When looks get in the way: optimising patient outcomes  through the training of health care professionals

Body image dissatisfaction, resulting from disfigurement or the consequence of perceived social pressure to conform to unrealistic and narrow beauty ideals, indiscriminately affects the mental and physical health of a significant and growing proportion of the European population. Those with disfigurement also experience social discrimination that negatively impacts on personal aspirations, education and work opportunities. As medical advances improve the survival rates of those born with or who acquire a disfigurement, and the demand for cosmetic interventions and psychological support increases, professionals from diverse health and social care areas are increasingly being exposed to the challenges of identifying and addressing the needs of patients burdened by complex and unique psychosocial issues. These professionals are perfectly placed to ameliorate these issues but report that they often lack the necessary expertise to help and therefore patient access to expert support is inadequate.

An EU funded collaboration between Universities and NGO’s across six European countries is developing an academic programme for health professionals from a variety of specialist areas, which will provide training to enable them to identify and support patients with appearance-related issues and thus optimise patient outcomes.

A consortium led by the Centre for Appearance Research in the UK with university partners in Italy, Lithuania, Sweden and Turkey, together with the European Cleft Organisation (NGO) in The Netherlands (who have collaborations with health professionals and patients in various healthcare settings) will execute an innovative project to design, test and implement a multi-modal, evidence-based course, that will be used in higher education. It will have extensive and culturally specific materials to enable health and social care trainees and qualified professionals identify and manage patients and clients affected by disfigurement and body image concerns. The need for action in this area is further validated by the current COST action IS1210 of which most partners are members, that highlights the negative psychosocial impact of appearance concerns and the importance of these issues within health settings.

Partners will form strategic regional working groups and will be allocated tasks to suit their strengths and expertise. University partners will survey at least 100 multidisciplinary health professionals in each partner country to determine the current state of training for health professionals involved in the care of people with any disfigurement, their awareness and understanding of the issues facing those affected, their confidence in supporting patients with appearance-related concerns, their training needs and views on the best way to deliver and promote educational materials. The European Cleft Organization will also produce a European report on health professionals' current awareness of appearance issues and training needs. Reports from each partner will inform the development of multilingual material for a six module course that will adhere to the European Quality Framework. This will provide education on the psychology of body image and disfigurement, risk factors for body image dissatisfaction and its psychosocial and health impact across the lifespan, the impact of disfigurement for the individual and family, the development of skills to the promote positive body image, assess and meet the needs of people with disfigurement and skills to manage professional issues related to instigating and sharing best practice around this subject. Materials and their mode of delivery will be pilot tested in each country by potential users and reviewed by the NGO and if necessary adapted further. A course handbook providing guidance to course administrators and course website with down-loadable multilingual materials will be developed and the course will be widely advertised using the many contacts and networks provided by the partners. National exploitation multiplier events in each country and via the COST action will ensure dissemination to hundreds of multidisciplinary health professionals from a minimum of 30 countries and 50 relevant organisations.

In the short term this project will provide a unique, cost-effective, widely available and internationally transferable course, informed by a UK partner with extensive expertise in the field that addresses educational and skill deficits identified by multidisciplinary health professionals across the UK and EU. It is expected this expertise will improve health care provision for people affected by disfigurement and more general body image dissatisfaction, which in the longer term has the potential to improve associated physical and mental health-related outcomes. It will also challenge poorly informed attitudes that can lead to discrimination, by raising awareness of these issues to health professionals and contributing to a social dialogue about stigmatisation and the social exclusion of individuals/families with disfiguring conditions and appearance-related concerns.