Mixed Model: 17% of practitioners recognized/managed some elements of psoriasis as complex and some as a skin condition. Sophisticated–Sophisticated Model: 13% recognized and managed psoriasis as a complex condition. Across the data set, five themes emerged illustrating key patterns underpinning these different models including Recognising complexity, Putting skin first, Taking on the complexities of psoriasis with the patient, Aiming for clearance, and Affective experiences within psoriasis consultations.

Conclusions:
Health care providers recognized psoriasis as a complex condition but commonly reported managing psoriasis as a simple skin condition. Providers’ beliefs and management approaches varied in the extent to which they were consistent with one another; and their emotional experiences during consultations may vary depending upon their personal model. Findings could inform future dermatology training programmes by highlighting the role of health care providers’ illness representations in clinical management of the condition.

Source: onlinelibrary.wiley.com

Funded by National Institute for Health Research (NIHR)

So 70% of professionals are treating us wrong? Sorry I usually just report and only comment if another replies, but that study makes for frustrating reading.

[D Foster]

This is another one of those interesting articles that looks at psoriasis from the side of the people that treat us, it suggests that 70% of practitioners recognized psoriasis as a complex condition but managed it as a skin condition.

Quote:

---

Objectives:
Individuals’ illness representations, including beliefs about psoriasis (a complex immune-mediated condition), and their emotional responses to the condition guide self-management behaviour. It is also plausible that health care providers’ illness representations guide their own management of psoriasis. Patients commonly report poor health care experiences related to psoriasis, and the role of health care providers’ beliefs, emotions, as well as their knowledge, experiences and behaviours (‘personal models’) in this is unexplored. This study aimed explore health care providers’ personal models of psoriasis.

Design and methods:
Qualitative analysis of 23 semi-structured interviews with health care professionals providing care for psoriasis patients was performed. Purposive sampling achieved maximum variation regarding participant discipline, level of experience, gender and age. The self-regulatory/common sense model informed data collection and initial data analysis. Principles of framework analysis were used to generate predetermined and emergent key issues related to practitioners’ personal models.

Results:
Three types of personal model emerged. Sophisticated–Linear Model: 70% of practitioners recognized psoriasis as a complex condition but managed it as a skin condition. Mixed Model: 17% of practitioners recognized/managed some elements of psoriasis as complex and some as a skin condition. Sophisticated–Sophisticated Model: 13% recognized and managed psoriasis as a complex condition. Across the data set, five themes emerged illustrating key patterns underpinning these different models including Recognising complexity, Putting skin first, Taking on the complexities of psoriasis with the patient, Aiming for clearance, and Affective experiences within psoriasis consultations.

Conclusions:
Health care providers recognized psoriasis as a complex condition but commonly reported managing psoriasis as a simple skin condition. Providers’ beliefs and management approaches varied in the extent to which they were consistent with one another; and their emotional experiences during consultations may vary depending upon their personal model. Findings could inform future dermatology training programmes by highlighting the role of health care providers’ illness representations in clinical management of the condition.

Source: onlinelibrary.wiley.com

Funded by National Institute for Health Research (NIHR)

So 70% of professionals are treating us wrong? Sorry I usually just report and only comment if another replies, but that study makes for frustrating reading.

I have just said that or a similar comment on the so called professionals'

[jiml]

Agreed it's frustrating that so many patients are being incorrectly treated, I'm not surprised after reading many experiences on here
Let's hope that now it's being talked about things may change in the future

[Celia]

I've been telling my doctors that all along, the skin is just the outside evidence of a problem inside the body. Of course they don't know what to do, other than treat the symptoms.

For the past several years I have been participating in a study by Psolar in which participants are tracked every 6 months for 8 years.
They ask a barrage of physical and mental health-related questions as well a do a physical examination (height, weight, blood pressure, etc) each 6 month appointment. Their stated purpose is to try to statistically relate certain conditions/states of mind/health status to the severity of psoriasis.

It's an interesting concept, I'm not sure exactly how helpful it really will be in the end. But I'm glad to join any study if it will help someone get relief!

[jiml]

Well done joining a study like that, it probably will produce some good information at the end. (Things we as sufferers know but they will scientifically prove)

It will help make doctors like yours realise that you were right all along

[Caroline]

Yes, good action !!

It is overall very good that also these type of investigations are being done, as they more look at the person instead of the disease. That could give much more insight in everything that is around psoriasis and the feeling of the condition you are in. Quality of life I mean.

[jiml]

Yes, good action !!

It is overall very good that also these type of investigations are being done, as they more look at the person instead of the disease. That could give much more insight in everything that is around psoriasis and the feeling of the condition you are in. Quality of life I mean.

Yes and then perhaps dermatologists will start treatment dealing with the whole disease, and it's cause,  not just the skin

[Celia]

I'm hoping that if they study enough of us for long enough someone actually stumbles on some sort of insight.

I saw something in another website today about some DNA research which seems to point to an antimicrobial peptide triggering the immune response. I'm hoping they actually find something concrete.

I'm somewhat distrustful of some of the drug companies, I wonder if they're really looking for a cure, as they're making quite a profit off selling the meds that just mask the disease.   Just my two cents worth.

[Caroline]

I am as distrustful as you are Celia.
There is no indication of searching for a real cure, just only for blocking the effects with expensive medication.

[jiml]

You are both right there will be just a short term profit for a cure ....whereas they are making millions from us by just offering control