Positive Changes in Self-management and Disease Severity Following Climate Therapy in People with Psoriasis

Abstract

The aim of this study was to investigate the impact of climate therapy on self-management in people with psoriasis. This was a prospective study of 254 adults with chronic psoriasis who participated in a 3-week climate therapy (CT) programme. The 8-scale Health Education Impact Questionnaire (heiQ) was completed at baseline, after 3 weeks of CT, and 3 months later. Change was assessed using paired sample t-tests mean (95% confidence interval) change scores (range 1-4). All heiQ scales showed statistically significant improvement after 3 weeks of CT. The greatest improvement was in Health-directed activity, followed by Emotional distress, and Skill and technique acquisition. At the 3-month follow-up, only the Emotional distress scale remained improved. In addition, disease severity (self-administered PASI; SAPASI) improved significantly from before CT to 3 weeks and 3 months after CT. This study suggests that CT provides a range of benefits that are important to people with psoriasis, particularly in the short term. A challenge is how to achieve long-term benefits.

Making robust decisions about the impact of health education programs: Psychometric evaluation of the Health Education Impact Questionnaire (heiQ) in diverse patient groups in Norway

“…The final instrument has eight scales, which have been translated and culturally adapted into over 20 languages, and are currently being applied in clinical trials worldwide, including in Norway [12][13][14][15]. However, only a few studies have reported the psychometric performance of the heiQ in the diverse settings, in which it is being applied [16][17][18][19][20][21][22].…”

“…This builds up the nomothetic web around the questionnaire and self-management across settings, and should give researchers, program implementers and policymakers the confidence that the heiQ will deliver reliable information on program outcomes and will support quality improvement activities. The heiQ has revealed effects in studies with different health care programs [e.g 14,15], and this is likely due to the scales being sensitive to meaningful and relevant outcomes for people participating in self-management programs. …”

Empowering Heliotherapy Improves Clinical Outcome and Quality of Life of Psoriasis and Atopic Dermatitis Patients

“…In our past study HT was regarded cost-effective for the high indirect costs only for patients with severe psoriasis (29). Similar to the Norwegian study (25) we were unable to confirm longterm improvement of QoL in PS patients (25).…”

“…New courses run by the patient organisations focus more on empowerment than clearance of the disease. Wahl et al (25) studied the effect of climate therapy on self-management in PS patients, and our study focused also on AD patients showing that both PS and AD were statistically significantly improved (25). In our past study HT was regarded cost-effective for the high indirect costs only for patients with severe psoriasis (29).…”

“…It is important to use more than one measure in parallel to increase reliability. An interesting measure, which we unfortunately were not aware of earlier, is the Health Education Impact Questionnaire (25). This was used in a recently published study of Wahl et al (25), however also in this study the educational impact of empowering HT was a challenge (25).…”