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DLQI SCORE IN VITILIGO PATIENTS    IN RE-MEDIKA HOSPITAL      Cross-sectional study       M.Sc. Natasa Teovska Mitrevska MD
Macedonia –REMEDIKA general hospital     Department of dermatology
VitiligoVitiligo is a common acquired, idiopathic and often familiar depigmentation disorder that affects both            ...
Patients often experience stigmatization, includingcuriosity, by other people, rejection and discrimination at work, low s...
Doctor/patients relationshipAdditionally, many healthcare professionals still  regard vitiligo as a harmless cosmetic skin...
Quality of life-QL                          DefinitionQuality of Life as individuals perception of their  position in life...
Quality of life at dermatology                             patients•   Dermatology-specific Quality of Life instruments•  ...
DLQI Dermatology Life             Quality IndexDLQI Dermatology Life Quality Index• First• The most used questionnaire• Si...
DLQI                (Dermatology Life Quality Index)• It is a simple 10-question validated questionnaire  which has been u...
DLQi scores for vitiligo patients             -review the literature worldwide-Porter et al. studied the effect of vitilig...
DLQi scores for vitiligo patients                -review the literature worldwideSampogna, Patients older than 40 years ol...
DLQi scores for vitiligo patients                    -review the literature worldwidePapadopoulos et All.have shown that p...
Motivation
Motivation•   Knowledge: What is the knowledge of health    information regarding his/her dermatology    illness.•   Attit...
Aim of the study• To determine score od DLQI in patients with  vitiligo in ReMedika general hospital, Skopje,  R.Macedonia...
Materials and Methods• Study design: prospective research-(cross  section) study for every new patient with vitiligo  atte...
DLQI questionnaire                       (Cardiff Universitys )1.   Questions about basic demographics characters2.   Symp...
DLQI questionnaire                      (Cardiff Universitys )• The DLQI is calculated by summing the score of  each quest...
Materials and MethodsThere were no restrictions on patient selection with          regard to extension of lesions.The pati...
Selection of patients             Criteria for participationAll the patients who are coming in dermatology                ...
Statistical analysesResponses on the DLQI will be scored according to         the guidelines of Finlay and Khan.   All sta...
Bias in Research Study• Selection bias  -Only patients from Re-Medika hospital  dermatology department is involved in this...
Results
Results                  From May –October 2011• Age of patients25 - 85 (middle age 53). Most of them (49, 49%)  were 45-6...
Demographics characteristics of patientsParameters                        Number         %Gender                          ...
Distribution of patients regarding                           the age16               1514                       12        ...
Comparison of mean DLQI scores                 and demographic variablesSex                    Mean DLQIMale              ...
Comparison of mean DLQI scores                   and demographic variablesEducational level               DLQIIlliterate  ...
As a conclusionThe chronic nature of disease, long termtreatment, lack of uniform effective therapy andunpredictable progn...
DLQI score in vitiligo patientsQuestions   Parameters                     Mean DLQI1.          Symptoms                   ...
Why is important in Macedonia?• Pilot project first one in Macedonia• At the end of this study we will give the answer of ...
Conclusions Our study quantifies the burden on the quality of life   caused by vitiligo and indicates specific areas ofpat...
Suggestions activitiesHolistic approaching is not only treatment of illness  of the patients but it is treatment of a pati...
ConclusionWith more effective treatment options and a closer patient/ physician relationship, patients can improve their q...
Conclusion• Doctor must give the right and adequate  information and education regarding the condition  of the patient• On...
Greetings from Macedonia
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DLQI SCORE IN VITILIGO PATIENTS IN RE-MEDIKA HOSPITAL Cross-sectional study - Dr.Teovska

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Vitiligo is a common acquired, idiopathic and often familiar depigmentation disorder that affects both sexes equally worldwide.
Although not painful or life-threatening, this disfiguring disorder can have a devastating effect on a patient’s psychosocial wellbeing and social life

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DLQI SCORE IN VITILIGO PATIENTS IN RE-MEDIKA HOSPITAL Cross-sectional study - Dr.Teovska

  1. 1. DLQI SCORE IN VITILIGO PATIENTS IN RE-MEDIKA HOSPITAL Cross-sectional study M.Sc. Natasa Teovska Mitrevska MD
  2. 2. Macedonia –REMEDIKA general hospital Department of dermatology
  3. 3. VitiligoVitiligo is a common acquired, idiopathic and often familiar depigmentation disorder that affects both sexes equally worldwide. Although not painful or life-threatening, thisdisfiguring disorder can have a devastating effect on a patient‟s psychosocial wellbeing and social life
  4. 4. Patients often experience stigmatization, includingcuriosity, by other people, rejection and discrimination at work, low self-esteem, embarrassment, impaired quality of life and a higher prevalence of sexual difficulties, especially in women . Stigmatization is the most influential factor in the variance of Dermatology Life Quality Index (DLQI) measurements.
