Patient Education and Self-Management Strategies in Psoriasis

Abstract

Background: Psoriasis is a chronic inflammatory skin disease that substantially impairs patients' physical, psychological, and social well-being. Although patient education is considered an essential component of psoriasis management, limited evidence has explained how it improves health-related quality of life through health literacy and self-management behaviours.

Objective: This study examined the direct effects of patient education on health literacy, self-management behaviours, and health-related quality of life, and investigated the mediating roles of health literacy and self-management behaviours among patients with psoriasis.

Methods: A quantitative cross-sectional research design was employed. Primary data were collected using a structured questionnaire from 500 adult patients with clinically diagnosed psoriasis receiving treatment at Mother Theresa University Hospital Center, University Hospital of Trauma, Pegasus Med Clinic, and EB Dermatology Clinic in Tirana, Albania. Eligible respondents were adults (≥18 years) with a confirmed diagnosis of psoriasis and previous experience with psoriasis treatment and education. Purposive sampling was adopted. The proposed model was analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) in SmartPLS 4. Reliability, convergent validity, discriminant validity, predictive relevance, direct effects, and mediation effects were assessed through bootstrapping with 5,000 resamples.

Results: Patient education significantly improved health literacy, self-management behaviours, and health-related quality of life. Both health literacy and self-management behaviours positively influenced health-related quality of life. Mediation analysis demonstrated complementary partial mediation for both constructs, with self-management behaviours exhibiting the stronger indirect effect. The model explained 31.7% of the variance in health literacy, 42.1% in self-management behaviours, and 46.2% in health-related quality of life.

Conclusion: Patient education enhanced health-related quality of life both directly and indirectly by improving patients' health literacy and promoting effective self-management behaviours. The findings emphasize that structured, literacy-sensitive, multidisciplinary patient education should be integrated into routine dermatology services to strengthen long-term disease management and patient well-being.