Turkiye Klinikleri Journal of Dermatology

.: ORIGINAL RESEARCH
Neglected Victims of Psoriasis
Gözardı Edilmiş Psoriasis Mağdurları
İjlal ERTURANa, Pınar YÜKSEL BAŞAKa, Gonca Meriç BİÇİCİa, Meltem ATAYb, Selma KORKMAZa, Mehmet YILDIRIMa, Havva Hilal AYVAZa
aDepartment of Dermatology, Süleyman Demirel University Faculty of Medicine, Isparta, TURKEY
bDepartment of Psychiatry, Süleyman Demirel University Faculty of Medicine, Isparta, TURKEY
Turkiye Klinikleri J Dermatol. 2020;30(3):95-101
doi: 10.5336/dermato.2020-78969
Article Language: EN
Full Text
ABSTRACT
Objective: The quality of life of patients is closely related to the quality of life of family members who share the same environment. The quality of life of the relatives may deteriorate more than the quality of life of patients. Except for atopic dermatitis, the impact of skin diseases on the families of patients has been largely neglected. In this study, we aimed to investigate how the quality of life of family members was affected by the psoriatic patients' disease. Material and Methods: Seventy psoriasis patients, their relatives and controls were included in the study. Psoriasis severity index (PASI), Nail Psoriasis Severity Index (NAPSI), Psoriasis Quality of life Questionnaire (PQLQ), Dermatological Diseases Family Impact Scale (DeFIS) and Hospital Anxiety and Depression Scale (HADS) were used to determine severity of the disease, and nail psoriasis, quality of life of the psoriatic patient, effect of the patient's psoriasis on the relatives' quality of life, anxiety and depression levels of the patients, respectively. Results: Of the relatives of psoriatic patients, 94.3% reported psychological problems, 57.1% reported financial burden, 61.4% reported problems with physical well-being, 51.4% had social and 81.4% had patient care need problems. The DeFIS scores of the relatives correlated with the PQLQ (r=0.413, p=0.00), HADS-depression (r=0.277, p=0.02) and NAPSI (r=0.240, p=0.046) scores of the patients. Conclusion: Our results suggest that psoriasis affects the quality of life of the patient, as well as the relatives. Family members should also be supported psychosocially for the patients' well being.

Keywords: Psoriasis; family members; quality of life; nail psoriasis severity index; psoriasis severity index; depression
ÖZET
Amaç: Hastaların yaşam kalitesi, aynı ortamı paylaşan aile bireylerinin yaşam kalitesi ile yakından ilgilidir. Yakınların yaşam kalitesi, hastaların yaşam kalitelerinden daha fazla bozulabilir. Atopik dermatit dışında, deri hastalıklarının hastaların aileleri üzerindeki etkisi büyük ölçüde ihmal edilmiştir. Bu çalışmada aile bireylerinin yaşam kalitesinin psoriatik hastaların hastalığından nasıl etkilendiğini araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya 70 psoriazis hastası, yakınları ve kontrolleri dahil edildi. Hastalığın şiddetini belirlemek için Psoriazis Şiddet İndeksi (PASI), Tırnak Psoriasis Şiddet İndeksi (NAPSI), Psoriasis Yaşam Kalitesi Anketi (PQLQ), Dermatolojik Hastalıklar Aile Etki Ölçeği (DeFIS) ve Hastane Anksiyete ve Depresyon Ölçeği (HADS) kullanılarak hastalık şiddeti, tırnak tutulumu, psoriatik hastanın yaşam kalitesi, hastanın sedef hastalığının yakınlarının yaşam kalitesi, hastaların anksiyete ve depresyon düzeylerine etkisi belirlendi. Bulgular: Psoriatik hasta yakınlarının %94,3'ü psikolojik sorunlar, %57,1'i maddi yük, %61,4'ü fiziksel sağlık sorunları, %51,4'ü sosyal ve %81,4'ü hasta bakım ihtiyacı sorunları bildirdi. Yakınlarının DeFIS puanları, hastaların PQLQ (r=0,413, p=0,00), HADS-depresyon (r=0,277, p=0,02) ve NAPSI (r=0,240, p=0,046) puanları ile korele idi. Sonuç: Sonuçlarımız sedef hastalığının hasta ve yakınlarının yaşam kalitesini etkilediğini düşündürmektedir. Hastaların iyiliği için aile üyeleri de psikososyal olarak desteklenmelidir.