  5. 5. Doctor/patients relationshipAdditionally, many healthcare professionals still regard vitiligo as a harmless cosmetic skin problem, truly underestimating the importance of treating these patients.The emotional aspect of diseases vitiligo is gravely underestimated because clinicians fail to include the psychological and sociological components that are so closely tied to this disease
  6. 6. Quality of life-QL DefinitionQuality of Life as individuals perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.It is a broad ranging concept affected in a complex way by the persons physical health, psychological state, level of independence, social relationships, personal beliefs and their relationship to salient features of their environment.
  7. 7. Quality of life at dermatology patients• Dermatology-specific Quality of Life instruments• Skindex• DLQI• Dermatology Quality of Life Scales• Chronic Skin Disease on Daily Life).
  8. 8. DLQI Dermatology Life Quality IndexDLQI Dermatology Life Quality Index• First• The most used questionnaire• Simple questionnaire self administrated who used to measure the health-related quality of life of adult patients suffering from a skin disease.
  9. 9. DLQI (Dermatology Life Quality Index)• It is a simple 10-question validated questionnaire which has been used in 33 different skin conditions in 32 countries and is available in 55 languages.• Its use has been described in over 500 publications including 30 multinational studies.
  10. 10. DLQi scores for vitiligo patients -review the literature worldwide-Porter et al. studied the effect of vitiligo on sexual relationships and found that embarrassment during sexual relationships was especially frequent for men with vitiligo-Salzer and Schallreuter reported that 75% found their disfigurement moderately or severely intolerable-Weiss et al compared the difficulties faced by patients with vitiligo with those with leprosy in India-Al-Abadie et al. indicated that psychological stress increases levels of neuroendocrine hormones, affects the immune system and alters the level of neuropeptides, which may be the initial steps in pathogenesis of vitiligo
  11. 11. DLQi scores for vitiligo patients -review the literature worldwideSampogna, Patients older than 40 years old, have lowerQoL. Patients with vitiligo reported a higher prevalenceof both alexithymia (a state of deficiency inunderstanding, processing, or describing emotions) anddepression or anxiety than the general population.In white populations, the prevalences of depression andalexithymia are both estimated as approximately 10%,while in this study the prevalence was 39%, and ofpatients with alexithymia 24%
  12. 12. DLQi scores for vitiligo patients -review the literature worldwidePapadopoulos et All.have shown that psychological counseling not only helps to improve body image, self-esteem and quality of life of patients with vitiligo, but also provides better control of disease.Ongenae K, Quality of life in female patients has shown to be more impaired than men and was equal to the impairment caused by psoriasis.
  13. 13. Motivation
  14. 14. Motivation• Knowledge: What is the knowledge of health information regarding his/her dermatology illness.• Attitude: What is the attitude of the patient regarding his dermatology condition?• Behaviors: What exactly the patient is doing regarding his dermatology condition?• Group behaviors: What is the group behavior in accepting of patient with dermatology illness?• Behavior of health system: What the health system is doing to change to change this
  15. 15. Aim of the study• To determine score od DLQI in patients with vitiligo in ReMedika general hospital, Skopje, R.Macedonia.• To determine the dominate factors that affects on quality of life• From the conclusion of this study to get the informations in order to start with interventions for improving and strength the quality of life in patients with vitiligo
  16. 16. Materials and Methods• Study design: prospective research-(cross section) study for every new patient with vitiligo attending the clinic. Using a standard “forward- backward” translation procedure, the English language version of the questionnaire was translated into Macedonian.• Place of study: Dermatology department, ReMedika general hospital. Skopje, Macedonia
  17. 17. DLQI questionnaire (Cardiff Universitys )1. Questions about basic demographics characters2. Symptoms and feelings (questions 1 and 2),3. Daily activities (questions 3 and 4),4. Leisure (questions 5 and 6),5. Personal relationships (questions 8 and 9)6. Work and school (question 7),7. and treatment (question10) .
