Experiences and Perceptions of People with Chronic Skin Disease: A Qualitative Study

Abstract

Aims: Skin diseases are a common reason for consulting the general practitioner (GP). Few studies have been conducted that explore the topic of chronic skin disease from the patient's perspective. The aim of this paper was to investigate experiences and perceptions of people with chronic skin diseases and their respective pathways into the health care system. Study Design: Qualitative study Place and Duration of Study: GP practices and patients’ homes; between July 2011 and August 2012. Methodology: Interviews (20-30min) with 16 patients using a semi-structured guideline were conducted. Patients were identified by their respective GP. Adult patients suffering from a chronic skin disease were included. Interviews were taped and transcribed verbatim. Qualitative analysis was conducted by two independent raters. Results: There was a broad variety of pathways into the healthcare system with about half the respondents at first contacting lay people like family members or neighbours. Nearly all participants reported an adverse effect on private, social or work life. Some of our respondents felt stigmatized. Most respondents applied a range of self-management strategies, mainly in the form of different dietary habits; many patients had also made use of complementary therapies. There were different patient expectations concerning GPs and dermatologists respectively. Conclusion: Patients with chronic skin disease show a complex health seeking behaviour which can lead to delays in accessing the official health care system. There is a considerable impact on the quality of life. Further research should address how German GPs perceive the treatment of patients with chronic skin disease and how cooperation with dermatologists can be improved.