The effects of cultural background on patient-perceived impact of psoriatic arthritis - a qualitative study conducted in Brazil and France

Penélope Esther Palominos,Rafael Mendonça Da Silva Chakr,Sarah Kreis,César Luis Hinckel,Charles Lubianca Kohem,Maarten De Wit,Willemina Campbell,Ana Laura Didonet Moro,Ricardo Machado Xavier,Laure Gossec,Niti Goel

doi:10.1186/s42358-018-0036-6

Abstract

BackgroundIn psoriatic arthritis (PsA) almost all qualitative studies have been performed in European populations. This work aimed to evaluate the impact of PsA in Brazilian and French subjects, as well as to explore cultural differences in the experience of disease and to recognize domains important for patients living with PsA outside Europe.MethodsA qualitative study was conducted in two university hospitals in Brazil and France; outpatients fulfilling Classification Criteria for PsA participated in individual interviews regarding the impact of PsA; interviews were conducted in the local language. The sample size was defined by saturation; interviews were recorded and transcribed and content analysis was performed.ResultsFifteen patients were interviewed in Brazil and 13 in France. Mean disease duration was 16.5 ± 12.5 years (range: 8 months to 47 years) and 14.4 ± 8.4 years (range 12 months to 29 years) for Brazilian and French subjects, respectively.A broad impact was perceived: 67 codes emerged from the interviews and were grouped in 41 categories. Although 2/3 of categories were common to both nationalities, some important health domains from the perspective of PsA patients from a non-European background were brought to light including sexual dysfunction, emotional impact of psoriasis and impact of prejudice on social and professional life.ConclusionsThis study highlights the importance of assessing the impact of PsA on a national level, emphasizing the common cross-cultural aspects but also revealing domains of interest for patients with PsA living outside Europe which merit further study.

Highlights

In psoriatic arthritis (PsA) almost all qualitative studies have been performed in European populations
We aimed to explore cultural differences in the experience of disease in Brazil and France and to recognize domains important to patients living with PsA outside the European background
Brazilian patients had higher disease activity, a higher proportion of participants with current or previous use of biological therapy and a lower educational level compared to the French sample (Table 2)

Summary

Introduction

In psoriatic arthritis (PsA) almost all qualitative studies have been performed in European populations. This work aimed to evaluate the impact of PsA in Brazilian and French subjects, as well as to explore cultural differences in the experience of disease and to recognize domains important for patients living with PsA outside Europe. Psoriatic arthritis (PsA) is a chronic rheumatic disease leading to altered quality of life, pain and functional disability, and professional and emotional burden [1,2,3,4,5]. Using qualitative methods to support the recognition of the most affected domains of health according to European patients, a questionnaire to evaluate patientperceived impact of disease, the PsA Impact of Disease Questionnaire (PsAID) was recently developed [7].

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