IMPACT OF CLINICAL, ORGANIZATIONAL, AND PSYCHOSOCIAL FACTORS ON THE QUALITY OF LIFE OF PATIENTS WITH DERMATOVENEREOLOGICAL DISEASES.

Abstract

Background: Skin diseases substantially impair patients' quality of life and may affect psychological well-being, social functioning, and daily activities. In addition to clinical characteristics, organizational and psychosocial factors may also influence quality-of-life outcomes; however, these associations remain insufficiently investigated in Central Asian countries.

Aim: To assess quality of life among patients with skin diseases in Almaty, Kazakhstan, and to identify socio-demographic, clinical, organizational, and psychosocial factors associated with impaired quality of life.

Material and methods: A cross-sectional analytical study was conducted between January and May 2026 among adult patients with dermatological diseases attending outpatient dermatovenereological clinics in Almaty, Kazakhstan. Data were collected using an author-developed questionnaire assessing socio-demographic characteristics, clinical features, healthcare accessibility, and psychosocial aspects of disease. Quality of life was assessed using the Dermatology Life Quality Index (DLQI). The internal consistency of the Kazakh-language DLQI version was evaluated using Cronbach's alpha. Statistical analyses included the Mann-Whitney U test, Kruskal-Wallis test with Bonferroni correction, and CHAID decision tree analysis.

Results: A total of 417 patients were included in the study. The Kazakh-language version of the DLQI demonstrated high internal consistency (Cronbach's alpha = 0.864). Poorer quality of life was observed among women, rural residents, students, and patients with secondary education (all p<0.05). Significant associations were identified between quality of life and primary diagnosis, disease duration, exacerbation frequency, hospitalization history, self-medication, distrust in physicians, perceived treatment ineffectiveness, use of alternative medicine, and healthcare accessibility indicators (all p<0.05). Patients with visible skin lesions, lack of social support, stigmatization, prolonged waiting times, and high treatment costs reported significantly poorer quality of life (all p<0.001). CHAID analysis identified perceived usefulness of online consultations, difficulties in obtaining medical consultations, use of alternative medicine, visible skin lesions, family support, waiting time for consultation, and diagnosis as the main predictors of extremely impaired quality of life. The model demonstrated an overall classification accuracy of 84.6%.

Conclusions: Quality of life in patients with skin diseases is influenced by a complex interplay of socio-demographic, clinical, organizational, and psychosocial factors. Healthcare accessibility, social support, and telemedicine-related factors appear to play an important role and should be considered in comprehensive patient management.