Anahtar Kelimeler: Psoriasis; aile üyeleri; yaşam kalitesi; tırnak psoriasis şiddet indeksi; psoriazis şiddet indeksi; depresyon
REFERENCES:
  1. Molina-Leyva A, Almodovar-Real A, Carrascosa JC, Molina-Leyva I, Naranjo-Sintes R, Jimenez-Moleon JJ, et al. Distribution pattern of psoriasis, anxiety and depression as possible causes of sexual dysfunction in patients with moderate to severe psoriasis. An Bras Dermatol. 2015;90(3):338-45.[Crossref] [PubMed] [PMC] 
  2. Dennis H, Rostill H, Reed J, Gill S. Factors promoting psychological adjustment to childhood atopic eczema. J Child Health Care. 2006;10(2):126-39.[Crossref] [PubMed] 
  3. Kouris A, Christodoulou C, Stefanaki C, Livaditis M, Tsatovidou R, Kouskoukis C, et al. Quality of life and psychosocial aspects in Greek patients with psoriasis: a cross-sectional study. An Bras Dermatol. 2015;90(6):841-5.[Crossref] [PubMed] [PMC] 
  4. Molina-Leyva A, Jiménez-Moleón JJ, Naranjo-Sintes R, Ruiz-Carrascosa JC. Sexual dysfunction in psoriasis: a systematic review. J Eur Acad Dermatol Venereol. 2015;29(4):649-55.[Crossref] [PubMed] 
  5. Fredriksson T, Pettersson U. Severe psoriasis--oral therapy with a new retinoid. Dermatologica. 1978;157(4):238-44.[Crossref] [PubMed] 
  6. Inanir I, Aydemir O, Gündüz K, Danaci AE, Türel A. Developing a quality of life instrument in patients with psoriasis: the Psoriasis Quality of Life Questionnaire (PQLQ). Int J Dermatol. 2006;45(3):234-8.[Crossref] [PubMed] 
  7. Rich P, Scher RK. Nail psoriasis severity ındex: a useful tool for evaluation of nail psoriasis. J Am Acad Dermatol. 2003;49(2):206-12.[Crossref] [PubMed] 
  8. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70.[Crossref] [PubMed] 
  9. Turan E, Gürel MS, Erdemir AS, Yüksel Eİ. [Development and preliminary validation of the dermatological family impact scale]. Turkderm-Arch Turk Dermatol Venerology. 2014;48:74-81.[Crossref] 
  10. Kirby B, Richards HL, Woo P, Hindle E, Main CJ, Griffiths CE, et al. Physical and psychologic measures are necessary to assess overall psoriasis severity. J Am Acad Dermatol. 2001;45(1):72-6.[Crossref] [PubMed] 
  11. Kaçar N, Ergin Ş, Erdoğan BŞ. [The quality of life in patients with psoriasis]. Turkderm- Arch Turk Dermatol Venerology. 2007;41(4):117-20.[Link] 
  12. Zachariae R, Zachariae H, Blomqvist K, Davidsson S, Molin L, Mørk C, et al. Quality of life in 6497 nordic patients with psoriasis. Br J Dermatol. 2002;146(6):1006-16.[Crossref] [PubMed] 
  13. Gelfand JM, Feldman SR, Stern RS, Thomas J, Rolstad T, Margolis DJ, et al. Determinants of quality of life in patients with psoriasis: a study from the US population. J Am Acad Dermatol. 2004;51(5):704-8.[Crossref] [PubMed] 
  14. Martínez-García E, Arias-Santiago S, Valenzuela-Salas I, Garrido-Colmenero C, García-Mellado V, Buendía-Eisman A, et al. Quality of life in persons living with psoriasis patients. J Am Acad Dermatol. 2014;71(2):302-7.[Crossref] [PubMed] 
  15. Eghlileb AM, Davies EE, Finlay AY. Psoriasis has a major secondary impact on the lives of family members and partners. Br J Dermatol. 2007;156(6):1245-50.[Crossref] [PubMed] 
  16. Eghlileb AM, Basra MK, Finlay AY. The psoriasis family index: preliminary results of validation of a quality of life instrument for family members of patients with psoriasis. Dermatology. 2009;219(1):63-70.[Crossref] [PubMed] 
  17. Tollefson MM, Finnie DM, Schoch JJ, Eton DT. Impact of childhood psoriasis on parents of affected children. J Am Acad Dermatol. 2017;76(2):286-9.e5.[Crossref] [PubMed] 
  18. Lawson V, Lewis-Jones MS, Finlay AY, Reid P, Owens RG. The family impact of childhood atopic dermatitis: the dermatitis family ımpact questionnaire. Br J Dermatol. 1998;138(1):107-13.[Crossref] [PubMed] 
  19. Dowlatshahi EA, Wakkee M, Arends LR, Nijsten T. The prevalence and odds of depressive symptoms and clinical depression in psoriasis patients: a systematic review and meta-analysis. J Invest Dermatol. 2014;134(6):1542-51.[Crossref] [PubMed] 
  20. Fleming P, Bai JW, Pratt M, Sibbald C, Lynde C, Gulliver WP, et al. The prevalence of anxiety in patients with psoriasis: a systematic review of observational studies and clinical trials. J Eur Acad Dermatol Venereol. 2017;31(5):798-807.[Crossref] [PubMed] 
  21. Tadros A, Vergou T, Stratigos AJ, Tzavara C, Hletsos M, Katsambas A, et al. Psoriasis: is it the tip of the iceberg for the quality of life of patients and their families? J Eur Acad Dermatol Venereol. 2011;25(11):1282-7.[Crossref] [PubMed] 
  22. Luca M, Luca A, Musumeci ML, Fiorentini F, Micali G, Calandra C, et al. Psychopathological variables and sleep quality in psoriatic patients. Int J Mol Sci. 2016;21;17(7):1184.[Crossref] [PubMed] [PMC] 
  23. Ricci G, Bendandi B, Bellini F, Patrizi A, Masi M. Atopic dermatitis: quality of life of young Italian children and their families and correlation with severity score. Pediatr Allergy Immunol. 2007;18(3):245-9.[Crossref] [PubMed] 
  24. Amer AA, Mchepange UO, Gao XH, Hong Y, Qi R, Wu Y, et al. Hidden victims of childhood vitiligo: impact on parents' mental health and quality of life. Acta Derm Venereol. 2015;95(3):322-5.[Crossref] [PubMed] 
  25. Basra MK, Finlay AY. The family impact of skin diseases: the greater patient concept. Br J Dermatol. 2007;156(5):929-37.[Crossref] [PubMed] 
  26. Marciniak J, Reich A, Szepietowski JC. Quality of Life of parents of children with atopic dermatitis. Acta Derm Venereol. 2017;9;97(6):711-4.[Crossref] [PubMed] 

.: Up To Date

Login



Contact


Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com