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Managing childhood eczema: qualitative study exploring carers' experiences of barriers and facilitators to treatment adherence

Managing childhood eczema: qualitative study exploring carers' experiences of barriers and facilitators to treatment adherence
Managing childhood eczema: qualitative study exploring carers' experiences of barriers and facilitators to treatment adherence
AIM: To explore parents and carers' experiences of barriers and facilitators to treatment adherence in childhood eczema

BACKGROUND: Childhood eczema is common and causes significant impact on quality of life for children and their families, particularly due to sleep disturbance and itch. Non-adherence to application of topical treatments is the main cause of treatment failure.

DESIGN: Qualitative interview study.

METHODS: Qualitative interviews were carried out with 31 carers from 28 families of children with eczema. Participants were recruited through primary care and included if they had a child aged 5 or less with a diagnosis of eczema. Interviews were carried out between December 2010-May 2011. Data were analysed using a constant comparative approach.

FINDINGS: Barriers to treatment adherence included carer beliefs around eczema treatment, the time consuming nature of applying topical treatments, and child resistance to treatment. Families employed a range of strategies in an attempt to work around children's resistance to treatment with varying success. Strategies included involving the child in treatment, distracting the child during treatment, or making a game of it, using rewards, applying treatment to a sleeping child or, in a few cases, physically restraining the child. Some carers reduced frequency of applications in an attempt to reduce child resistance.

CONCLUSIONS: Regular application of topical treatments to children is an onerous task, particularly in families where child resistance develops. Early recognition and discussion of resistance and better awareness of the strategies to overcome this may help carers to respond positively and avoid establishing habitual confrontation.
0309-2402
2493-2501
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Burgess, Hana
c103e930-9676-49d6-bbab-ca29eb7c4222
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Ersser, Steven J.
e04fca2d-1d1b-41df-93f0-510b0e656c96
Lewis-Jones, Sue
8427ec8f-c5de-4c15-8cd0-3dd0e1e4e03a
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Hugh, Catherine
a0909a5a-dabd-4d46-bf28-92599b788e51
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Burgess, Hana
c103e930-9676-49d6-bbab-ca29eb7c4222
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Ersser, Steven J.
e04fca2d-1d1b-41df-93f0-510b0e656c96
Lewis-Jones, Sue
8427ec8f-c5de-4c15-8cd0-3dd0e1e4e03a
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Hugh, Catherine
a0909a5a-dabd-4d46-bf28-92599b788e51
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777

Santer, Miriam, Burgess, Hana, Yardley, Lucy, Ersser, Steven J., Lewis-Jones, Sue, Muller, Ingrid, Hugh, Catherine and Little, Paul (2013) Managing childhood eczema: qualitative study exploring carers' experiences of barriers and facilitators to treatment adherence. Journal of Advanced Nursing, 69 (11), 2493-2501. (doi:10.1111/jan.12133). (PMID:23528163)

Record type: Article

Abstract

AIM: To explore parents and carers' experiences of barriers and facilitators to treatment adherence in childhood eczema

BACKGROUND: Childhood eczema is common and causes significant impact on quality of life for children and their families, particularly due to sleep disturbance and itch. Non-adherence to application of topical treatments is the main cause of treatment failure.

DESIGN: Qualitative interview study.

METHODS: Qualitative interviews were carried out with 31 carers from 28 families of children with eczema. Participants were recruited through primary care and included if they had a child aged 5 or less with a diagnosis of eczema. Interviews were carried out between December 2010-May 2011. Data were analysed using a constant comparative approach.

FINDINGS: Barriers to treatment adherence included carer beliefs around eczema treatment, the time consuming nature of applying topical treatments, and child resistance to treatment. Families employed a range of strategies in an attempt to work around children's resistance to treatment with varying success. Strategies included involving the child in treatment, distracting the child during treatment, or making a game of it, using rewards, applying treatment to a sleeping child or, in a few cases, physically restraining the child. Some carers reduced frequency of applications in an attempt to reduce child resistance.

CONCLUSIONS: Regular application of topical treatments to children is an onerous task, particularly in families where child resistance develops. Early recognition and discussion of resistance and better awareness of the strategies to overcome this may help carers to respond positively and avoid establishing habitual confrontation.

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More information

Published date: 25 March 2013
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 352688
URI: http://eprints.soton.ac.uk/id/eprint/352688
ISSN: 0309-2402
PURE UUID: 8aabbb7e-0dff-4b5d-a348-fc278b51f6f2
ORCID for Miriam Santer: ORCID iD orcid.org/0000-0001-7264-5260
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X
ORCID for Ingrid Muller: ORCID iD orcid.org/0000-0001-9341-6133

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Date deposited: 20 May 2013 11:33
Last modified: 15 Mar 2024 03:33

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Contributors

Author: Miriam Santer ORCID iD
Author: Hana Burgess
Author: Lucy Yardley ORCID iD
Author: Steven J. Ersser
Author: Sue Lewis-Jones
Author: Ingrid Muller ORCID iD
Author: Catherine Hugh
Author: Paul Little

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