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Magin PJ, Tng ETV. Specialists and generalists in skin disease management: educational, clinical and research imperatives. Br J Dermatol 2022; 186:1-2. [PMID: 34988983 DOI: 10.1111/bjd.20575] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 11/30/2022]
Affiliation(s)
- P J Magin
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,NSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organisation, Mayfield West, NSW, Australia
| | - E T V Tng
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Department of Dermatology, John Hunter Hospital, New Lambton Heights, NSW, Australia
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2
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Mahdavi Nejad T, Mohammadi F, Gorgulu O, Motalebi SA, Hosseinkhani Z. Validation of the Persian version of Skindex-16 among older patients with skin diseases. BMC Geriatr 2021; 21:724. [PMID: 34922470 PMCID: PMC8684253 DOI: 10.1186/s12877-021-02635-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 11/15/2021] [Indexed: 11/17/2022] Open
Abstract
Background Skin conditions often considerably impact the older patients’ psycho-social health and quality of life (QoL). The present study was aimed to examine the validity and reliability of the Persian version of Skindex-16 among older people with skin diseases. Methods In this validation study, 260 older patients suffering from a range of skin conditions were recruited from a dermatology clinic in Rasht, Iran. Data were collected using a checklist for demographic and clinical characteristics and the Skindex-16 questionnaire. In this study, validity (face, content, and construct) and reliability (Cronbach’s alpha) of the Skindex-16 were assessed and reported. Results The mean age of participants was 64.51 ± 5.04 years. The results of confirmatory factor analysis showed that the model had acceptable fitness into the expected three-factor structure [χ 2 /df = 249.363, P < 0.001; GFI = 0.961; TLI =0.952; RMSEA = 0.078 (90% CI = 0.06, 0.09) and SRMR = 0.06]. The reliability analysis results confirmed that the values of Cronbach’s alpha coefficient for Skindex-16 were in the acceptable range (0.923). Conclusions Our evaluation of the Skindex-16 indicates that it is reliable and a valid instrument that can be used for measuring QoL for Iranian dermatologic patients.
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Affiliation(s)
- Tahereh Mahdavi Nejad
- Student Research Committee, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Mohammadi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ozkan Gorgulu
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ahi Evran University, Kırşehir, Turkey
| | - Seyedeh Ameneh Motalebi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Zahra Hosseinkhani
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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3
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Tauber M, Lourari S, Bérard E, Questel E, Redoules D, Giordano-Labadie F, Simon M, Carle P. Positive change in hand care habits using therapeutic patient education in chronic hand eczema. Contact Dermatitis 2019; 82:10-17. [PMID: 31461531 DOI: 10.1111/cod.13390] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 08/23/2019] [Accepted: 08/27/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chronic hand eczema (CHE) is a major burden for patients. Maintenance treatment involves prevention measures limiting detrimental behaviour and aggravating factors. OBJECTIVE To evaluate the effect of a standardised care program including therapeutic patient education (TPE) on hand care behaviours, clinical severity, quality of life, and work productivity. METHODS A single-centre study was conducted prospectively. Together with the prescription of a topical steroid, patients participated in individual TPE sessions. Evaluations were performed initially and repeated three months after the therapeutic intervention. They included a structured analysis of hand care behaviours, the assessment of the mTLSS (modified Total Lesion Symptom Score), DLQI (Dermatology Life Quality Index), and WPAI (Work Productivity and Activity Impairment). RESULTS Seventy-one patients were included (30 men, 42.3%). Three months after completion of the standardised care program, hand care behaviours such as hand washing and rinsing, hand drying, wearing protective gloves, using moisturizing creams, and following specific treatments and recommendations for CHE improved significantly in the 58 patients who completed the study and were associated with a significant improvement in the mTLSS, DLQI, and WPAI scores. CONCLUSIONS TPE helps patients change their hand care behaviours and adopt skin protection measures, and may improve CHE severity, quality of life, and work productivity.
