Patients' perspectives on quality of care for chronic hand eczema: A qualitative study

Abstract

Background Hand eczema (HE) has a significant impact on patients’ quality of life and work‐related activities. However, little is known about the patients' perspectives on quality of care for HE. Objectives To evaluate the patient perspective of the HE care process in a tertiary referral center. Methods Qualitative, semi‐structured focus groups were carried out, recorded, transcribed, and analysed using an inductive‐deductive thematic approach. Results Fifteen patients participated in four focus groups. Time and attention, together with being listened to and understood by the health care professional, were the most important aspects of care for HE mentioned by participants. Other aspects of care that were regarded as important were that diagnoses, causes and follow‐up of HE were not always clear to the participant; more psychosocial support was needed, and that participants experienced frequent changes in doctors. Information provided by nurses was valuable, but more individualized advice was needed. Conclusions To better meet the needs of patients, more explanation should be given about the causes of HE and the final diagnosis. Besides focusing on the treatment, it is also important to focus on its impact on the patient and options for psychosocial and peer support should be discussed. Furthermore, the beneficial role of the specialized nurse as part of integrated care was emphasized.

Chronic hand eczema in Europe: Patient experiences and perspectives (CHEPEP) in qualitative interviews

“…Like previously interviewed patients with occupational skin disease, 8 our participants might be forced to face retraining or unemployment and could therefore be worried about their occupational future. We confirmed that CHE impaired emotional well‐being 2,5,6,8–10,20 and daily activities 5,6,9,11 . In contrast to Danish CHE patients, 9 CHEPEP participants did not describe themselves as indolent due to these restrictions.…”

“…As previously reported, our participants were concerned about the safety of treatments, 6 in particular corticosteroids, 6,11 and relapses after treatment. 6,11 However, they were open to treatment recommendations.…”

“…As previously reported, our participants were concerned about the safety of treatments, 6 in particular corticosteroids, 6,11 and relapses after treatment. 6,11 However, they were open to treatment recommendations. Barriers towards certain therapies were rather self-evident: adverse effects, poor effectiveness, time requirements or limited availability.…”

“…To address barriers in practice, it has been recommended (along with further suggestions 5,6,8,9,11,20 ) that treatment teams acknowledge the difference between theory and practice 11 and assist patients in developing new habits (as 'shortcuts to the brain') in accordance with patient preferences. 9 Recommendations are required on how to address the specific barriers that patients have identified (Figure 3).…”

Publication Trends of Qualitative Research in Dermatology

“…Figure 1 shows the PRISMA flow diagram of the selection criteria. A total of 1398 studies were screened, and 249 studies (17.8%) were ultimately included in the database …”