This is the short, summarized version of my Bachelor Thesis. For the complete version, please go here.

núna

LIFESTYLE SYSTEM FOR PEOPLE LIVING WITH PSORIASIS

Between 250.000 to 300.000 people live with psoriasis in Sweden today. 50% develop psoriasis before they are 25 years old. When living with psoriasis, one have an increased risk of developing comorbidities, which includes overweight, joint problems, high blood pressure, cardiovascular diseases and depression, among others. 

Based on recent findings, people living withBetween 250.000 to 300.000 people live with psoriasis in Sweden today. 50% develop psoriasis before they are 25 years old. When living with psoriasis, one have an increased risk of developing comorbidities, which includes overweight, joint problems, high blood pressure, cardiovascular diseases and depression, among others. Based on recent findings, people living with

 

10 weeks | Spring 2015

Bachelor Thesis | Myself

Problem | How can we increase the Health Related Quality of Life in People Living with Psoriasis?

Scholarship | Granted by the Brita-Stina Nordenstedt's Donation

Collaboration Partner | Psoriasisförbundet, Psoriasisföreningen i Umeå

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Abstract

Between 250.000 to 300.000 people live with psoriasis in Sweden today. 50% develop psoriasis before they are 25 years old. When living with psoriasis, one have an increased risk of developing comorbidities, which includes overweight, joint problems, high blood pressure, cardiovascular diseases and depression, among others. 

Based on recent findings, people living with psoriasis can achieve health benefits and improve the symptoms of the condition through living a good lifestyle. I have developed a lifestyle system named “núna”, which will empower the patient, encourage a good lifestyle, prevent comorbidities and improve the healthcare personnel and patient communication. 

The system includes an application which consists of five different main categories (Activity, diet, quit smoking, photography documentation and  administrating issues related to ones healthcare providers), and an activity tracker with two different portable docks and a charging station.

According to a survey that was preformed with Psoriasisförbundet’s members, 70% of people living with psoriasis experience decreased life quality.

--- Pfizer AB, Psoriasisförbundet 2012 Brochure: “Under huden: En liten bok om psoriasis och samsjuklighet”



WHAT IS PSORIASIS?

Psoriasis is a chronic, immune-mediated inflammatory skin disease which affect 2-4% of the world’s population. In Sweden there are 250.000 to 300.000 people living with different kinds of psoriasis. Half of these get their diagnosis before they turn 25 years of age. 

Psoriasis appears on the skin and is generally categorized as scaly, erythematous plaques/patches of skin which flake off and leaves the skin sore and itchy. The severity of the psoriasis symptoms varies from individual to individual. It can appear on smaller, concentrated areas of the skin and stretch to covering the whole body. It is estimated that approximately 40% of the people affected by psoriasis has “psoriasis arthritis”.  Psoriasis arthritis is an inflammatory joint disease that causes pain, stiffness of the joints and may, in the most serious cases, lead to immobility. In the different degrees of severity of psoriasis and psoriasis arthritis, there are different kinds of treatment.

There is no known cure for psoriasis. Today there are only treatments which ease the symptoms of the diagnosis. The treatments can be categorized in three groups: external treatment (creams and over-the-counter treatments), light treatment and internal treatment (oral medicine, biologic injections and infusions). Most people with psoriasis have to perform a daily ritual where they make sure to descale the skin and keep it smooth and moisturized. This ritual is not enough by itself and is usually accompanied by treatments given by different health care providers. 

Psoriasis is not contagious, which is one of the more common misconceptions by the public. People living with psoriasis experience that the diagnosis has a severe impact on their life quality, as well as their social and professional life.


Psoriasis, Lifestyle & Life-Quality

According to a brochure provided by Psoriasisförbundet, many people who are living with psoriasis experience that their condition affect their life quality. Can a good life-style have a significant effect on psoriasis and improve life-quality? There has been found connections between the effect lifestyle factors have on psoriasis. In the same brochure, Birgitta Stymne (attenting physician at the skin clinic at Lindköping’s University Hospital) stress the importance of living well and the importance and health benefits a good lifestyle can have for people living with psoriasis.

