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1. Introduction
Psoriasis is a chronic, immune-mediated skin disorder that results from a polygenic
predisposition. [1] The prevalence of psoriasis is said to be 1-3 % of the world’s population. [2]
Although psoriasis is non-communicable disease, but it has associated with an increased risk of
developing severe co-morbid conditions such as cardiovascular disease, diabetes and psoriatic arthritis,
as well as depression and even suicidal ideation. [3]
There are various treatment options depend on type and severity of psoriasis, age and
general heath of patients. [4] Psoriasis treatments can be divided into topical therapy, systemic
therapy, phototherapy and biologic therapy. [5] In summary, apart from medication or medical
treatment technology, the success in psoriasis treatments cannot be achieved without patient
participation in the process of treatment. Providing knowledge about psoriasis and its treatment to the
patient and giving them an opportunity to share their knowledge like how to avoid exacerbating
factors, how to prevent or minimize flare-ups, can motivate patients’ treatment adherence that in turn
can decrease psoriasis flare ups. There was a research to evaluate the effects of self-help group and
the results showed that the disease severity using PASI score was decreased from 5.9 to be 4.4 after 3
months after participating in self-help group. The patients have improved psoriasis symptoms, quality
of life, and reduced stress level when compared to baseline. The study results has supported that the
appropriate psoriasis management care by providing knowledge about psoriasis and its treatment as
well as psychological care can reduce psoriasis symptoms. [6]
Currently, Institute of Dermatology, Bangkok, Thailand has adopted a conceptual framework
of self-help group (group instruction) to maximize quality of life, to support and to increase patient
self-care ability in order to promote all aspects of psoriasis patient self-care. The self-help group has
been well-cooperated by many psoriasis patients. In Fiscal Year 2011, the Institute has conducted 4
sessions of group instruction for psoriasis patients and there were 33 patients participated the activity.
Most participants (78.2%) were satisfied with the group activity. The assessment of patient knowledge
before and after the group participation showed that 18.25% of participants had higher knowledge
after attending the group instruction. [7] However, the study result did not include the information
whether the patients had applied the knowledge gained from participating in the group instruction to
their daily self-care or not. However, there has been an increasing trend of unplanned readmission
within 28 days of psoriasis patients at rate of 4.76%, 7.5% and 8.21% in 2009, 2010 and 2011
respectively. [8] Preliminary review of psoriasis patients' medical records found that the major cause of
