Psoriasis is a common and easily recurring chronic inflammatory skin disease with a prevalence rate of about 0. 123% in China, mostly in young adults, which has a great impact on the physical health and mental health of patients and reduces their quality of life. In recent years, more studies on the relationship between mental tension, psychological factors and psoriasis have been reported at home and abroad, and it is believed that psoriasis is the result of the combined effect of genetic, psychological and environmental factors, which is a typical psychosomatic disease. At present, the efficacy of clinical single drug treatment is limited, the prevention and treatment of psoriasis with modern medical model is increasingly recognized, and health education is an important means to prevent and treat psoriasis.
The psychological pain of psoriasis patients is often greater than the symptoms of their skin lesions. Many patients, after being diagnosed with psoriasis by doctors, are under great psychological pressure and are influenced by traditional concepts and public opinion, believing that they are suffering from an incurable disease and are emotionally depressed and suppressed, which is not only detrimental to the remission and recovery of the disease, but can also aggravate the disease and make the treatment resistant.
The current psoriasis medical market is very confusing, and the advertisements for the treatment of psoriasis in various media and even in the streets and alleys are all over the place and abound, and some “wandering doctors”, who are not even dermatologists at all, are driven by economic interests and call themselves “experts” and “specializing in the treatment of psoriasis”. They are driven by economic interests, claim to be “experts” and “specialize in treating psoriasis”, cheat patients and make huge profits, causing a lot of physical and mental injuries of medical origin and a huge economic burden to patients. Many psoriasis patients and their families are poor in knowledge about psoriasis, blindly pursue the root cure, gullibly believe in some advertising propaganda and throw themselves at doctors indiscriminately, and the phenomenon of aggravating the disease and even causing serious consequences by mis-treatment and drug abuse is quite serious.
A survey conducted by the Institute of Dermatology of the Chinese Academy of Medical Sciences shows that 58.6% of the 320 psoriasis patients do not know about psoriasis, 8.6% consult doctors about the knowledge, 89% do not read the scientific knowledge of psoriasis, 24% believe that it can be cured, 72.6% believe in various advertisements and have received treatment from individual doctors. The percentage of those who have received treatment from individual doctors is 65.7%. Therefore, the prevention and control of psoriasis must strengthen the popular education of psoriasis-related knowledge, and regular medical treatment and good health education can make the condition improve or even cure.
Content of health education
(1) Awareness of the disease
When patients visit the doctor, the receiving doctor should explain in detail the knowledge of psoriasis to the patients according to their conditions and acceptability, such as the current epidemiological situation, pathogenic factors, pathogenesis, impact on the body, treatment purpose and status, problems and precautions in current treatment, so that the patients can correctly understand the occurrence of the disease and establish confidence in overcoming the disease. Make it clear to patients and family members that the disease is not contagious and does not require isolation from relatives. For patients who need to be hospitalized, after admission, the nurse in charge should provide health education and psychological care according to the condition of the patient, so as to relieve the patient’s worries and build up confidence in the cure, so that the patient can actively cooperate with the treatment and promote the patient’s recovery.
(2) Psychological guidance
Since psoriasis has a long course, is prone to recurrence and occurs on the surface of the body, which hinders the beauty, many patients are under great psychological pressure and heavy mental burden. Some patients mistakenly think that psoriasis is an incurable disease, and some people mistakenly believe that the disease is contagious and discriminate against patients. Therefore, the psychological pain of patients is often greater than the symptoms of their skin lesions. A survey shows that psoriasis patients have multiple psychological disorders, and the degree of their psychological disorders is closely related to the generalization and progress of their skin lesions. In view of some negative psychology of psoriasis patients, medical and nursing staff should try to communicate with patients more often, understand and analyze their psychology in detail, and adopt enlightenment and consolation, distraction and psychological talk, suggestion method and other methods to tell patients that excessive mental load can both provoke the onset of psoriasis in patients with a genetic basis and aggravate the disease. Give patients correct psychological guidance and spiritual encouragement, so that they can adjust their mental state and accept treatment with a good attitude, thus promoting early recovery.
