Psoriasis: The Skin I'm In - Development of a behaviour change tool to improve the care and lives of people with psoriasis.

BACKGROUND Psoriasis is a long-term skin condition associated with considerable life impairment. Extensive literature regarding the needs of patients with psoriasis is not translated into clinical practice. OBJECTIVES To explore and communicate the experience of living with psoriasis and interacting with healthcare professionals. METHODS 21 patients attending a tertiary adult psoriasis service were interviewed individually. Interviews were recorded and transcribed. Transcripts were examined and thematic analyses and qualitative content analysis performed. Results were communicated via a short film. RESULTS Three key themes were identified: comparison with cancer, misalignment of response with need, and fear of social exclusion. Cancer comparison subthemes included poorer services, lack of awareness and trivialisation of psoriasis compared with cancer. Misalignment subthemes related to lack of knowledge and inappropriate response of healthcare professionals and society towards psoriasis. Fear of social exclusion subthemes included erroneous belief of psoriasis being contagious, and expectation of rejection. Consequent emotions of fear, shame and anxiety resulted in avoidant behaviours, which perpetuated social exclusion. Participants valued active listening, shared decision-making and communication of hope regarding treatment by healthcare professionals. CONCLUSIONS Despite extensive research into psoriasis and the availability of effective treatment for many, people with psoriasis live unnecessarily impaired lives and have unsatisfactory healthcare experiences. Storytelling techniques provide a method to communicate scientific information in a way that may drive change in delivery of healthcare and improve the lives of patients.