Knowledge, instruction and behavioural change: building a framework for effective eczema education in clinical practice

Abstract

AimsA discussion on the reasons educational interventions about eczema, by nurses, are successful, with the subsequent development of a theoretical framework to guide nurses to become effective patient educators.BackgroundEffective child and parent education is the key to successful self-management of eczema. When diagnosed, children and parents should learn to understand the condition through clear explanations, seeing treatment demonstrations and have ongoing support to learn practical skills to control eczema. Dermatology nurses provide these services, but no one has proposed a framework of the concepts underpinning their successful eczema educational interventions.DesignA discussion paper.Data SourcesA literature search of online databases was undertaken utilizing terms ‘eczema OR atopic dermatitis’, ‘education’, ‘parent’, ‘nurs*’, ‘framework’, ‘knowledge’, motivation’, in Scopus, CINAHL, Web of Science, Medline and Pubmed. Limits were English language and 2003–2013.Implications for NursingThe framework can inform discussion on child and parent education, provide a scaffold for future research and guide non-specialist nurses, internationally, in providing consistent patient education about eczema.ConclusionFounded on an understanding of knowledge, the framework utilizes essential elements of cognitive psychology and social cognitive theory leading to successful self-management of eczema. This framework may prove useful as a basis for future research in child and parent education, globally, in the healthcare community. A framework has been created to help nurses understand the essential elements of the learning processes at the foundation of effective child and parent education. The framework serves to explain the improved outcomes reported in previous nurse-led eczema educational interventions.

Knowledge mobilisation: an ethnographic study of the influence of lay mindlines on eczema self-management in primary care in the UK

“…Consistency of care and enduring relationships are key to successful eczema treatment, and for these reasons, nurses with requisite knowledge and skills may be best placed to provide cost-effective ongoing care. 58–60 …”

Extended implementation of educational programs for atopic dermatitis in childhood

“…Quality of life of children with AD and their families is reduced by interrupted sleep, itching skin conditions, and a stigmatizing appearance but also the fear of recurring (super)infections and possible hospitalization . Furthermore, a possible development of coexisting allergic disorders—such as food allergy or, later, asthma—contributes to this great burden ().…”

“…Several theoretical behavior‐change models exist, but only a few strategies have proven effective in supporting and sustaining behavior change in chronically ill patients . The social cognitive theory (social learning theory) assumes that regulating one's health may be mediated through: social modeling (learning from one another), various forms of support, and feedback in combination with the idea ‘that learning occurs best when the learner observes a task or skill, practices it, and refines it, with the mastery providing motivation for potential behavior changes’ . In the last decades, patient education has emerged from initially pure information to a more comprehensive intervention with the goal of empowering the patient with a chronic condition to take responsibility for his life.…”

How nurses and other health professionals use learning principles in parent education practice: A scoping review of the literature

“…Only 44/89 (49%) of the 89 publications included Learning Principles consistent with all five of Marzano et al's Dimensions of Learning [17]. These studies are summarised in Table 3 [33,34,35,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57], [58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77]. Papers that did not include all five dimensions of learning are described in Supplementary 109,110,111,112,…”

“…A number of the authors of publications who did not use Learning Principles aligning with the Dimensions of Learning did not describe parents' decision-making and problem-solving skills development needed for autonomy in their children's care [79,81,84,88,89,92,96,99,100,104,115,121]. Only 4/89 (4.5%) publications made clear distinctions between factual (declarative) knowledge and practical (procedural) knowledge [75,76,79,104]. Only Thompson and Thompson [75], Thompson [76] and Archibald et al [79] explained why this distinction was important for HPs to facilitate parents' knowledge, motivation and skill development.…”