Identifying key components for a psychological intervention for people with vitiligo: a quantitative and qualitative study in the United Kingdom using web-based questionnaires of people with vitiligo and healthcare professionals

Ahmed, A.; Steed, L.; Burden-Teh, E.; Shah, R.; Sanyal, S.; Tour, S.; Dowey, S.; Whitton, M.; Batchelor, J.M.; Bewley, A.P.

Abstract

Background: Psychological interventions are recommended as part of routine management of vitiligo. However, the development and effectiveness of such interventions have been rarely addressed. This study aimed to identify key components for a psychological intervention for people with vitiligo. This is the first time perspectives of people with vitiligo, and healthcare professionals (HCPs) have been directly explored to inform intervention content and delivery.
Objectives: To identify: 1. which psychological difficulties are highlighted that can be targeted by an intervention; 2. what is important in terms of intervention content and delivery.
Methods Web-based questionnaires containing both quantitative and qualitative items were completed by people with vitiligo and HCPs. Questionnaires collected data from people with vitiligo on demographics, clinical features, psychological difficulties and priority areas for psychological interventions, including ideas on delivery and content. HCPs questionnaires collected data on psychological difficulties reported, use of psychological interventions and suitability within health services. Quantitative data were analysed using descriptive statistics, and qualitative data utilized thematic framework analysis.
Results: A total of 100 people with vitiligo (66% female, 92% Caucasian) and 39 HCPs (54% dermatologists) participated. Key areas of difficulty were the impact of vitiligo, coping, issues with appearance/body image and the sun, and medical interactions. Vitiligo on sensitive sites was associated with more psychological impact. Interventions directed at increasing acceptance, confidence and self-esteem, as well as managing embarrassment, were important. These issues could be managed through interventions such as cognitive behavioural therapy, mindfulness and acceptance and commitment therapy. Both people with vitiligo and HCPs favoured individual interventions.
Conclusion: Vitiligo has significant impact, requiring ongoing psychosocial support. There is a strong need for a psychoeducational intervention with focus on acceptance and managing social impact. The results of this study are the first steps to informing the development of a patient-centred psychological intervention.

Citation

Ahmed, A., Steed, L., Burden-Teh, E., Shah, R., Sanyal, S., Tour, S., Dowey, S., Whitton, M., Batchelor, J., & Bewley, A. (2018). Identifying key components for a psychological intervention for people with vitiligo: a quantitative and qualitative study in the United Kingdom using web-based questionnaires of people with vitiligo and healthcare professionals. Journal of the European Academy of Dermatology and Venereology, 32(12), 2275-2283. https://doi.org/10.1111/jdv.15168

• Journal Article Type: Article
• Acceptance Date: Jun 21, 2018
• Online Publication Date: Jul 4, 2018
• Publication Date: Aug 13, 2018
• Deposit Date: Sep 10, 2018
• Publicly Available Date: Jul 5, 2019
• Journal: Journal of the European Academy of Dermatology and Venereology
• Print ISSN: 0926-9959
• Electronic ISSN: 1468-3083
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 12
• Pages: 2275-2283
• DOI: https://doi.org/10.1111/jdv.15168
• Keywords: Infectious Diseases; Dermatology
• Public URL: https://nottingham-repository.worktribe.com/output/1067713
• Publisher URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/jdv.15168
• Additional Information: This is the peer reviewed version of the article, which has been published in final form a https://onlinelibrary.wiley.com/doi/abs/10.1111/jdv.15168 . This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions
• Contract Date: Sep 10, 2018