The effects of cultural background on patient-perceived impact of psoriatic arthritis - a qualitative study conducted in Brazil and France

Abstract

Background: In psoriatic arthritis (PsA) almost all qualitative studies have been performed in European populations. This work aimed to evaluate the impact of PsA in Brazilian and French subjects, as well as to explore cultural differences in the experience of disease and to recognize domains important for patients living with PsA outside Europe. Methods: A qualitative study was conducted in two university hospitals in Brazil and France; outpatients fulfilling Classification Criteria for PsA participated in individual interviews regarding the impact of PsA; interviews were conducted in the local language. The sample size was defined by saturation; interviews were recorded and transcribed and content analysis was performed. Results: Fifteen patients were interviewed in Brazil and 13 in France. Mean disease duration was 16.5 ± 12.5 years (range: 8 months to 47 years) and 14.4 ± 8.4 years (range 12 months to 29 years) for Brazilian and French subjects, respectively. A broad impact was perceived: 67 codes emerged from the interviews and were grouped in 41 categories. Although 2/3 of categories were common to both nationalities, some important health domains from the perspective of PsA patients from a non-European background were brought to light including sexual dysfunction, emotional impact of psoriasis and impact of prejudice on social and professional life. Conclusions: This study highlights the importance of assessing the impact of PsA on a national level, emphasizing the common cross-cultural aspects but also revealing domains of interest for patients with PsA living outside Europe which merit further study.

The Experiences of Functioning and Health of Patients With Primary Sjögren's Syndrome: A Multicenter Qualitative European Study

“…Among the concepts found, the majority (67%) were mentioned by the people with pSS in at least four of five countries, and nearly half of the concepts (44%) were common in all the five countries. A similar observation was made in a recent study in which people with PsA from two different countries had two thirds of categories in common ( 14 ). In our study, two thirds of concepts assigned to body functions and structures (67%) and nearly half of the concepts related to the activities and participation (52%) were mentioned in all the five countries, indicating the importance of those two domains.…”

“…had two thirds of categories in common (14). In our study, two thirds of concepts assigned to body functions and structures (67%) and nearly half of the concepts related to the activities and participation (52%) were mentioned in all the five countries, indicating the importance of those two domains.…”

“…This is majorly due to that the perception is built upon several mental sources that are implicit and specific to the individuals (13). A recent study in the psoriatic arthritis (PsA) highlighted the influence of cultural backgrounds on differences in the perception of illness (14). The illness perception is dependent on the disease activity, and negative views of the illness are linked to the worse future health outcomes (15)(16)(17) whereas positive beliefs are associated with the better health outcomes (18)(19)(20)(21).…”

Patient-Centered Care in Psoriatic Arthritis—A Perspective on Inflammation, Disease Activity, and Psychosocial Factors

“…PsA shares a different pattern of QoL impairment from other inflammatory arthritides [ 25 ]. Another factor adding to the complexity in disease manifestations and psychosocial impact are cross-cultural differences with regard to social and emotional impact [ 26 ] that emphasize a comprehensive biopsychosocial approach is needed.…”