Nurse-led home care management to support pediatric psoriasis care: A task-sharing model to unburden dermatologists in a tertiary setting . A mixed-methods protocol

Background: Psoriasis is a public health concern and a common chronic dermatosis in children, significantly impacting their physical, emotional, and social functioning, as well as the overall quality of life of both the child and caregiver. In India, the shortage of dermatologists and rising cases of chronic skin conditions like pediatric psoriasis have increased patient load at tertiary centers. This protocolized nursing intervention aims to reduce the burden on dermatologists. Objectives: To evaluate the effectiveness of a “Nurse-Led Home Care Package for Children with Psoriasis and Their Caregivers” on selected outcomes among children with psoriasis and their caregivers attending the dermatology outpatient department. Methods: An exploratory sequential mixed-methods design will be adopted. In-depth interviews with children and caregivers will be conducted in the qualitative phase, using purposive sampling to identify challenges and need-based package will be developed. In the quantitative phase, randomization will be done in two groups using block randomization. The experimental group will receive the package in vernacular language using flash book, while the control group will receive usual care. Outcomes: Quality of life of children and caregivers using CDLQI and FDLQI will be measured as the primary outcome. Secondary outcomes include severity of psoriasis, itch intensity, treatment adherence, and psychological profile. Baseline and 8 weeks postintervention assessment will be done with telephonic reinforcement at 1 and 4 weeks. Conclusion: This study will assess the impact of nurse-led, task-sharing care model in improving the quality of life and clinical outcomes among children with psoriasis and their caregivers, supporting decentralization and continuity of care.