A self-report questionnaire to detect hand dermatitis in nurses

Parsons, V., Williams, H.C., English, J., Llewellyn, J., Ntani, G. and Madan, I. (2020) A self-report questionnaire to detect hand dermatitis in nurses. Occupational Medicine, 70 (9), 645-648. (doi:10.1093/occmed/kqaa188).

Abstract

Background
Hand dermatitis is highly prevalent among nurses due to their frequent exposure to wet work. Providing cost-effective dermatological health surveillance for this occupational group presents a challenge to health service providers.

Aims
To ascertain the predictive value of nurses’ self-assessment of whether they had current hand dermatitis using a screening questionnaire when compared with the assessment made by a dermatologist of the nurses’ hand photographs.

Methods
We conducted a cross-sectional study comparing the self-report decision made by student and intensive care nurses using a single hand dermatitis screening question with the clinical assessment of their hand photographs made by dermatologists using a standardized photographic guide.

Results
We analysed data collected at study baseline (n = 1599). The results showed that the screening question had a high negative predictive value (91%; 95% CI 89–93), but a low positive predictive value (39%; 95% CI 34–45). It demonstrated acceptable accuracy in distinguishing those with and without the disease (area under the receiver operator curve = 0.7) and had a high specificity (86%; 95% CI 84–88) but a sensitivity of only 52% (95% CI 46–59) in identifying hand dermatitis.

Conclusions
We found that nurses were able to accurately self-assess themselves as not having any signs of hand dermatitis. By contrast, they were less able to accurately self-assess positive cases suggesting under-recognition of early disease. We propose that a questionnaire containing a single hand dermatitis screening question should be considered as a tool for screening out clear cases as part of a workplace health surveillance programme for detecting hand dermatitis.

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