title: Chronic pruritus--more than a symptom: a qualitative investigation into patients' subjective illness perceptions.
abstract: OBJECTIVE
  This article is a report of a study exploring the subjective illness perceptions of patients with chronic pruritus (>6 weeks).
  
  
  BACKGROUND
  Pruritus is a common symptom of dermatological as well as other conditions. This pervasive symptom has a substantial impact on quality of life. Little is known about how patients with chronic pruritus construct the symptom, what causes they ascribe, consequences they endure, how they control the symptom and experience the healthcare system.
  
  
  METHODS
  A qualitative design taking a constructivist inquiry perspective.
  
  
  METHODS
  Semi-structured interviews with 16 patients were conducted between September 2008-February 2009 and analysed by qualitative content analysis.
  
  
  RESULTS
  Many patients find it very difficult to adequately describe the symptom to others resulting sometimes in bizarre accounts of the symptom that provoke irritation in lay people and health professionals. This irritation frequently leaves the sufferer feeling misunderstood. Patients often feel their burden is not taken seriously by health professionals. This and various other reasons contribute to difficulties in accepting a given diagnosis. This can leave patients unsatisfied with their current health care and the system. They respond with frequent doctor changes and consideration of complementary and alternative therapeutic methods.
  
  
  CONCLUSIONS
  Assisting patients with chronic pruritus in their efforts to adequately describe the symptom along with unconditional regard and empathy are key factors that can help enhance the provider-patient relationship and subsequent acceptance of a given diagnosis. A stronger emphasis on the perspectives of these patients may also improve the quality of healthcare provision.
authors.affiliation: Department of Clinical Social Medicine, University Hospital Heidelberg, Germany. anja_bathe@web.de
authors.forename: Anja
authors.initials: A
authors.lastname: Bathe
authors.forename: Elke
authors.initials: E
authors.lastname: Weisshaar
authors.forename: Uwe
authors.initials: U
authors.lastname: Matterne
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002908:Chronic Disease; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D010817:Physician-Patient Relations; D011537:Pruritus / Q000523:psychology*; D055815:Young Adult