الفهرس 
Introduction and Aim of the Work
QuAlity of lifeOnly 14 pages are availabe for public view
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Abstract
Skin is an extraordinary structure. It is frequently damaged because it is directly in the ”firing line”. So, skin diseases are very common. Indeed it is true to say that everyone will at some time in his life have some form of skin disease (Basra and Shahrukh, 2009). Skin diseases are often obvious and very visible to others. Those who have skin diseases have not only to cope with the effects of their disease but also the reaction of others to their condition (Roosta et al, 2010).
Although most of the chronic skin conditions, such as atopic eczema, psoriasis and vitiligo are not immediately life-threatening conditions, they are recognized as a considerable burden on health status and quality of life (QoL), including physical, emotional and financial consequences that is more pronounced than those of some major chronic medical conditions such as asthma or diabetes (Adams et al, 1999).
Health-related quality of life (HRQOL) is generally considered as a multi-factorial construct focusing on individuals’ subjective evaluations of their physical health, mental health and social functioning (Sawyer et al, 2001) and the objective impact of the disorder associated with the disease or medical treatment (Gill and Feinstein, 1994).Its Components can be either economical (related to costs incurred or income lost) or non-economical (related to survival and wellbeing)(Chren and Weinstock, 2004).
Psoriasis has a significant negative impact on patients’ quality of life. Various factors may contribute to this lower QoL; the chronic nature of the disease and the lack of control over unexpected outbreaks of the symptoms are among the most bothersome aspects of psoriasis (Gelfand et al, 2004). Up to 85% of those affected with psoriasis describe it as a ‘significant problem’ impacting their quality of life (Sampogna et al, 2012).
Although there are various measures available for assessing health-related quality of life (HRQoL) in research studies, there is no consensus on which measure is best to be used in clinical practice or in researches. Measures used to assess the extent and severity of the disease, cannot capture the impact of the disease on patients’ life. So, tools for measuring psoriasis severity and HRQoL should be used together. These measures are classified as psoriasis-specific, skin-specific, generic, and mixed(Tan et al, 2012).
In statistical terms, reliability means the ability of an instrument to measure something consistently and repeatedly (Cameron et al, 2008).On the other hand, validity refers to how well a test measures what it is purported to measure(Colin and Julie, 2008).
The present study was concerned with translation and validation of an Arabic version of the PDI which is an important psoriasis-specific measure for QOL that was developed by Finlay and Coles (Finlay et al, 1990), and has been translated into about 26 languages (Finlay, 2016).
We had taken a formal permission from the original author Professor Andrew Finlay on April 30, 2014, to translate the original version of the PDI questionnaire into Arabic language and to validate this Arabic version. It was already published online in December 21, 2014; as the only available Arabic version for the PDI on the Cardiff University online page (Finlay, 2016).
The Arabic version was easily understood and answered by the patients. Face and content validity were assessed as satisfactory. The PDI seemed to capture issues of importance to patients as that was found in the Norwegian version (Wahl et al, 1999). Concurrent validity was assessed and the mean of the PDI score in the current study was 23.9 ± 2.9 (range 4 – 40), nearly equal to the mean PDI score of a previous study in Upper Egypt that was 20.4 ± 6.8 (range 3 – 38) (Zedan and Mostafa, 1999). That reflects the strong social distress in our community which was noted previously by Zedan and Mostafa, 1999.
In our study, there was a significant difference in both PASI and PDI scores between married and single patients (P-value = 0.007 and 0.032, respectively). Also, PDI showed a significant different score between smokers and non-smokers (P = 0.001). On the other hand, it was shown that there was no statistically significant difference in either PASI or PDI scores with different age and sex groups (P = 0.19 and 0.34) for age and (0.36 and 0.31) for sex, respectively. Also, there was no significant difference between patients at regular work or school and patients not at regular work in both PDI and PASI scores (0.28 and 0.16).
On the other hand, we found that there was no significant difference on the mean of the PDI score between patients with mild PASI score and those with moderate PASI score (p-value = 0.06). Which means that the patient’s quality of life can be affected even with mild psoriasis lesions. So, we cannot replace the PDI scale by the PASI scale as a tool for assessment of the disability of psoriasis.
The internal consistency for the 15 items of the developed Arabic version of the PDI indicated a good reliability of the instrument.