背景:自从人类基因研究开始以来,很少有出版物分享罕见遗传性皮肤病(RGSD)对患者体验的负面影响。本系统评价评估了这些疾病在日常生活经验方面的社会心理影响,情绪状态,自我感知,和生活质量(QoL)。
方法:对白化病进行了系统评价,神经纤维瘤病1型(NF1),胎记和遗传性鱼鳞病.PubMed,Scopus,PsycArticle,PsychInfo,心理学与行为科学合集,并查询了SOCindex数据库。纳入标准为患有这些RGSD之一的成年患者。进行了简单的描述性统计和定性内容分析,以总结作者报告的主要结果。
结果:在检索到的9987篇文章中,包括48篇文章:白化病(16),NF1(16),遗传性鱼鳞病(10),胎记(6)。大多数关于白化病的研究是在非洲进行的。27项研究定量评估了各种心理参数:13项显示疾病对QoL的显着影响,关于情绪状态的五个,两个关于自我陈述,另外两个关于精神病合并症。疾病严重程度和能见度是QoL的良好预测因子(白化病除外)。身体形象和外观问题也与QoL和情绪状态有关。19项定性研究强调了这些疾病中重复出现的主题:童年和青春期的歧视和污名,社交互动中的不适,传输的罪恶感,家人和朋友社会支持的重要性,改变了日常生活功能,改变了浪漫和性生活,有限的学术和专业抱负,缺乏医学领域的兴趣和支持,以及疾病演变的不可预测性。本综述中仅有的两项混合方法研究无法对任何推论分析做出贡献,但可以证实一些定性发现。
结论:这些结果表明RGSD对患者生活的不同方面有显著影响。这篇综述表明,确实需要为这些疾病的患者提供支持系统。应开发此类系统,为他们提供必要的信息,并指导他们通过适当的护理途径。
Since the beginning of human genetic research, there are very few publications sharing insights of the negative impact of rare genetic skin diseases (RGSD) on patients\' experiences. This systematic
review assessed the psychosocial implications of these conditions in terms of daily life experiences, emotional state, self-perception, and Quality of Life (QoL).
A systematic
review was carried out on albinism, neurofibromatosis type 1 (NF1), birthmarks and inherited ichthyosis. The PubMed, Scopus, PsycArticle, PsychInfo, Psychology and Behavioral Sciences Collection, and SOCindex databases were queried. Inclusion criteria were adult patients with one of these RGSDs. Simple descriptive statistics and qualitative content analysis were conducted to summarize the main results reported by the authors.
Of the 9987 articles retrieved, 48 articles were included: albinism (16), NF1 (16), inherited ichthyosis (10), birthmarks (6). The majority of the studies on albinism were conducted in Africa. Twenty-seven studies quantitatively assessed diverse psychological parameters: 13 showed a significant impact of the disease on QoL, five on emotional state, two on self-representation and two others on psychiatric comorbidities. Disease severity and visibility were good predictors of QoL (except for albinism). Body image and appearance concerns were also associated with QoL and emotional state. The 19 qualitative studies highlighted recurring themes across each of these diseases: discrimination and stigma during childhood and adolescence, discomfort in social interactions, guilt of transmission, the importance of social support from family and friends, altered daily life functioning, altered romantic and sex life, limited academic and professional aspirations, lack of interest and support from the medical field, and the unpredictability of the evolution of the disease. The only two mixed-method studies in this
review were unable to contribute to any inferential analyses but could corroborate some of the qualitative findings.
These results showed that RGSDs have a significant impact on different aspects of patients\' lives. This
review has demonstrated that there is a real need for support systems for patients with these diseases. Such systems should be developed to provide them with necessary information and to guide them through an appropriate care pathway.