| Objective1. Translated and revised the questionnaire about the stigma of psoriasis experience (Feeling of stigmatization of psoriasis FSQ), to form a set of suitable measurement tool for to psoriasis patients in China.2. From the characteristics of Social demography, illness and other aspects of psoriasis patients, explore the major factors affecting the stigma of patients3. Provide a theoretical basis for clinical practice on patients with psoriasis, by studying the biological, psychological and sociological factors on the life quality of patients and their related mechanism.Method1.By scale translation process, translate the Feeling of stigmatization of psoriasis (FSQ) into Chinese version. From October to December, 2008,185 psoriasis patients from three hospitals in Changsha and Changde City were sampled and asked to fill in the Chinese version of FSQ. Integrating research methods including principal component analysis and Cattell Scree tests, revised Chinese version of the FSQ, and formulated Chinese scale of FSQ.2.With random sampling, a total of 144 inpatients with psoriasis from 3 hospitals in Changsha and Changde were surveyed and assessed in disease severity from January to October in 2009. Survey information consists of general situation, prevalence, social support, medical response, psychological measurement and quality of life.Measurement tools involved includes social support scale, Medical Coping Scale, FSQ Chinese revision, Dermatology Life Quality Questionnaire.Assessment of disease severity was completed by a doctor through calculating PASI score. And Chinese revision of the FSQ scales was evaluated focus on reliability and validity.3.Filtering the factors of psoriasis patients including stigma, medical response, social support and life quality by the research of single factor and multiple linear regression analysis. Finally, explore the influnce on patients'life brought by these factors, and built up a structural equation model (SEM) making use of professional equation analysis software Amos 18, and carried out the path analysis on relationships among these factors.Results1. Through Chinese localization and preliminary factor analysis, identify four dimensions contains 27 entries in FSQ Chinese revision of scale.2. Reliability test:(1) test-retest reliability:the test-retest reliabilities of all subscales and main scale changes between 0.747～0.890. (2) split-half reliability:two sub-scale scores Banzai split-half reliability (corrected by Spearman-Brown formula) coefficient of 0.66. (3) Cronbach's a factor:all subscales and total scale achieve a coefficient between 0.73 to 0.90. (4) subscale consistency:the correlation coefficient between each entry and subscales varies between 0.550～0.852; that of all subscales is from 0.027 to 0.254; the correlation coefficients between sub-scales and total scale moves between 0.385 and 0.853.3. Validity:(1) content validity:the correlation coefficient between the revised Scale and source Scale is 0.984, the correlation coefficients between all dimensions of revised scale and the corresponding dimension of the source scale change from 0.843 to 1. (2) construct validity:the results of confirmatory factor analysis showed that the stigma of the four-factor model= 12.21, df= 3, the parameters of GFI, NFI, RFI, IFI, CFI confirms the good fitness.4. Stigma in psoriasis patients scores 89.44±16.08 points on average, and multiple linear regression analysis showed that lesions bleeding, itching, rejected experience, exposure and other skin lesions are compiled into the regression equation, R2= 0.386.5. Social support to psoriasis patients score 39.09±10.19 in overall average, the difference with norm makes no sense in statistics. Multiple linear regression analysis showed that the factors impacting social support in patients with psoriasis are:skin lesions, payment methods, family history, complications, disease severity, and bleeding, R2= 0.489.6. Multiple linear regression analysis showed that the factors related to psoriasis patients's "evasive" response are:skin lesions, age, family history, course of disease, occupation, R2= 0.404. The factors affecting people's "surrender" are:Denied experience, lesions exposure, occupation, degree of itching, bleeding, R2=0.414. Affect the patients "face" response factors:gender, education level, job status, income, family history, itching degree course, R2= 0.492.7. The life quality of psoriasis patients scores an average of 11.90±5.79, multiple linear regression analysis showed that the factors affecting the quality of life of patients with psoriasis are:age, education level, income, employment status, disease severity, bleeding, itching degree of exposure to skin lesions, joint damage, rejected experience, complications, R2= 0.696.8.Pearson correlation analysis indicated that the stigma of psoriasis patients correspond to medical response, social support and quality of life, their correlation coefficients moves between 0.27 and-0.62. The quality of life of patients is affected by disease severity, medical response, social support and stigma. Their correlation coefficients changes from 0.23 to-0.67.9. According to the results of SEM analysis, disease severity has a direct (positive) impact (β= 0.192, P<0.01) on quality of life, and affected quality of life indirectly by stigma and social support. Medical treatment method can affected quality of life indirectly through the stigma or social support; Stigma (β=-0.642, P<0.01) and social support (β=-0.311, P <0.01) have a direct effect on quality of life. As mediating variables (mediated variable), stigma and social support regulate the relationship between degree of seriousness and quality of life.conclution1 The revised Chinese FSQ scale has good reliability and validity.2. The factors affecting stigma of patients with psoriasis include age, education level, work status, bleeding and itching, the exposed skin lesions and the experience of being rejected.3. Psoriatic patients "face", "evasive" and "surrender" in responding manners were higher than the norm.4. The risk factors decline in the life quality of patients with psoriasis are Young and old age, low educational level, no job, low income, serious illness, bleeding skin lesions, itching, lesions exposure, onset age more than 45 years of age, disease complications, the experience of being rejected.5. The degree of seriousness, stigma, social support, medical treatment methods impose direct and/or indirect effects on the quality of life. 6. As mediators, Stigma and social support can regulate the relationship between disease severity and quality of life. |
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