The Lived Experiences of Females with Psoriasis: An Interpretative Phenomenological Analysis

Abstract

Background: Psoriasis is an immune-mediated, inflammatory skin ailment that affects the immune system of the body and multiple aspects of the lives of the affected patients. It is known to be recurrent in nature, resulting in a prolonged and intensified experience that adds to the burden of disease. Globally, it influences 2%-3% of the world's population. Psoriasis is commonly associated with adverse quality of life and disturbed perception of self, along with disrupted social relations. Individuals affected by this disease tend to go through several difficulties in life which may lead to psychological inflictions. Psoriasis is associated with several psychological symptoms which include feelings of guilt, shame, embarrassment or helplessness, poor self-esteem and low self-worth which can often lead to social isolation and a compromised quality of life. Objectives: Multiple studies have shown a consistent association between psoriasis and low quality of life, a negative perception of self, maladaptive coping patterns and difficulties in daily functioning. Although, numerous quantitative studies have confirmed a strong relationship between psoriasis and the aforementioned variables and many studies from the qualitative paradigm have shown similar patterns of these experiences to be fairly consistent, the focus on the in-depth qualitative exploration of the experiences of psoriasis is still deficient. To the author’s knowledge, no published qualitative study in Pakistan exists to examine the experience of psoriasis. The purpose of the study was hence to gain an insight into the lived experiences of females with psoriasis and to explore how the stated associations impact the lives of individuals in the context of Pakistan. Although there are a few pieces of research that have been published globally concerning psoriasis, there seems to be a scarcity of qualitative studies in this line of research. This study is an in-depth qualitative study in the social context of Pakistan regarding psoriasis. Therefore, the study aims to gain an in-depth 4 Lived Experiences of Females with Psoriasis: An IPA understanding of these experiences and to provide a detailed insight on the subjective experiences of women suffering from this condition, in the cultural context of Pakistan. Method: A semi-structured interview guide was designed and used to extensively engage with participants to gain rich data regarding their experiences. Six females aged 18-60 years, who had been diagnosed with psoriasis since at least a duration of one year were interviewed. The sample comprised of women who were in-patients at the Fauji Foundation Hospital in Rawalpindi. Purposive sampling was used for a homogenous sample of women for whom the area of research; Psoriasis, was meaningful. Narratives were analyzed using Interpretative Phenomenological Analysis (IPA). Results: Three superordinate themes emerged: self as defected, existential pain and coping with psoriasis. These constituted of sub-themes, perception of self as toxic, shame and self derogation, meaning in life, sin and faith, fear of dependency, experiential avoidance and carrying distress that have been discussed in detail. A detailed description and interpretation of the main themes and the subsequent sub-themes have been presented. The findings provide support to the global literature on psoriasis through a culturally contextualized study, it also provides with a deeper understanding of the experiences of the individuals with the condition of psoriasis. Conclusion: Findings from the current study have been discussed in light of the existing literature. Highlighting the subjective experiences of females with psoriasis, the study provides culturally and globally relevant contributions to the existing body of knowledge. This attempts to bridge the gap between the findings of researches to allow integrationof the findings to clinical practice, to enhance treatment facilities and treatment effectiveness for patients experiencing psoriasis.