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Affiliation(s)
- Marie Tauber
- Dermatology and Allergology Department, Larrey Hospital, Toulouse University, Toulouse, France.,UDEAR, U1056 INSERM, Paul Sabatier Toulouse University, Toulouse, France
| | - Siham Lourari
- Dermatology and Allergology Department, Larrey Hospital, Toulouse University, Toulouse, France
| | - Emilie Bérard
- Department of Epidemiology, Health Economics and Public Health, UMR1027 INSERM- Toulouse University, Toulouse University Hospital (CHU), Toulouse, France
| | | | | | | | - Michel Simon
- UDEAR, U1056 INSERM, Paul Sabatier Toulouse University, Toulouse, France
| | - Paul Carle
- Dermatology and Allergology Department, Larrey Hospital, Toulouse University, Toulouse, France.,UDEAR, U1056 INSERM, Paul Sabatier Toulouse University, Toulouse, France
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4
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Versteegh JJ, Dulfer K, Stuvel K, Pasmans SG, Utens EM. Netherton syndrome; neuropsychological and psychosocial functioning of child and adult patients and their parents. J Health Psychol 2018; 25:2296-2316. [PMID: 30129381 PMCID: PMC7583452 DOI: 10.1177/1359105318790052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Netherton syndrome is a rare severe skin disease. Clinical experience showed considerable psychosocial burdens among Netherton syndrome patients/families. Their (neuro)psychological functioning has never been investigated. Objective: To investigate neuropsychological/psychosocial functioning of Netherton syndrome patients and parents. Methods: A total of 12 Netherton syndrome patients and/or parents completed neuropsychological tests, semi-structured-interviews, and psychological-questionnaires. Results: Intelligence results showed disharmonic profiles, with below-average scores on processing speed. Neuropsychological problems and unfavorable outcomes on health-related quality of life, illness-appearance-related problems, and negative social consequences among patients/parents were found. Psychopathological (emotional) problems were reported; stigmatization, bullying was common among Netherton syndrome patients. Conclusion: Compared with normative data, Netherton syndrome patients showed neuropsychological and psychosocial problems. Standard follow-up is necessary to identify problems at early stage.
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Affiliation(s)
| | - Karolijn Dulfer
- Erasmus University Medical Center-Sophia Children's Hospital, The Netherlands
| | - Kira Stuvel
- Erasmus University Medical Center-Sophia Children's Hospital, The Netherlands
| | - Suzanne Gma Pasmans
- Erasmus University Medical Center-Sophia Children's Hospital, The Netherlands
| | - Elisabeth Mwj Utens
- Erasmus University Medical Center-Sophia Children's Hospital, The Netherlands.,University of Amsterdam, The Netherlands.,The Bascule - Academic Center for Child Psychiatry, The Netherlands.,Academic Medical Center, The Netherlands
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5
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Peerdeman KJ, van Laarhoven AIM, Donders ART, Hopman MTE, Peters ML, Evers AWM. Inducing Expectations for Health: Effects of Verbal Suggestion and Imagery on Pain, Itch, and Fatigue as Indicators of Physical Sensitivity. PLoS One 2015; 10:e0139563. [PMID: 26448183 PMCID: PMC4598027 DOI: 10.1371/journal.pone.0139563] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 09/15/2015] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Research into placebo effects has convincingly shown that inducing positive outcome expectations can reduce pain and other physical sensations. However, the comparative effects of different expectation inductions, such as verbal suggestion or mental imagery, and their generic effects on physical sensitivity, to different sensations such as pain, itch, and fatigue, are still largely unknown. In the current study, we assessed the individual and combined effects of verbal suggestion and imagery on pain, itch, and fatigue as indicators of physical sensitivity in a randomized study design. Healthy participants (n = 116) were given an inert (placebo) capsule that was said to be effective for reducing physical sensitivity in either the majority (positive verbal suggestion) or the minority (control verbal suggestion) of users. Subsequently, they imagined either their best possible health (positive imagery) or a typical day (control imagery). Sensitivity to pain, itch, and fatigue was tested using a cold pressor test, histamine iontophoresis, and a bicycle test, respectively. Heart rate and skin conductance were recorded continuously. Results showed that positive verbal suggestion and imagery successfully induced positive expectations, but they did not affect physical sensitivity, as indicated by sensitivity to pain, itch, or fatigue, or concurrent physiological responses. These results could indicate that the specificity and concreteness of expectation inductions might be important for their applicability in the treatment of physical symptoms. TRIAL REGISTRATION Nederlands Trial Register NTR3641.
