A new qualitative study conducted at an urban safety-net hospital in San Francisco has revealed important insights into how Latine patients perceive and experience psoriasis care, highlighting both shared perspectives with the general population and unique cultural considerations that could impact treatment outcomes.
The research, led by Nathaly Gonzalez, MS, BS, from the Medical College of Wisconsin School of Medicine, examined the experiences of 30 Latine adults with moderate to severe psoriasis through detailed interviews conducted between July and August 2022.
Patient Demographics and Study Design
The study population averaged 50 years of age, with 67% male participants and 73% preferring Spanish as their primary language. Participants represented diverse Latin American backgrounds, including Mexico (23%), Guatemala (13%), El Salvador (7%), and other countries. All participants were insured through Medicaid or Healthy San Francisco, a program for lower-income patients.
Researchers conducted 45-minute semi-structured interviews, either via Zoom or in person, using a bilingual interviewer certified in qualitative methods. The interview format was carefully designed to explore patients' understanding of psoriasis, their experiences with care, and their perspectives on clinical research.
Key Themes in Patient Experience
The analysis revealed six interconnected themes that characterize Latine patients' experiences with psoriasis:
- Strong influence of social and family networks in medical decision-making
- Unique cultural perceptions of psoriasis as an illness
- Significant impact on employment and workplace concerns
- Challenges in accessing quality dermatologic care
- Openness to both prescribed and over-the-counter treatment options
- Generally positive attitudes toward participation in clinical research
Cultural Perspectives and Treatment Attitudes
A notable finding was patients' concern about workplace discrimination due to visible psoriasis symptoms. The study also uncovered distinct cultural beliefs about disease causation, with many participants attributing their condition to factors such as nervousness and dietary choices.
"Studies have found that Latine patients often avoid discussing home remedies with their clinicians," noted Gonzalez and colleagues, highlighting a potential communication gap in clinical settings. However, the research also revealed encouraging attitudes toward biologic medications and willingness to participate in clinical research when language and educational barriers are addressed.
Clinical Implications
The findings suggest several important considerations for dermatologists treating Latine patients:
- The need to proactively inquire about non-prescribed treatments
- The importance of discussing biologic medications when clinically appropriate
- The value of addressing language and cultural barriers in treatment plans
- The potential for increased participation in clinical research with appropriate support
This research underscores the importance of culturally competent care in dermatology and suggests opportunities for improving treatment outcomes through better understanding of patient perspectives and needs.