Psoriasis cannot be cured, and the symptoms of the condition can only be treated. Traditionally, the symptoms are treated with topical agents and softening creams, UVB-light treatment or biological injections. The connection between psoriasis and lifestyle is a relatively new area within  research which has in recent years drawn more attention. That there is a connection between smoking and overweight is well-know, but the affect other lifestyle choices can have on psoriasis is left for further exploration.

“To take care of oneself is important for everyone. Eating well and right, drinking alcohol in moderation and exercising regularly makes life healthier and happier for everyone. But for you who are living with psoriasis or psoriatic arthritis, it is even more important. [...] Simply put, psoriasis have a tendency to worsen when we live carelessly - and improve when we live well. Smoking, overweight, alcohol consumption - yes, everything which is of no use for the ordinary man - affect psoriasis patients even worse.”

--- Birgitta Stymne, attending physician at the skin clinic at Lindköping’s University Hospital Quotation from “Må bra med Psoriasis: om livsstil og livskvalitet” by Psoriasisförbundet, page 3

What can people who are living with psoriasis actively do to take care of themselves and their condition, besides having a good lifestyle? In the same brochure  from Psoriasisförbundet, one of the headlines says as follows: “Help your doctor.” In this chapter, Psoriasisförbundet express the importance of informing ones doctor about the effectiveness ones treatment. However, in order for the doctor to help, they need to know details about the patients life and lifestyle. In this way, the doctor can assist the patient with lifestyle recommendations suited for each individual case. In the same chapter, Psoriasisförbudet states: your treatment will get more effective in combination with the right kind of lifestyle.

Based on this information, it could be claimed that there are health benefits to be found in acquiring a healthy lifestyle, which affect your health related quality of life. Lifestyle and health related life quality are interconnected, and through improving your lifestyle and actively participate in developing your own treatment and lifestyle regime, you could see significant improvements in health related life quality and the state of  the psoriasis. 

“Everyone feels better of a healthier life-style. You can affect your psoriasis quite a lot through living a balanced life. However, the changes does not come over night. It’s about creating good habits, and they become habits after some time. Therefore it is important to compare back in time in order to see your improvement. Life-quality forms and writing a diary are two good ways to keep track of this. In this way, you’re also collecting information which can help your doctor do a good job. That is also important.”

--- Birgitta Stymne, attending physician at the skin clinic at Lindköping’s University HospitalQuotation from “Må bra med Psoriasis: om livsstil og livskvalitet” by Psoriasisförbundet, page 7


Psoriasis and Comorbidity

For quite some time, psoriasis was viewed as mainly a skin condition. In later years, this has proven to be wrong. People living with psoriasis have an increased risk of developing other chronic and serious health conditions in addition to their psoriasis. These additional conditions are known as “comorbidities”. 

As much as half of the people living with psoriasis are overweight. Being overweight is bad for everyone, and particularly bad for someone living with psoriasis. Not only do people with psoriasis already have an increased risk of developing a series of conditions, but along with overweight, the risk of developing diabetes type 2, high blood pressure and cardiovascular diseases increase additionally. 

Over 1/5 people living with psoriasis suffer from depressions. Living with a condition like psoriasis cause considerable amount of emotional distress. People living with psoriasis can experience low self-esteem and insecurities as a result of the condition and the stigma that comes along with it. There might also be a biological reason why people with psoriasis are prone to develop depressions. According to the National Psoriasis Foundation, people living with psoriasis have twice the chance of developing depressions from the rest of the population. Depression have a significant impact on ones life quality. 

In recent years, evidence has been found that if your take control of your lifestyle, the chance of developing any comorbidities decrease. Preventing overweight, quit smoking, avoid exsessive alcohol consumption, decrease stress, have good sleeping habits and so forth, show great potential health benefits. 

How can a design solution give people living with psoriasis incentives to acquire a balanced lifestyle in order to prevent comorbidities?