الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
V
itiligo is a chronic skin condition characterized by portions of the skin losing their pigments. It occurs when skin pigments cells die or are unable to function. Aside from cases of contact with certain chemicals, the cause of vitiligo is unknown. Vitiligo may arise from autoimmune, genetic, oxidative stress, neural, or viral causes.
The Body Image (BI) is a concept which implies an individual’s subjective perception created by his or her lifelong changing thoughts about his or her own body.
Self-Esteem (SE) can be considered as the individual’s perception of self as being valuable, sufficient, diligent, effective and successful.
The majority of published studies indicate that vitiligo has an effect on psychological and social status of vitilgo people.
Aim of the study
The aim of this study is to assess the psychosocial problems associated with vitiligo.
Research question:
What is the psychosocial problem associated with vitiligo? Subjects and methods:
Subject and method
Research Design:
The design followed for this study was a cross sectional descriptive research design.
Setting:
The study was conducted in the-Benha Dermatology Hospital.
Subjects
A convenient sample of 80 patients of both sexes, medically diagnosed as having vitiligo, was selected from the Outpatient clinics. Patients fulfilled the following inclusion criteria:
Both sexes.
Different age groups.
With no psychotic problems.
Willing to participate in the study.
Tools of the data collection:
1-Interview questionnaire (Appendix I): It was designed by the researcher after reviewing literature in the field of vitiligo. It was included
a- The socio-demographic data of the study subjects such as code number, age, sex, marital states, residence, monthly income, occupation and educational level, Physical illness, Start of illness(years), Start of treatment (years), Medication type and Number of hospital entry. . It was designed by the investigator and guided by the supervisors.
b- Social problems among patient with vitiligo.
It was designed by the researcher and guided by the supervisors. The scale was used to assess social problems among patient with vitiligo. The scale consists of 26 questions in the form of closed ended questions (strongly agree-agree-disagree).
2- Psychosocial measurement to assess social problems among patient with vitiligo (Appendix II):it consist of two scale :
(A) Self-esteem scale: IT was developed by Rosenberg, (1965)it was modified and translated into Arabic language by the researcher and guided by the supervisors to assess Self-esteem of the patients, it included (10) items to measure positive & negative feelings toward self. The scoring system used to assess Psychological problems of the patients as follows; each sentence has score ranging from 1-3 (1=strongly agree, 2=agree,3 =disagree and 4= strongly disagree).
B) Body image scale: It was developed by lindgren & pauly(1975) it was modified and translated into Arabic language by the researcher and guided by the supervisors to assess Body image of the patients, it was included (30) items to measure perception patient body. The scoring system used to assess Psychological problem of the patients as follows; each sentence has score ranging from 1-3 (1= strongly agree, 2=agree and 3= disagree).
Administrative design:
An official permission was obtained from Benha Dermatology Hospital, in which the research was conducted. Subjects who fit the study criteria were interviewed by the researcher during their coming to the outpatient clinic, at that time, the purpose and nature of the study was explained, also agreement to participate in the study was and confidentiality was assured.
Pilot study:-
The pilot study was conduct on 10% from the total sample in order to ensure the clarity of questions, applicability of the tools, time needed to complete them and perform the required modification according to the expertise opinionnaire and the result of pilot study.
The results of the present study reached to the following:
There is a statistical significant relation between residence and self-esteem while, there is no statistical significant relation between patients illness history and their self-esteem.
Also, there is a significant relation between residence of patients and monthly their income. While, there is no significant relation between age, gender, marital status, Lives with who, occupation and education.
And there is no significant relation between illness history of patients and body image satisfaction. While, There is a significant relation between medication type and the patient’s body image
There is a significant relation between social problems and age, marital status and residence monthly income. Also, there is a highly significant relation between social problems and monthly income among patients while, there is a non-significant relation between social problems and patients gender, live with who, education and occupation.
And there is a statistical significant correlation between self-esteem and social problems.
The current study shows that the total body image satisfactions score of the sample was 56.9%. Items which the sample answered highest percent of usually was (I am concerned with deformities in my body) with 38.7% .Item with the highest percent of sometimes was (I look negatively to my body) with 60%.Item with the highest percent of rarely was (I feel I look terrible) and (People loves and accepts me) with 27.5% while item with the highest percent of never was (I judge people by their looks) with 36%.
The present study shows that the total social problems score of the sample was 64.8%. Items which the sample strongly agreed to was (I avoid people who will talk about skin problems) with 41% .Item with the highest percent of agree to some extent was (My colleagues avoid me) and (I am isolated from others) with 48%. Item with the highest percent of disagree was (I avoid high positions because of my skin) and (I feel unsatisfied because of my work skills decreasing) with 45%.
Results show a moderate significant inverse relation between self-respect and social problems; a very strong significant inverse relation between body image satisfaction and social problems.
The current study shows a significant relation between residence and self-respect. The self-respect of people in urban areas is higher than rural areas; no significant relation between illness history and self-respect.
The present study shows a significant relation between body image satisfaction and age, marital status, residence, who he lives with, and monthly income. The score is higher for patients aged 30-39, married patients, living in urban area, lives with family and those with enough income.
The current study shows no significant relation between illness history and body image satisfaction; a significant relation between social problems and age, marital status, residence, and monthly income. The score is higher for patients aged 50-59, widow patients, living in rural area, and those with not enough income.
The present study shows a significant relation between start of treatment and social problems. The score is higher for patients who started treatment since more than 5 years.
In the light of the study findings, the following were recommended
1. Designing and conducting a national level mass campaign of health education for the general public. The general public should be made aware that vitiligo patients need social support.
2. Encouraging a better coordination between all healthcare partners like dermatologists, psychiatrists, and healthcare workers to settle all the issues and to help in achieving the eradication goals of vitiligo disease.
3. Improving psychological rehabilitation, increasing emotional stability and self-worth of the discharged vitiligo patients should be encouraged to maintain stable married life for them. Also as a step to reduce depression, loneliness, discrimination and rejection common among discharged patients.
4. Highlighting the need to encourage the discharged patients to be active in all religious activities.
5. The family members of discharged patients should be health educated on the benefits of providing emotional support to vitiligo patients. They should be enlightened on the need to assist vitiligo patients to combat the problem of stigma in the communities.