Examining the effect of integrative body-mind-spirit model on quality of life and pruritus management for people with psoriasis

Abstract

BACKGROUND: Itch and pain experience for people with psoriasis can result in poor quality of life (QoL) including irritating skin condition, emotional distress and psychosocial dysfunction. Integrative Body-Mind-Spirit (IBMS) is a psychosocial intervention model that is found to be effective in improving the holistic well-being of various kinds of participant. This study aims to investigate the effectiveness of IBMS in improving dermatology-related quality of life and pruritus condition of people with psoriasis. METHOD: 39 adults suffering from mild to moderate grade of psoriasis were recruited to attend six 3-hour weekly intervention group sessions developed based on IBMS Model. Outcome measures including Skindex29, Dermatology Quality of Life Index (DLQI), Patient Health Questionnaire (PHQ9), General Anxiety Scale (GAD7), Psoriasis Disability Index (PDI), 5D Itch Scale (5DIS) and Visual Analogue Itch Score (VASI) were assessed before (T0) and after intervention (T1). Paired t-tests were conducted to compare the changes between two time points. RESULT: At baseline, participants have shown moderate to severe problem in maintaining QoL based on scoring standard of Skindex29 [overall 42.6 (SD=22.7), emotion 46.2 (SD=26.3), symptom 41.3 (SD=26.3), function 40.4 (SD=24.2)] and DLQI [9.6 (SD=5.8)], and with mild problem based on PHQ9 [7.1 (SD=5.5)] and GAD7 [5.6 (SD=5.1)]. Paired ttest (T1-T0) showed that there were significant improvements in Skindex29 [overall 95% confidence interval (CI): -14.92 (SD=16.22), t=-5.75, p < .001, emotion 95% CI: -15.26 (SD=19.29), t=-4.94, p < .001, symptom 95% CI: -11.67 (SD16.22), t=-4.49, p < .001, function 95% CI: -16.41 (SD=17.64), t=-5.81, p < .001], DLQI [95% CI: -2.92 (SD=3.48), t=-5.24, p < .001], PHQ9 [95% CI: -2.33 (SD=4.41), t=-3.31, p=.002], GAD7 [95% CI: -2.05 (SD=3.95), t=-3.25, p=.002], PDI [95% CI: -3.87 (SD=5.55), t=-4.35, p < .001], 5DIS [95% CI: -2.26 (SD=2.58), t=-5.46, p < .001] and VASI [95% CI: -1.39 (SD=2.17), t=-3.98, p < .001]. Skindex29 score was improved from ‘moderate/severe’ to mild level, and PHQ9 from mild to minimal level. CONCLUSION: Result showed that IBMS intervention could improve dermatological-related quality of life and pruritus condition of people with psoriasis in terms of physical, emotional and psychosocial spheres.