ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Education and Promotion
Barriers and facilitators to adopting health-promoting lifestyles in patients with psoriasis in China: A qualitative study using the COM-B and SEM
Provisionally accepted
- Henan Provincial People's Hospital, Zhengzhou, China
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Background Psoriasis is an inflammatory skin disease that places a heavy burden on patients and society. Lifestyle can affect the occurrence and progression of psoriasis and its associated comorbidities. Objectives To explore facilitators and barriers to health-promoting lifestyles among patients with psoriasis using the capability, opportunity, motivation behavior (COM-B) model and the Social Ecological Model. Methods A descriptive qualitative study was conducted using semi-structured interviews with 16 patients recruited via a WeChat group of Psoriasis Patients' Home. Data were collected and analyzed using content analysis in NVivo software (version 14). Results At the individual level, barriers included limited knowledge and awareness, excessive dietary restrictions, symptom burden, difficulty changing habits, ineffective behaviors, effective food temptation, and inappropriate self-image; facilitators were disease knowledge, healthy diet attention, behavioral change, proactive information seeking, awareness of habit-related skin aggravation, improved body image, self-pleasure, and overall health promotion. At the interpersonal level, barriers were social contact needs, while facilitators included peer and family support and patient role models. At the organizational/community level, barriers were work and life pressure and unhealthy workplace eating, whereas facilitators were social support. At the societal level, barriers were stigmatization and lack of disease-specific health promotion guidance. Conclusions This study highlights the multi-level factors influencing health-promoting lifestyles among patients with psoriasis and underscores the need for interventions that enhance individual capability and motivation while fostering supportive social and environmental contexts.
Keywords: Psoriasis, barriers, Facilitators, lifestyle, qualitative study
Received: 29 Aug 2025; Accepted: 04 Nov 2025.
Copyright: © 2025 Song, Yu, Wang, Huang, Liu and Xing. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Liyuan Xing, xingliyuan1116@126.com
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