Views and experiences of managing eczema : systematic review and thematic synthesis of qualitative studies

Teasdale, E; Ghio, D; Muller, I; Sivyer, K; Greenwell, K; Wilczynska, S; Roberts, A; Ridd, MJ; Francis, N; Yardley, L; Thomas, KS; Santer, M

Abstract

Background
The number of qualitative studies on eczema has increased rapidly in recent years. Systematically reviewing these can provide greater understandings of people’s perceptions of eczema and eczema treatments.

Objectives
We sought to systematically review and thematically synthesise qualitative studies exploring views and experiences of people with eczema and parents/carers of children with eczema.

Methods
We searched MEDLINE, PsycINFO, CINAHL and EMBASE from the earliest date available to February 2019. We selected papers focusing on views and experiences of eczema, eczema treatments, and barriers/facilitators to eczema self‐management. We excluded papers focusing on health service provision models or health professionals’ views.

Results
We synthesised 39 papers (reporting 32 studies) from 13 countries. We developed four analytical themes: 1) Eczema not viewed as long‐term condition, 2) Significant psychosocial impact not acknowledged by others, 3) Hesitancy (patient/carer uncertainty) about eczema treatments and 4) Insufficient information and advice. Our findings suggest people with eczema and their carers experience frustration at having to manage a condition that is often seen by others as mundane but has significant psychosocial impact and is difficult to manage due to concerns about, and burden of, treatment. This frustration can be exacerbated by experiences of conflicting and/or insufficient information and advice from health professionals, family and others.

Conclusions
Effective self‐management of eczema could be supported by addressing beliefs and concerns about treatments; seeking positive ways to promote a ‘control not cure’ message; acknowledging psychosocial impacts of eczema and treatment burden; and providing clear consistent advice or signposting towards reliable information.

• Journal Article Type: Article
• Acceptance Date: Jun 3, 2020
• Online Publication Date: Jun 12, 2020
• Publication Date: Apr 9, 2021
• Deposit Date: Jul 10, 2020
• Publicly Available Date: Aug 18, 2020
• Journal: British Journal Of Dermatology
• Print ISSN: 0007-0963
• Electronic ISSN: 1365-2133
• Publisher: Wiley
• Volume: 184
• Issue: 4
• Pages: 627-637
• DOI: https://doi.org/10.1111/bjd.19299
• Publisher URL: https://doi.org/10.1111/bjd.19299
• Related Public URLs: http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2133
• Additional Information: Projects : Eczema care online; Grant Number: RP-PG-0216- 20007; Grant Number: PDF-2014-07-013