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Affiliation(s)
- Kaya J. Peerdeman
- Unit Health, Medical and Neuropsychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
- Department of Medical Psychology, Radboudumc, Nijmegen, the Netherlands
| | - Antoinette I. M. van Laarhoven
- Unit Health, Medical and Neuropsychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
- Department of Medical Psychology, Radboudumc, Nijmegen, the Netherlands
| | | | | | - Madelon L. Peters
- Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands
| | - Andrea W. M. Evers
- Unit Health, Medical and Neuropsychology, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands
- Department of Medical Psychology, Radboudumc, Nijmegen, the Netherlands
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Kleyn C, McKie S, Ross A, Elliott R, Griffiths C. A temporal analysis of the central neural processing of itch. Br J Dermatol 2012; 166:994-1001. [DOI: 10.1111/j.1365-2133.2012.10849.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C.E. Kleyn
- Dermatological Sciences, Salford Royal NHS Foundation Trust and
| | - S. McKie
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester Academic Health Science Centre, Manchester M6 8HD, U.K
| | - A. Ross
- Dermatological Sciences, Salford Royal NHS Foundation Trust and
| | - R. Elliott
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester Academic Health Science Centre, Manchester M6 8HD, U.K
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7
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van Gils RF, van der Valk PGM, Bruynzeel D, Coenraads PJ, Boot CRL, van Mechelen W, Anema JR. Integrated, multidisciplinary care for hand eczema: design of a randomized controlled trial and cost-effectiveness study. BMC Public Health 2009; 9:438. [PMID: 19951404 PMCID: PMC2793258 DOI: 10.1186/1471-2458-9-438] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Accepted: 12/01/2009] [Indexed: 12/03/2022] Open
Abstract
Background The individual and societal burden of hand eczema is high. Literature indicates that moderate to severe hand eczema is a disease with a poor prognosis. Many patients are hampered in their daily activities, including work. High costs are related to high medical consumption, productivity loss and sick leave. Usual care is suboptimal, due to a lack of optimal instruction and coordination of care, and communication with the general practitioner/occupational physician and people involved at the workplace. Therefore, an integrated, multidisciplinary intervention involving a dermatologist, a care manager, a specialized nurse and a clinical occupational physician was developed. This paper describes the design of a study to investigate the effectiveness and cost-effectiveness of integrated care for hand eczema by a multidisciplinary team, coordinated by a care manager, consisting of instruction on avoiding relevant contact factors, both in the occupational and in the private environment, optimal skin care and treatment, compared to usual, dermatologist-led care. Methods The study is a multicentre, randomized, controlled trial with an economic evaluation alongside. The study population consists of patients with chronic, moderate to severe hand eczema, who visit an outpatient clinic of one of the participating 5 (three university and two general) hospitals. Integrated, multidisciplinary care, coordinated by a care manager, including allergo-dermatological evaluation by a dermatologist, occupational intervention by a clinical occupational physician, and counselling by a specialized nurse on optimizing topical treatment and skin care will be compared with usual care by a dermatologist. The primary outcome measure is the cumulative difference in reduction of the clinical severity score HECSI between the groups. Secondary outcome measures are the patient's global assessment, specific quality of life with regard to the hands, generic quality of life, sick leave and patient satisfaction. An economic evaluation will be conducted alongside the RCT. Direct and indirect costs will be measured. Outcome measures will be assessed at baseline and after 4, 12, 26 and 52 weeks. All statistical analyses will be performed on the intention-to-treat principle. In addition, per protocol analyses will be carried out. Discussion To improve societal participation of patients with moderate to severe hand eczema, an integrated care intervention was developed involving both person-related and environmental factors. Such integrated care is expected to improve the patients' clinical signs, quality of life and to reduce sick leave and medical costs. Results will become available in 2011.
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Affiliation(s)
- Robin F van Gils
- Department of Public and Occupational Health and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
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