  18. 18. DLQI questionnaire (Cardiff Universitys )• The DLQI is calculated by summing the score of each question resulting in a maximum of 30 and a minimum of 0.• The higher the score, the more quality of life is impaired.• The DLQI can also be expressed as a percentage of the maximum possible score of 30.
  19. 19. Materials and MethodsThere were no restrictions on patient selection with regard to extension of lesions.The patients were introduced to the subject of this study and informed about the personal nature of the questionnaire, and all those who gave consent were given the DLQI questionnaire to complete.
  20. 20. Selection of patients Criteria for participationAll the patients who are coming in dermatology department Criteria for elimination Children, babies. Patients with other dermatology condition. Defined time May-2011 to May 2012
  21. 21. Statistical analysesResponses on the DLQI will be scored according to the guidelines of Finlay and Khan. All statistical analyses is carried out using theStatistical Package for the Social Sciences (SPSS 11.0 for Windows).To test the reliability, the internal consistency of the questionnaire will be assessed by Cronbachs αcoefficient and α equal to or greater than 0.70 was considered satisfactory.
  22. 22. Bias in Research Study• Selection bias -Only patients from Re-Medika hospital dermatology department is involved in this study• Bias from nonresponse -refusing from patients• Reporting bias-lack of information regarding their condition
  23. 23. Results
  24. 24. Results From May –October 2011• Age of patients25 - 85 (middle age 53). Most of them (49, 49%) were 45-65 years old. Place of living:½ of the patients (53, 53%) are from Skopje.
  25. 25. Demographics characteristics of patientsParameters Number %Gender 50 % Male 16 32% Female 34 68%Age 25-34 11 22% 35-44 2 4% 45-54 15 30% 55-64 12 24% 65-74 10 20% Над 75 1 2%Place of livingSkopje 35 70,00%Out side Skopje 15 30,00%
  26. 26. Distribution of patients regarding the age16 1514 12 25-3412 11 10 35-4410 45-54 8 55-64 6 65-74 4 2 Над 75 2 1 0
  27. 27. Comparison of mean DLQI scores and demographic variablesSex Mean DLQIMale 7,50Female 9,53Marital statusSingle 8,23Maried 7,25Place of livingSkopje 9,25Out side from Skopje 7,38
  28. 28. Comparison of mean DLQI scores and demographic variablesEducational level DLQIIlliterate 8,00Under graduate 8,20Graduate 8,38Bachelor degree 9,56Doctorate 7,00Visibility of lesionExposed 9,45Unexposed 8,23
  29. 29. As a conclusionThe chronic nature of disease, long termtreatment, lack of uniform effective therapy andunpredictable prognosis of disease/therapy makethe patients suffer more from the disease.
  30. 30. DLQI score in vitiligo patientsQuestions Parameters Mean DLQI1. Symptoms 1,162 Feelings 2,223 Daily activities 1,564 Kind of clothes 2,225 Social or leisure activities 2,166 Physical exercise 2,117 Educational activities 2,028 Interpersonal relationships 2,889 Sexual activities 1,0610 Treatment 1,86
  31. 31. Why is important in Macedonia?• Pilot project first one in Macedonia• At the end of this study we will give the answer of influence of demographics characteristics of patients in Macedonia regarding the quality of life Review from literature is showing that DLQI not only can measure the quality of life but can also be used as a instrument of measuring the quality of doctors working.
  32. 32. Conclusions Our study quantifies the burden on the quality of life caused by vitiligo and indicates specific areas ofpatients lives which are most affected by the disease.. These results should awake the interest of physicians in this „cosmetic‟ disease, sinceappropriate treatment is likely to improve the quality of life of vitiligo patients.
  33. 33. Suggestions activitiesHolistic approaching is not only treatment of illness of the patients but it is treatment of a patient as human been and not only threatening illness.So thinking about the DLQI at patient with dermatology illness is thinking about the factors who determinate the quality of life which are individual and changeable.DLQI can help in identifying the dominant needs and searching of the patients the solution for those..
  34. 34. ConclusionWith more effective treatment options and a closer patient/ physician relationship, patients can improve their quality of life and overall well-being.Before beginning on a specific treatment course, both patient and healthcare provider should be aware of patients current QoL and monitor it closely throughout the course of a treatment regimen.
  35. 35. Conclusion• Doctor must give the right and adequate information and education regarding the condition of the patient• On this way educated patient will have more control of his disease and he will accept emotional more his condition.• So with this DLQI will became a part of every clinical examinations of the patients, and with this we will increase the relationships between doctors and patient.
  36. 36. Greetings from Macedonia

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