Structured education program improves the coping with atopic dermatitis in children and their parents—a multicenter, randomized controlled trial

Kupfer, J.; Gieler, Uwe; Diepgen, Thomas L.; Fartasch, Manigé; Lob-Corzilius, Thomas; Ring, Johannes; Scheewe, S.; Scheidt, Reginald; Schnopp, Christina; Szczepanski, R.; Staab, Doris; Werfel, Thomas; Wittenmeier, Marita; Wahn, Ulrich; Schmid-Ott, ­Gerhard

doi:10.1016/j.jpsychores.2009.04.014

Cited by 83 publications

(99 citation statements)

References 24 publications

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“…34 Further, a recent review of coping skills training programs for diabetes found that such programs are effective means of improving health outcomes. 35 Overall, it appears there is value to coping-focused interventions, but they ought to be directed at patient's individual deficits.…”

Section: Discussionmentioning

confidence: 99%

Coping and social problem solving correlates of asthma control and quality of life

McCormick

Nezu

et al. 2014

Chron Respir Dis

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In a sample of adults with asthma receiving care and medication in an outpatient pulmonary clinic, this study tested for statistical associations between social problem-solving styles, asthma control, and asthma-related quality of life. These variables were measured cross sectionally as a first step toward more systematic application of social problem-solving frameworks in asthma self-management training. Recruitment occurred during pulmonology clinic service hours. Forty-four adults with physician-confirmed diagnosis of asthma provided data including age, gender, height, weight, race, income, and comorbid conditions. The Asthma Control Questionnaire, the Mini Asthma Quality of Life Questionnaire (Short Form), and peak expiratory force measures offered multiple views of asthma health at the time of the study. Maladaptive coping (impulsive and careless problemsolving styles) based on transactional stress models of health were assessed with the Social Problem-Solving Inventory-Revised: Short Form. Controlling for variance associated with gender, age, and income, individuals reporting higher impulsive-careless scores exhibited significantly lower scores on asthma control (b ¼ 0.70, p ¼ 0.001, confidence interval (CI) [0.37-1.04]) and lower asthma-related quality of life (b ¼ 0.79, p ¼ 0.017,). These findings suggest that specific maladaptive problem-solving styles may uniquely contribute to asthma health burdens. Because problem-solving coping strategies are both measureable and teachable, behavioral interventions aimed at facilitating adaptive coping and problem solving could positively affect patient's asthma management and quality of life.

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Section: Discussionmentioning

confidence: 99%

Coping and social problem solving correlates of asthma control and quality of life

McCormick

Nezu

et al. 2014

Chron Respir Dis

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“…In previous studies, interventions including elements of cognitive behavioural therapy were shown to alter itch-related cognitions and/or the itch intensity in patients with chronic itch (24)(25)(26). Furthermore, education programmes for AD children and their parents including a session on itch/scratching caused an increase in functional itch-related cognitions and behaviours (27,28). Even though this study included more females than males and the median itch intensity was rather low in the sample, its findings still underline the relevance of especially cognitive restructuring as a treatment strategy for patients with chronic itch.…”

Section: Discussionmentioning

confidence: 79%

Coping as mediator of the relationship between stress and itch in patients with atopic dermatitis: a regression and mediation analysis

