Chisholm, Anna, Nelson, Pauline A., Pearce, Christina J., Keyworth, Chris, Griffiths, Christopher E. M., Cordingley, Lis and Bundy, Christine ORCID: https://orcid.org/0000-0002-5981-3984 2016. The role of personal models in clinical management: exploring health care providers' beliefs about psoriasis. British Journal of Health Psychology 21 (1) , pp. 114-134. 10.1111/bjhp.12148 |
Abstract
Objectives Individuals’ illness representations, including beliefs about psoriasis (a complex immune-mediated condition), and their emotional responses to the condition guide self-management behaviour. It is also plausible that health care providers’ illness representations guide their own management of psoriasis. Patients commonly report poor health care experiences related to psoriasis, and the role of health care providers’ beliefs, emotions, as well as their knowledge, experiences and behaviours (‘personal models’) in this is unexplored. This study aimed explore health care providers’ personal models of psoriasis. Design and methods Qualitative analysis of 23 semi-structured interviews with health care professionals providing care for psoriasis patients was performed. Purposive sampling achieved maximum variation regarding participant discipline, level of experience, gender and age. The self-regulatory/common sense model informed data collection and initial data analysis. Principles of framework analysis were used to generate predetermined and emergent key issues related to practitioners’ personal models. Results Three types of personal model emerged. Sophisticated–Linear Model: 70% of practitioners recognized psoriasis as a complex condition but managed it as a skin condition. Mixed Model: 17% of practitioners recognized/managed some elements of psoriasis as complex and some as a skin condition. Sophisticated–Sophisticated Model: 13% recognized and managed psoriasis as a complex condition. Across the data set, five themes emerged illustrating key patterns underpinning these different models including (1) Recognising complexity, (2) Putting skin first, (3) Taking on the complexities of psoriasis with the patient, (4) Aiming for clearance, and (5) Affective experiences within psoriasis consultations. Conclusions Health care providers recognized psoriasis as a complex condition but commonly reported managing psoriasis as a simple skin condition. Providers’ beliefs and management approaches varied in the extent to which they were consistent with one another; and their emotional experiences during consultations may vary depending upon their personal model. Findings could inform future dermatology training programmes by highlighting the role of health care providers’ illness representations in clinical management of the condition.
Item Type: | Article |
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Date Type: | Publication |
Status: | Published |
Schools: | Healthcare Sciences |
Publisher: | Wiley |
ISSN: | 1359-107X |
Date of First Compliant Deposit: | 13 February 2018 |
Date of Acceptance: | 14 June 2015 |
Last Modified: | 23 Oct 2022 12:51 |
URI: | https://orca.cardiff.ac.uk/id/eprint/108898 |
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