title: Facing the dilemma of patient-centred psoriasis care: a qualitative study identifying patient needs in dermatological outpatient clinics.
abstract: BACKGROUND
  Caregivers must be aware of patients' current needs by providing care responsive to patients' values and preferences and by identifying what approach improves and encourages patients to participate in their treatment and disease management. Patients with psoriasis healthcare needs perhaps change as medical knowledge improves, new drugs emerge and the healthcare system improves its efficiency as a result of constant structural development.
  
  
  OBJECTIVE
  To explore the unmet needs and health perceptions of people with psoriasis, regarding interaction with clinicians and the structure inherent to consultations in a hospital outpatient dermatological clinic.
  
  
  METHODS
  A qualitative investigation with data generated from semi-structured interviews. Transcriptions were subsequently analysed using the template analysis method.
  
  
  RESULTS
  Sixteen patients with psoriasis were interviewed. Challenges and dilemmas of patient-centred psoriasis care were identified. Patients have a strong need to be met as individuals as the burden of living with psoriasis goes beyond the skin. Patients strive for efficient treatment and ultimately dream of being cured of psoriasis. They prefer individualized health education in order to adjust their knowledge and self-management skills. These central issues are as yet rarely addressed in clinical consultations.
  
  
  CONCLUSIONS
  Consultations with a standardized structure do not match the individual challenges and healthcare needs of patients with psoriasis. In order to achieve a more patient-centred approach, health professionals should implement minor structural changes to dermatological services to meet patients' current needs and invite dialogue about the patients' emotional well-being and concerns that go beyond biomedical factors, as well as offer individualized health education.
authors.affiliation: Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: L R
authors.initials: LR
authors.lastname: Khoury
authors.affiliation: Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Skov
authors.affiliation: University Hospitals Centre for Health Care Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Møller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration / Q000592:standards; D001294:Attitude to Health; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D000070497:Healthy Lifestyle; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000592:standards; D010465:Perception; D010817:Physician-Patient Relations; D011565:Psoriasis / Q000523:psychology / Q000628:therapy*; D012054:Reinforcement, Psychology; D012648:Self Care; D055815:Young Adult