Illness perceptions of occupational hand eczema in German patients based on the common-sense model of self-regulation: A qualitative study

Abstract

Background Occupational skin diseases (OSD) in the form of hand eczema (HE) are a common work-related disease. Illness perceptions as presented in Leventhal’s Common-Sense Model (CSM) are important for patients’ self-management of diseases. Understanding these illness perceptions is essential for patient communicating. No quantitative or qualitative studies which investigated subjective illness perceptions in patients with occupational HE utilized the CSM as theoretical framework. The Objective of this study is to investigate illness perceptions of patients with occupational hand eczema (HE) using the CSM. Methods We applied an exploratory qualitative approach and conducted purposive sampling. Thirty-six patients with occupational HE were interviewed using an interview guide based on the dimensions of the CSM, including coherence and emotional representation. All participants participated in a three-week inpatient program at a clinic specialized on occupational dermatology. One interview had to be excluded before analysis, since one participant’s diagnosis was retrospectively changed from ICD to tinea and hence did not match the inclusion criteria. Thirty-five interviews were transcribed verbatim and analyzed. Data was analyzed deductively and inductively using qualitative text analysis. MAXQDA 2018 (Verbi, Berlin, Germany), a software for qualitative data analysis, was applied for coding and summarizing of results. All dimensions of the CSM were explored for occupational HE. Results Several sub-categories could be identified. Participants named a variety of causes in different areas (e. g. external irritants and other hazardous factors, psycho-social factors, allergies, having a ‘bad immune system’ or lifestyle). The great impact of the disease on the participants’ life is shown by the wide range of consequences reported, affecting all areas of life (i. e. psychological, physical, occupational, private). Considering coherence, an ambivalence between comprehensibility and non-comprehensibility of the disease is apparent. Discussion The complexity of illness perceptions presented in this paper is relevant for those involved in HE patient education and counseling, e. g, health educators, dermatologists, and, occupational physicians. Future research might further investigate specific aspects of illness perceptions in patients with occupational HE, especially considering the complexity of coherence and overlapping dimensions (i. e. emotional representation and psychological consequences).

Work-Related Hand Eczema in Healthcare Workers: Etiopathogenic Factors, Clinical Features, and Skin Care

“…Allergic contact dermatitis occurs due to skin contact with an allergen to which the person is sensitized and a subsequent T-cell-mediated response (type 4 hypersensitivity reaction) [35][36][37]. The initial severity of the condition plays a crucial role in determining its duration and the effectiveness of treatment and ultimately affects the patient's overall well-being.…”

“…Healthcare workers are among the groups with an increased risk of developing contact dermatitis due to constant exposure to allergens and irritants [43]. Work-related hand eczema predominantly presents as contact dermatitis, primarily in the form of irritant contact dermatitis, due to the constant exposure of the skin of the hands to irritants [37] (Figure 2). It can manifest clinically as an acute or chronic disease.…”