Extent of misconceptions, negative prejudices and discriminatory behaviour to psoriasis patients in France.

BACKGROUND: The perception of stigmatization of patients with psoriasis is largely due to misconceptions and negative prejudice about this skin disease. 'Uneducated' judgments can give rise to discriminatory behaviours. OBJECTIVE: Evaluate the prevalence, in France, of misconceptions, negative prejudice and discriminatory behaviour towards psoriasis patients. METHODS: Online survey conducted in June 2011, aimed at 1005 persons aged 16-64 years, representative of the French population. The representativeness of the sample was ensured by quota methodology (gender, age, occupation of the interviewed person) after stratification by region and location category. The respondents were asked to respond to a questionnaire on their knowledge of psoriasis, their attitude and main feelings/perceptions towards psoriasis patients. RESULTS: About 62.4% of respondents recognize a lack of information about psoriasis and 19.7% have misconceptions about this disease. About 16.5% believe that psoriasis is contagious, 6.8% believe this skin disease is related to personal hygiene and 3.2% believe that it affects more people with low personal hygiene. About 50.0% of respondents show discriminatory behaviour towards psoriasis patients, reflected by reluctance to maintain friendship ties/a relationship of friendliness (7.6%), to have lunch or dinner with a person with visible manifestations (17.9%), to give a kiss on the cheek in greeting (29.7%), to shake hands (28.8%) and to have sexual relations/intercourse (44.1%). Patients with negative prejudice about the psoriasis frequently have misconceptions towards psoriasis patients. About 52.8% of respondents do not know anyone with psoriasis. Socio-demographic indicators such as gender, education level and rural or urban way of life are not associated with an increased prevalence of misconceptions and/or discriminatory behaviour. CONCLUSION: The lack of knowledge about psoriasis in France is important. There is an urgent need to strengthen information campaigns about psoriasis intended for the General Public.

[Guide for therapeutic education program in psoriasis]. / Élaboration d'un référentiel d'éducation thérapeutique dans le psoriasis.

INTRODUCTION: Psoriasis is a chronic inflammatory skin disease which can cause significant impairment of quality of life, absenteeism at work and significant psychological distress. This justifies the elaboration of a multidisciplinary education program for patients. The objective of this work was to develop the content of a therapeutic education program in psoriasis, which may serve as a basis for teams wishing to develop psoriasis therapeutic education in their community. PATIENTS AND METHODS: A group of 15 health professionals (dermatologists, dermatology nurses, and psychologist) and four psoriasis patients representatives of the psoriasis patient association (Association pour la lutte contre le psoriasis) participated in the development of this program. Health professionals all had an experience in therapeutic patient education in psoriasis through prior participation in a multicenter open pilot study, evaluating a therapeutic education program in psoriasis. Based on the previous experience, preparatory work in subteams was initiated to prepare draft objectives and content of the program. A two-day meeting was then organized to discuss in depth content of the therapeutic education program and elaborate recommendations. The meeting structure combined subteam work and plenary sessions. The following program was elaborated: two individual sessions and three group sessions. The groups have worked for two days, according to a predefined pattern: interview guide of educational diagnostic, content of collective workshops and knowledge questionnaire. All these documents were validated in plenary session. The methodology used for the development of this program followed the recommendations of the HAS in the field of chronic disease. RESULTS: In the end, were retained three collective workshops, preceded by a consultation of individual educational diagnosis and knowledge questionnaire followed by an evaluation session at the end of the program. The interview guide for educational diagnosis and the knowledge basis questionnaire have been defined. Three themes of group workshops were defined: (1) understanding the disease, (2) understanding the mechanism of onset of disease and treatments available, (3) how to live with psoriasis in everyday life. For each workshop, were defined learning objectives, skills to acquire and how to get there. DISCUSSION: We describe here a framework of educational therapy program in psoriasis comprising educational objectives, skills to acquire, basic disease knowledge, suitable for patients with psoriasis. The content was tailored to patient language and knowledge based on feedback from participating patients. The list of skills may be adapted to patient's individual needs. This program serves primarily as a working basis for the caregiver, to standardize practices in terms of therapeutic education in psoriasis in France.

Psoriasis: an epidemiological evaluation of disease burden in 590 patients.

BACKGROUND: There are limited data available on the economical burden of psoriasis and its impact on everyday life. OBJECTIVE: The aim of this study was to evaluate the impact of psoriasis on personal and professional life, and to evaluate the cost of psoriasis for the patient. METHODS: We performed a cross-sectional study in psoriasis patients. All patients aged >or=18 years with a diagnosis of plaque-psoriasis confirmed by a physician were included. A self-administered questionnaire evaluating everyday life was constructed with members of the French association of psoriasis patients. In addition, the Dermatology Life Quality Index (DLQI), Working Productivity and Activity Impairment and individual costs were assessed. RESULTS: A total of 590 patients completed the study. Mean age of the responders was 56 years. The mean DLQI score was 8.5 for patients with severe psoriasis vs. 6.4 for mild psoriasis. Global loss of productivity was 10.7% without significant difference according to the disease severity. Daily activities alteration was most important in patients with severe psoriasis. In this study, 36.8% of patients with severe psoriasis reported a negative impact on their professional life vs. 19.6% for patients with mild psoriasis (P = 0.002). Time devoted to phototherapy was on average 33 h/year/patient and the application of emollients took 25 h/year/patient; 47.3% of patients had a feeling to clean the house more often, in correlation with the severity of the disease. Mean out-of-pocket expenses for the disease was estimated to be 543 euro/year/patient. High impact of psoriasis on quality of life (DLQI >10), age <40 years and joint involvement were significantly associated with an increased risk of loss of work productivity. CONCLUSION: Psoriasis, particularly severe psoriasis, is a true burden for patients and impacts significantly everyday life and patient's economical resources.