Evaluation of a Therapeutic Education Program on Self-image in Patients With Chronic Inflammatory Rheumatic Diseases

A chronic disease is a long-term, progressive illness that affects the daily life of the person affected. The onset of the disease is a major upheaval, a moment of rupture between a before and an after. Physical functions and appearance can be altered by the disease (deformities, stiffness… in the case of rheumatic diseases) and by treatments.

According to Schilder, body image is "the way our body appears to ourselves." It can be defined as the set of perceptions, emotions, and thoughts related to appearance. It consists of perceptions but also of representations and feelings, which are built and evolve throughout the individual's experience. It is not limited to physical appearance and properties. It is the foundation of identity.

The disease affects the body, but also has an impact on self-perception, self-esteem, and even identity.

The literature highlights the importance of using qualitative research in addition to quantitative methods to grasp the full complexity of body image.

Despite the progress and effectiveness of treatments, recent studies showed that patients with chronic inflammatory rheumatic diseases (CIRD) have an unsatisfactory, disturbed body image. Literature data also reveal that self-esteem and quality of life in this population are lower than in the general population.

Most studies focused on the consequences of the disease, and very few on the actions taken to address these difficulties encountered by patients, even though such actions are recommended.

Therapeutic patient education (TPE) is support offered to the patient and their relatives so they can take ownership of their disease. TPE is a comprehensive approach that meets the patient's needs and aims to maintain and/or improve quality of life with the illness.

Most therapeutic education workshops related to self-image are proposed in the context of cancer, psychiatric disorders, or obesity. Body image is rarely the direct subject of a workshop in programs aimed at patients with CIRD.

A few studies on the impact of image consulting workshops have been conducted in oncology, but very few in the context of other diseases, including rheumatic conditions. Existing studies show an improvement in self-image, self-esteem, and quality of life after educational interventions, thus a real benefit for patients.