A role for denial in poor adherence to psoriasis treatment

Awadalla, Farah; Yentzer, Brad A.; Balkrishnan, Rajesh; Feldman, Steven R.

doi:10.1080/09546630701731131

Cited by 8 publications

(6 citation statements)

References 12 publications

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“…This is related to the fact that patients with higher education usually have a broader spectrum of coping strategies [ 9 , 31 ]. Avoidance and denial are relatively primitive and immature mechanisms for ego defence in contrast to humor, focusing on the task, or positive reappraisal [ 15 , 23 ]. Again, it is commonly believed that using these emotional strategies is detrimental to patient health [ 11 , 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…A very good understanding of their health condition and compliance to a strict medical regiment is paramount for their survival. This is a different context compared to psoriasis, lupus, coronary artery disease, or spinal cord injury [ 8 , 11 , 15 , 16 ]. In the case of chronic disease, optimal coping should deal with the emotional aftermath of the illness, allowing patients to fully adhere to treatment.…”

Section: Introductionmentioning

confidence: 99%

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Denial Defense Mechanism in Dialyzed Patients

2015

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BackgroundIt is a struggle to identify the most adaptive coping strategies with disease-mediated stress. Here, we hypothesize that intensity of coping strategies, including denial, in patients with end-stage renal disease (ESRD), varies with type of renal replacement therapy (RRT).Material/MethodsWe enrolled 60 in-center hemodialyzed patients (HD) and 55 patients treated with continuous ambulatory peritoneal dialysis (CAPD). We administered the Coping Inventory with Stressful Situation, Profile of Mood States, and Stroop Anxiety Inventory to measure patient coping strategies in the context of their ESRD. Denial defense mechanism was measured via the IBS-R/ED. The Nottingham Health Profile was used to evaluate self-perceived quality of life. Serum potassium, urea, creatinine, phosphorus, calcium, albumin, and hematocrit were utilized as the measurements of adequacy of dialysis.ResultsHD patients had higher self-reported intensity of denial mechanism and avoidance-oriented strategies versus CAPD patients. Because a single strategy is almost never employed, we conducted cluster analysis. We identify 3 patterns of coping strategies using cluster analysis. “Repressors” employed denial and avoidance strategies and were predominant in HD. The second cluster consists of subjects employing predominantly task-oriented strategies with equal distribution among dialyzed patients. The third cluster encompassed a small group of patients who shared higher intensity of both denial and task-oriented strategies. Health-related outcome, anxiety, and mood profile were similar across all patients.ConclusionsHD patients predominantly used “repressive” strategies. Patients on RRT utilized denial and avoidance-based strategies to achieve satisfactory outcome in terms of perceived quality of life. We conclude that these coping mechanisms that were previously thought to be inferior are beneficial to patient compliance with RRT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Denial Defense Mechanism in Dialyzed Patients

2015

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“…Denial of the disease can help some patients to cope and must also be taken into account as a potential factor for non-adherence [51]. It was against this background that a questionnaire survey of the acceptance of their disease was conducted in 100 hospitalized patients.…”

Section: Resultsmentioning

confidence: 99%

“…The emotional condition of patients has a significant influence on adherence and, in psoriasis patients, differs from that of healthy persons in that the wish of the former for social contact and self-assertion is less pronounced, and patients suffer to a significantly greater extent from anxiety, depression and worry. The influence of depression, anxiety, worry, resignation, denial of the disease and a low (disease-related) quality of life on adherence has been demonstrated in several studies [39,41,51,52,56,70]. In contrast, a positive attitude towards the drug prescribed and acceptance of the disease promote patient adherence to therapy [28,57].…”

Section: Discussionmentioning

confidence: 99%

Adherence in the Treatment of Psoriasis: A Systematic Review

Augustin¹,

Holland²,

et al. 2011

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Background: Medication adherence and compliance are essential for disease management and can significantly improve outcomes and quality of patient care. The literature suggests that up to 40% of patients do not use their medication as intended. Objective: To elucidate current knowledge on adherence/compliance in psoriasis. In particular, methods of adherence/compliance evaluation and influencing factors were to be identified. Methods: Systematic literature review based on a protocol-rooted search in online databases, followed by a structured critical appraisal and consecutive descriptive report. Results: Thirty-five original publications on adherence/compliance in psoriasis were identified, addressing the extent and quality of adherence/compliance in topical, systemic and UV treatments. Estimates of compliance varied considerably between 27 and 97%. Age, sex, psychosocial, disease-specific and treatment-specific factors were identified as predictors of adherence/compliance. Conclusion: A better understanding of the determinants of adherence can improve the outcomes of psoriasis treatment and lead to higher patient satisfaction and quality of care.

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“…Denial is a classic example of maladaptive strategy. 9 It has been shown that in hemo dialyzed patients the preferential use of certain strategies to cope with ESRD-related stress results in different body gain during the time between dialysis. 10 Coping with disease-related stress is a complicated, multi-step process.…”

mentioning

confidence: 99%

Psychological aspects of dialysis: does cognitive appraisal determine the overall outcome?

Laudański

Nowak²,

Wańkowicz³

2010

Polish Archives of Internal Medicine

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Psycho logical aspects of renal replacement therapy have been studied by numerous researchers. However, many of these studies are of poor quality, involve small study groups, or focus only on a narrowly defined hypothesis. Due to a lack of general conceptual framework, it is difficult to generalize and inter pret the data, especially in terms of the cause-and-effect relationship. Further research is required to assess how patients with end-stage renal disease cope with dialysis-related stress. Particular emphasis should be placed on the preparation of experimental studies and clinical trials with a longer follow-up.

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A role for denial in poor adherence to psoriasis treatment

Cited by 8 publications

References 12 publications

Denial Defense Mechanism in Dialyzed Patients

Denial Defense Mechanism in Dialyzed Patients

Adherence in the Treatment of Psoriasis: A Systematic Review

Psychological aspects of dialysis: does cognitive appraisal determine the overall outcome?

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