(3) Treatment guidance
Tell the patient not to believe in the propaganda of “cure for all” and not to seek medical advice in a hurry, but to go to the dermatology department of a regular hospital for reasonable treatment under the guidance of a doctor. Tell patients not to abuse drugs with high side effects and high recurrence rates, such as corticosteroids, anti-cancer drugs and immunosuppressants. In particular, they should not be used for common psoriasis, as their potential harm is greater than the condition itself. In the acute stage, avoid the external use of irritating drugs to avoid triggering heavy psoriasis. Avoid hot water and soap baths, scratching or mechanical stimulation to prevent aggravation of lesions and itchiness.
Tell patients to pay attention to avoiding the application of some drugs that may induce or aggravate psoriasis, such as corticosteroids, tidingsan, tetracycline, lithium, antimalarials, ampicillin, anti-inflammatory pain, pau taison, acetylsalicylic acid, interferon, etc.
According to the patient’s economic situation, choose inexpensive and good treatment plan for the patient, instruct the patient how to take the medication, understand the possible side effects of the medication, and explain that there should be a longer consolidation treatment period after the recovery of the disease.
(4) Dietary guidance
Instruct patients to have a reasonable diet, to consume the right amount of water, protein, vitamins and trace elements, etc. Eat less beef and mutton because of their high arachidonic acid content. Spicy food should be avoided, because spicy food can stimulate the body, make the skin blood vessels dilate and congestion, and induce or aggravate psoriasis. Psoriasis is a chronic recurrent disease, patients can pay attention to the food that may cause the attack or aggravation of the disease in daily life, and should try to avoid the suspicious food. Pay attention to scientific diet and avoid too strict taboos to avoid causing serious malnutrition.
Avoid smoking and alcoholism. Smoking and alcoholism play a role in triggering and aggravating psoriasis. Studies have found that the number of psoriasis patients who smoke and drink alcohol is significantly related to the severity of the disease, and the greater the number of smoking and drinking, the more serious the onset. Alcohol consumption can also hinder the efficacy of psoriasis, as alcohol may affect the absorption or metabolism of some drugs. Therefore, psoriasis patients should be advised to avoid smoking and quit drinking, or at least to drink less and not to drink more.
(5) Guidance on rest and activities
Instruct patients to pay attention to the combination of work and rest and not to overexert themselves. Keep the living room environment neat, dry and warm, and avoid humidity. Encourage patients to do appropriate physical exercise to enhance physical fitness, pay attention to cold and warmth, timely increase and decrease clothing, and prevent colds, because 6-20% of patients’ morbidity or aggravation is closely related to colds. Some doctors in China have adopted the method of “exercise and sweating”, allowing winter-type patients to exercise for half an hour every day since the end of autumn to make their bodies sweat slightly, which has the effect of preventing recurrence and aggravation. Pay attention to self-protection in daily work and life, and try to avoid trauma to prevent recurrence or isomorphic reactions caused by trauma. Encourage patients to actively participate in cultural, sports and social activities to shorten the distance between them and others, cultivate optimism, form good psychological qualities and improve psychological tolerance to the disease and other difficulties.
(6) Discharge guidance
Seriously ill patients, after basic recovery from inpatient treatment, can be discharged home to continue treatment. When patients are discharged from the hospital, they should be told to take medication strictly in accordance with medical prescriptions to consolidate the therapeutic effect, and to follow up regularly so as to observe their condition, adjust treatment and provide psychological guidance in a timely manner.
Medical and nursing staff should fully realize that health education guidance for patients in clinical work is an indispensable part of our duties, especially dermatologists in outpatient clinics should actively do a good job in health education guidance when receiving psoriasis patients. By implementing health education for patients with psoriasis, patients can voluntarily adopt health-friendly behaviors, change poor lifestyles, reduce morbidity, prolong remission periods, reduce complications, avoid aggravation and transformation, and improve their quality of life.