DISEASE COPING ISSUES IN PATIENTS WITH CHRONIC ALLERGIC SKIN DISEASES
Objective: to analyze the way of a disease coping by adult patients with chronic allergic skin disease at new relapse start.
Materials and methods. 123 patients with Atopic dermatitis (AD) divided in two groups depending on age of the disease onset, 62 patients with Chronic true eczema (CTE) and 74 patients with Chronic infectious eczema (CIE) were examined. At first examination for current relapse of the disease precise medical history of the patients and clinical symptoms were registered, the disease severity evaluated with SCORAD index and itch severity scale. Disease coping issues and potential ability to cooperate with medical staff were investigated with “TOBOL” testing tool. Results were analyzed using parametric and nonparametric statistical tools.
Results. Disease coping types were different in examined research groups at the disease relapse start. Pure coping type that includes only one coping subtype was observed in part of each research group. Frequency of pure and combined disease copings was similar in CIE patient and AD patients with early age disease start.
Adaptive disease coping type is the most desirable for effective cooperation between a patient and medical staff. Adaptive coping subtypes were registered for all research patients as an example of pure adaptive type or in combinations with maladaptive ones. Harmonic and ergopathic (realistic) disease coping were observed in all research patients’ groups. The highest frequency of harmonic was observed for CIE patients and lowest for AD patients with start in adulty. The highest frequency of ergopathic coping was in AD patients with start in adulty. Anosognostic (euphoric) was registered in eczema patients only.
Maladaptive coping types are usually associated with impaired cooperation between a patient and medical staff due to changes in emotional-effective sphere. Depression, anxiety, “escape to disease’, refusal to fight with a disease are frequent issues. Different subtypes of maladaptive coping vary in the way they impact patient’s compliance. Anxious disease coping was more common for AD patients with start in adulty, neurasthenic one for CTE patient, melancholic one was observed for all research groups with similar frequency, hypochondriacal coping was less common for CIE patients, apathetic one was not common for adult type AD and CIE patients.
Conclusions. Disease coping by a patient may significantly impair patient’s compliance, objectiveness of a medical staff, effectiveness of examination and treatment. Chronic course of skin disease, age of the disease onset may influence the way of this coping. Due to that it should be taken in account while examination and treatment to provide better patient’s compliance and disease management results. Pure type of disease coping is not the commonest situation at chronic allergic skin diseases and was observed in less than 40% of research groups. Adaptive disease coping by a patient is a good situation for medical staff and hopefully was registered often in researched groups. Realistic coping as the best prognosis for patient’s compliance we dominantly observe in CIE and CTE patients with the lowest rate in AD patients with start at adulty. Maladaptive coping was often observed not as a pure type but in combination with at least one adaptive subtype.
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