Supporting families managing childhood eczema: developing and optimising eczema care online using qualitative research
BRITISH JOURNAL OF GENERAL PRACTICE(2022)
摘要
Background Childhood eczema is often poorly controlled owing to underuse of emollients and topical corticosteroids (TCS). Parents/carers report practical and psychosocial barriers to managing their child's eczema, including child resistance. Online interventions could potentially support parents/carers; however, rigorous research developing such interventions has been limited. Aim To develop an online behavioural intervention to help parents/carers manage and co-manage their child's eczema. Design and setting Intervention development using a theory-, evidence-, and person-based approach (PBA) with qualitative research. Method A systematic review and qualitative synthesis of studies (n = 32) and interviews with parents/carers (n = 30) were used to identify barriers and facilitators to effective eczema management, and a prototype intervention was developed. Think-aloud interviews with parents/ carers (n = 25) were then used to optimise the intervention to increase its acceptability and feasibility. Results Qualitative research identified that parents/ carers had concerns about using emollients and TCS, incomplete knowledge and skills around managing eczema, and reluctance to transitioning to co-managing eczema with their child. Think-aloud interviews highlighted that, while experienced parents/carers felt they knew how to manage eczema, some information about how to use treatments was still new. Techniques for addressing barriers included providing a rationale explaining how emollients and TCS work, demonstrating how to use treatments, and highlighting that the intervention provided new, up-to-date information. Conclusion Parents/carers need support in effectively managing and co-managing their child's eczema. The key output of this research is Eczema Care Online for Families, an online intervention for parents/carers of children with eczema, which is being evaluated in a randomised trial.
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关键词
atopic eczema,caregivers,family practice,internet-based intervention,paediatric dermatology,qualitative research
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