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circular seating arrangements can promote face-to-face interaction. In addition, the circular seating
arrangements promote the members feel comfortable and feel closer to each other when discussing
or exchanging of the experiences with other members who have the similar problems. The circular
seating arrangements also allow the member to see all demonstration or acting of all other during the
meeting. These could promote the members’ self-confident and promote self-esteem from helping
and suggesting others. [14] Similarly, a study by Powwattana A. about the effectiveness of participation
in self-help group on self-care in patients with essential hypertension at Chiangraiprachanukrur Hospital
found that the patients who participated in self-help group had gained a significantly better self-care
than the regular advice control group (p-value<0.001). [12]
The third hypothesis was that the PASI score used for psoriasis disease severity
assessment after the experiment (post-test) was lower than the PASI score before the
experiment (pre-test) within the experimental group.
There was a statistically significant difference of pre-post PASI score within the experimental
group (p-value=0.017). The result was consistent with the third hypothesis. The lowering of PASI scores
may be because the patients might understand about the psoriasis disease and self-care through
mutual discussion and the exchange of experiences, concept and knowledge among the members.
The patients brought the knowledge and understanding of the disease and self-cares that they get to
solve their own problems and change their own self-care behaviors. According to Bandura A., people
took action when they hold efficacy beliefs and outcome expectations that make the effort seem
worthwhile. The activities in the self-help group may help the patients in the experimental group to
learn about the new behaviors and skills and could promote the patient to perceive their abilities to
take action, leading to continually change of self-care behaviors and resulting in good health. [15] The
studies in many countries found that the meeting among psoriasis patients to share experiences, to
mutually help other patients for solving their problems can lower stress and can decrease the severity
of psoriasis disease, including improving of the patients’ quality of life. Similarly, a study by
Suthipinittharm P. about the holistic management of psoriasis showed that patients had quality of life,
stress level and psoriasis symptoms better than prior to participation self-help group. The mean score
of disease severity with Psoriasis Area and Severity Index (PASI) score was decreased from 5.9 to 4.4
after 3 months participation in self-help group. [6] Similarly, a study by Phochanapan K. about Quality
of Life in Psoriasis at Institute of Dermatology, Thailand showed that therefore nurse and health care
team should educate the patients to take good self-care and correct health believes for better quality
of life. [16] These results were in the same way with Orem’s concept that self-care was an efficient
