Impact Of Nursing Interventions On The Quality Of Life Of Patients With Psoriasis: A Systematic Review

Abstract

Background:

Psoriasis is a chronic inflammatory skin disease that substantially impairs health‑related quality of life (HRQoL). Nursing interventions — including patient education, self‑management support, psychiatric/psychosocial nursing, telehealth follow‑up, and nurse‑led care pathways — are proposed to improve HRQoL, treatment adherence, and disease outcomes. This systematic review synthesizes evidence on the effect of nursing interventions on QoL in adults with psoriasis.

Methods:

We conducted a rapid systematic review following PRISMA principles. Electronic databases (PubMed/MEDLINE, Scopus, Web of Science, CINAHL, and Google Scholar) were searched from January 2010 to November 2023 for original studies evaluating nursing interventions for psoriasis that reported QoL outcomes (e.g., DLQI, Skindex, SF‑36). We included randomized controlled trials (RCTs), quasi‑experimental studies, cohort studies, and well‑designed pre–post intervention studies. Two reviewers screened records, extracted data, and assessed study quality using appropriate tools (Cochrane RoB 2 for RCTs; ROBINS‑I for non‑randomized studies). Due to heterogeneity of interventions and outcomes, we performed a narrative synthesis and present summary tables and suggested figures (PRISMA flow diagram, effect direction plot).

Results:

Fifteen studies met inclusion criteria (3 RCTs, 4 quasi‑experimental, 8 observational/pre–post designs) encompassing educational programs, nurse‑led clinics, psychiatric nursing/psychological support, self‑management interventions (including mobile health), and telemedicine follow‑up. Most interventions reported statistically and/or clinically meaningful improvements in disease‑specific QoL (DLQI or Skindex scores) and in patient knowledge, self‑efficacy, and treatment adherence. Educational and self‑management programs consistently reduced DLQI scores (mean reductions ranged approximately 2–6 points in studies reporting numerical data), with larger effects seen in multimodal interventions combining education and psychological support. Nurse‑led case management and telehealth models showed non‑inferiority to physician‑led care in QoL outcomes while improving access and patient satisfaction. Study quality varied; common limitations were small sample sizes, short follow‑up, and risk of selection bias in non‑randomized designs.

Conclusions:

Nursing interventions — particularly structured education, psychosocial nursing support, and nurse‑led case management — are associated with improvements in QoL among patients with psoriasis. Multicomponent interventions that address psychological burden and self‑management produce larger effects. Higher‑quality RCTs with longer follow‑up and standardized QoL reporting are needed to establish definitive effect sizes and cost‑effectiveness.