A randomized controlled feasibility trial of online compassion-focused self-help for psoriasis

Background People with psoriasis can experience psychological distress that might be amenable to psychosocial self-help. Objectives This study tested the feasibility and acceptability of two theoretically developed self-help interventions designed to reduce feelings of shame and improve quality of life. Methods A randomized controlled feasibility trial was conducted comprising 130 participants with psoriasis who were randomly allocated to receive either compassion-based self-help (n = 65) or mindfulness-based self-help (n = 65), over a 4-week period. Both interventions were provided online. Results The interventions were found to be acceptable, with over 70% of study completers reporting that they found the materials helpful. Of the 130 participants, 92 completed the study, with attrition at 29%. Both interventions showed modest yet statistically significant reductions in shame (Cohen’s d = 0.20) and improvements in quality of life (Cohen’s d = 0.40). Conclusions Self-help based on compassion and mindfulness is acceptable to users, and can reduce feelings of shame and improve quality of life for people living with psoriasis

Depression in people with skin conditions: The effects of disgust and self‐compassion

Objectives Skin conditions can be accompanied by significant levels of depression; there is therefore a need to identify the associated psychological factors to assist with the development of appropriate interventions. This study sought to examine the effects of disgust propensity, disgust sensitivity, self‐focused/ruminative disgust, and self‐compassion on depression in people with skin conditions. Design A cross‐sectional survey with follow‐up survey. Methods Dermatology outpatients (N = 147) completed self‐report measures of disgust traits, self‐compassion, and depression. At three‐month follow‐up, participants (N = 80) completed the depression measure again. Results Multiple regression analyses revealed that disgust propensity, disgust sensitivity, self‐focused/ruminative disgust, and self‐compassion each explained significant amounts of variance in baseline depression. Self‐compassion also explained a significant amount of variance in depression at follow‐up, after accounting for baseline depression. In addition, self‐compassion moderated the effect of disgust propensity on depression at baseline, such that at high levels of self‐compassion, disgust propensity no longer had a positive relationship with depression. Conclusions Disgust traits contribute to depression in people with skin conditions, while being self‐compassionate may be protective against depression. High self‐compassion also buffers the effects of disgust propensity on depression in people with skin conditions. The findings indicate the potential of compassion‐focused interventions for depression in people with skin conditions

The development of a self-help intervention to build social confidence in people living with visible skin conditions or scars: a think aloud-study

Introduction: People with a visible difference, such as scarring or a skin condition, can experience anxiety and intrusive reactions from others when in social situations. The use of products to conceal marks on the skin is provided in a number of different hospital services and by charities. However, there are relatively few psychosocial interventions available for these individuals. Objectives: To examine the views of skin camouflage users and practitioners on the acceptability, usability and need for a specifically developed cognitive behavioural therapy (CBT) self-help booklet. Methods: A think-aloud protocol and descriptive form of thematic analysis were used to ascertain participants’ views of this novel psychosocial intervention. Nine participants took part in think-aloud interviews that were analysed using thematic analysis. Six skin camouflage users and three skin camouflage practitioners participated in the study. Results: Support for the relevance, acceptability and usability of the booklet was found from both participants who used camouflage and those who provided it. However, some participants reported that they would envisage that some people would need additional support so as to be able to use the techniques described within the booklet. Conclusions: This study represents an important step towards developing a brief self-help intervention for people with living with visible skin conditions or scars and demonstrates the importance of seeking feedback from experts by experience on theoretically informed psychological interventions for this patient group

Acceptability of healthcare interventions : an overview of reviews and development of a theoretical framework

Abstract Background It is increasingly acknowledged that \u2018acceptability\u2019 should be considered when designing, evaluating and implementing healthcare interventions. However, the published literature offers little guidance on how to define or assess acceptability. The purpose of this study was to develop a multi-construct theoretical framework of acceptability of healthcare interventions that can be applied to assess prospective (i.e. anticipated) and retrospective (i.e. experienced) acceptability from the perspective of intervention delivers and recipients. Methods Two methods were used to select the component constructs of acceptability. 1) An overview of reviews was conducted to identify systematic reviews that claim to define, theorise or measure acceptability of healthcare interventions. 2) Principles of inductive and deductive reasoning were applied to theorise the concept of acceptability and develop a theoretical framework. Steps included (1) defining acceptability; (2) describing its properties and scope and (3) identifying component constructs and empirical indicators. Results From the 43 reviews included in the overview, none explicitly theorised or defined acceptability. Measures used to assess acceptability focused on behaviour (e.g. dropout rates) (23 reviews), affect (i.e. feelings) (5 reviews), cognition (i.e. perceptions) (7 reviews) or a combination of these (8 reviews). From the methods described above we propose a definition: Acceptability is a multi-faceted construct that reflects the extent to which people delivering or receiving a healthcare intervention consider it to be appropriate, based on anticipated or experienced cognitive and emotional responses to the intervention. The theoretical framework of acceptability (TFA) consists of seven component constructs: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy. Conclusion Despite frequent claims that healthcare interventions have assessed acceptability, it is evident that acceptability research could be more robust. The proposed definition of acceptability and the TFA can inform assessment tools and evaluations of the acceptability of new or existing interventions