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O'Reilly P, Whelan B, Ramsay B, Kennedy C, Meskell P, Coffey A, Wilson DM, Fortune DG, Ryan S. Patients', family members' and healthcare practitioners' experiences of Stevens-Johnson syndrome and toxic epidermal necrolysis: a qualitative descriptive study using emotional touchpoints. J Eur Acad Dermatol Venereol 2020; 35:e232-e234. [PMID: 32977354 PMCID: PMC7984232 DOI: 10.1111/jdv.16958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/10/2020] [Accepted: 09/14/2020] [Indexed: 11/26/2022]
Affiliation(s)
- P O'Reilly
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland.,Health Implementation Science and Technology (HIST) Research Cluster, University of Limerick, Limerick, Ireland
| | - B Whelan
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - B Ramsay
- Charles Centre for Dermatology, University Hospital Limerick, ULHG, Limerick, Ireland
| | - C Kennedy
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.,School of Nursing and Midwifery, Robert Gordon University, Aberdeen, UK
| | - P Meskell
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - A Coffey
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland.,Health Implementation Science and Technology (HIST) Research Cluster, University of Limerick, Limerick, Ireland
| | - D M Wilson
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.,Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - D G Fortune
- Health Research Institute, University of Limerick, Limerick, Ireland.,Department of Psychology, University of Limerick, Limerick, Ireland
| | - S Ryan
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.,Charles Centre for Dermatology, University Hospital Limerick, ULHG, Limerick, Ireland
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O'Reilly P, Kennedy C, Meskell P, Coffey A, Delaunois I, Dore L, Howard S, Ramsay B, Scanlon C, Wilson DM, Whelan B, Ryan S. The psychological impact of Stevens-Johnson syndrome and toxic epidermal necrolysis on patients' lives: a Critically Appraised Topic. Br J Dermatol 2020; 183:452-461. [PMID: 31792924 PMCID: PMC7687230 DOI: 10.1111/bjd.18746] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2019] [Indexed: 12/11/2022]
Abstract
CLINICAL SCENARIO A 65-year-old man presented with a 12-h history of deteriorating rash. Two weeks previously he had completed a course of neoadjuvant chemotherapy for ductal carcinoma of the breast. On examination there were bullae, widespread atypical targetoid lesions and 15% epidermal detachment. There was no mucosal involvement on presentation, but subsequently it did evolve. Skin biopsy showed subepidermal blistering with epidermal necrosis. This confirmed our clinical diagnosis of overlap Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). On transfer to intensive care he was anxious and fearful. MANAGEMENT QUESTION What are the psychological impacts of SJS/TEN on this man's life? BACKGROUND SJS and TEN have devastating outcomes for those affected. OBJECTIVES To conduct a Critically Appraised Topic to (i) analyse existing research related to the psychological impact of SJS and TEN and (ii) apply the results to the clinical scenario. METHODS Seven electronic databases were searched for publications focusing on the psychological impact of SJS/TEN on adults over 18 years of age. RESULTS Six studies met the inclusion criteria. Healthcare practitioners' (HCPs') lack of information around the disorder was highlighted. Patients experienced undue stress and fear. Some patients had symptoms aligned to post-traumatic stress disorder (PTSD), anxiety and depression. DISCUSSION AND RECOMMENDATION The evidence suggests that SJS and TEN impact psychologically on patients' lives. Education of HCPs, to address their lack of awareness and information on SJS/TEN, should facilitate their capacity to provide information and support to patients, thereby reducing patient anxiety. On discharge, a follow-up appointment with relevant HCPs to reduce the possibility of PTSD occurring should be considered.
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Affiliation(s)
- P O'Reilly
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland.,Health Implementation Science and Technology (HIST) Research Cluster, University of Limerick, Limerick, Ireland
| | - C Kennedy
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.,School of Nursing and Midwifery, Robert Gordon University, Aberdeen, U.K
| | - P Meskell
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - A Coffey
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland.,Health Implementation Science and Technology (HIST) Research Cluster, University of Limerick, Limerick, Ireland
| | - I Delaunois
- Regional Medical Library, University Hospital Limerick, Limerick, Ireland
| | - L Dore
- Glucksman Library, University of Limerick, Limerick, Ireland
| | - S Howard
- Health Research Institute, University of Limerick, Limerick, Ireland.,Department of Psychology, University of Limerick, Limerick, Ireland
| | - B Ramsay
- Charles Centre for Dermatology, University Hospital Limerick, Limerick, Ireland
| | | | - D M Wilson
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.,Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - B Whelan
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - S Ryan
- Charles Centre for Dermatology, University Hospital Limerick, Limerick, Ireland
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