Schut

Weik

Tews

et al. 2014

Experimental Dermatology

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Even though it has been shown that stress and itch are associated in patients with atopic dermatitis (AD), it remains unclear whether this relationship occurs due to certain coping strategies being activated under stress. Therefore, this study investigates the role of coping as possible mediating factor between stress and itch in 31 patients with AD. Coping and itch were assessed by self-reported measures, while stress was measured both by a validated questionnaire and by a physiological stress marker, the postawakening cortisol. Using a regression and a mediation analysis, this study showed a relationship between perceived stress and itch (corrected R 2 = 0.21), which was fully mediated by negative itch-related cognitions. 62.3% of the variance of itch intensity could be explained by negative itchrelated cognitions. This finding helps to explain the positive effects of cognitive restructuring in the treatment of chronic itch.Key words: atopic dermatitis -coping -itch -postawakening cortisolstress Accepted for publication 28 October 2014Background Atopic dermatitis is a chronically relapsing skin disease characterized by pruritus, lichenification at certain body sites and other atopic diseases in the patient or his family (1). In most of the patients, itch occurs daily (2,3). Stress is proposed to have an impact on the itch intensity (4). Some studies have shown a link between stress and the AD severity (e.g. 5-8), but only one study has specifically shown a relationship between itch and stress in this patient group (9).Coping can be defined as adaptable thoughts and behaviours intended to manage subjective demanding experiences (10). Some authors found that depressive mood/social anxiety, negative itchrelated cognitions and catastrophization are associated with itch in patients with chronic itch (11,12), but whether the effect of stress on itch is mediated by this kind of coping remains unclear thus far. Question addressedThis study investigates whether the relationship between stress and itch in patients with AD is mediated by coping. Experimental designThe data were collected in the context of a greater research project on the effects of stress management in AD (13). Thirty one patients with AD came for two appointments. During the first appointment, patients gave their informed written consent and were instructed on how to collect saliva in the morning on two consecutive days. During the second appointment, perceived stress, coping and itch were assessed. This appointment took place on the second day of saliva collection. VariablesThe criterion variable, 'itch intensity', was determined using a visual analogue scale (0-10) in the context of assessing the severity of AD [SCORAD (14)].The predictor variable, 'perceived stress', was measured by the Recovery-Stress Questionnaire [REST-Q; short version (15)]. The stress items of the REST-Q were aggregated to 'overall strain'. Postawakening cortisol as a physiological marker of chronic stress (e.g. 16,17) was assessed as further predictor. Patients colle...

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“…Moreover, in parents of children aged G7 years, all quality-of-life subscale scores were significantly ameliorated, and in parents of children aged 8-12 years, a significant improvement in 3 out of 5 subscales was observable as well. Furthermore, a greater improvement in children's coping behavior and in parents' handling of their children was observable [19]. Quality of life in children (aged 8-12 years) and adolescents (aged 13-18 years) showed a significant negative correlation with itch intensity [20].…”

Section: Educational Training Programs For Children (Or Their Parentsmentioning

confidence: 99%

Therapeutic Patient Education

Heratizadeh

2014

Curr Treat Options Allergy

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Opinion statementPatient education in atopic dermatitis (AD) represents an essential therapeutic tool, which should be offered in addition to routine care, since previous studies have revealed that AD outpatients are often insufficiently treated and show severe limitations of quality of life. Considering the multifactorial pathogenesis of this chronic skin disease, the success of therapeutic patient education seems to depend on the involvement of a multidisciplinary team of professionals. The training program should include aspects on dermatology and allergy, but also on diet and nursing, as well as on disease-specific psychological issues. Synergistic beneficial effects upon interaction between affected patients or parents should be considered by performing the training in small groups. The overall aim of therapeutic patient education in AD should be an improvement of selfmanagement strategies to finally achieve a decrease in disease severity and an increase in quality of life. For children (and their parents) and adolescents with AD, successful programs have already been developed. However, in many countries, there is still a need for official recommendations in order to regulate reimbursement for the costs of such programs. Since the preliminary results from pilot studies in adults have been promising, further large controlled trials on patient education in this age group are needed to finally improve outpatient care also in adulthood AD.

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Structured education program improves the coping with atopic dermatitis in children and their parents—a multicenter, randomized controlled trial

Cited by 83 publications

References 24 publications

Coping and social problem solving correlates of asthma control and quality of life

Coping and social problem solving correlates of asthma control and quality of life

Coping as mediator of the relationship between stress and itch in patients with atopic dermatitis: a regression and mediation analysis

Therapeutic Patient Education

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