1
|
Health Promotion Model-Based Skin Health Program to Improve Skin Health Behaviors, Quality of Life, and Self-Efficacy and Reduce Eczema Symptoms in Hairdresser Apprentices. JOURNAL OF THE DERMATOLOGY NURSES' ASSOCIATION 2023. [DOI: 10.1097/jdn.0000000000000716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
2
|
Heijkants CH, van Hooff MLM, Geurts SAE, Boot CRL. A team level participatory approach aimed at improving sustainable employability of long-term care workers: a study protocol of a randomised controlled trial. BMC Public Health 2022; 22:984. [PMID: 35578213 PMCID: PMC9109341 DOI: 10.1186/s12889-022-13312-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/27/2022] [Indexed: 11/25/2022] Open
Abstract
Background Staff currently working in long-term care experience several difficulties. Shortage of staff and poor working conditions are amongst the most prominent, which pose a threat to staff’s sustainable employability. To improve their sustainable employability it is important to create working conditions that fulfil workers’ basic psychological need for autonomy, relatedness and competence in line with Self-Determination Theory. Since many long-term care organisations work with self-managing teams, challenges exist at team level. Therefore, there is a need to implement an intervention aimed at maintaining and improving the sustainable employability of staff on team level. Methods We developed a participatory workplace intervention, the Healthy Working Approach. In this intervention teams will uncover what problems they face related to autonomy, relatedness and competence in their team, come up with solutions for those problems and evaluate the effects of these solutions. We will evaluate this intervention by means of a two-arm randomized controlled trial with a follow-up of one year. One arm includes the intervention group and one includes the waitlist control group, each consisting of about 100 participants. The primary outcome is need for recovery as proxy for sustainable employability. Intervention effects will be analysed by linear mixed model analyses. A process evaluation with key figures will provide insight into barriers and facilitators of the intervention implementation. The Ethical Committee Social Sciences of the Radboud University approved the study. Discussion This study will provide insight in both the effectiveness, and the barriers/facilitators of the implementation process of the Healthy Working Approach. The approach is co-created with long-term care workers, focuses on team-specific challenges, and is rooted in the evidence-based participatory workplace approach and Self-Determination Theory. First results are expected in 2022. Trial registration Netherlands Trial Register, NL9627. Registered 29 July 2021 - Retrospectively registered.
Collapse
Affiliation(s)
- Ceciel H Heijkants
- Radboud University, Behavioural Science Institute, Thomas van Aquinostraat 4, Nijmegen, 6525GD, The Netherlands.
| | - Madelon L M van Hooff
- Radboud University, Behavioural Science Institute, Thomas van Aquinostraat 4, Nijmegen, 6525GD, The Netherlands
| | - Sabine A E Geurts
- Radboud University, Behavioural Science Institute, Thomas van Aquinostraat 4, Nijmegen, 6525GD, The Netherlands
| | - Cécile R L Boot
- Radboud University, Behavioural Science Institute, Thomas van Aquinostraat 4, Nijmegen, 6525GD, The Netherlands
| |
Collapse
|
3
|
Shepherd HL, Geerligs L, Butow P, Masya L, Shaw J, Price M, Dhillon HM, Hack TF, Girgis A, Luckett T, Lovell M, Kelly B, Beale P, Grimison P, Shaw T, Viney R, Rankin NM. The Elusive Search for Success: Defining and Measuring Implementation Outcomes in a Real-World Hospital Trial. Front Public Health 2019; 7:293. [PMID: 31681724 PMCID: PMC6813570 DOI: 10.3389/fpubh.2019.00293] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 09/27/2019] [Indexed: 11/13/2022] Open
Abstract
Objective and Study Setting: Research efforts to identify factors that influence successful implementation are growing. This paper describes methods of defining and measuring outcomes of implementation success, using a cluster randomized controlled trial with 12 cancer services in Australia comparing the effectiveness of implementation strategies to support adherence to the Australian Clinical Pathway for the Screening, Assessment and Management of Anxiety and Depression in Adult Cancer Patients (ADAPT CP). Study Design and Methods: Using the StaRI guidelines, a process evaluation was planned to explore participant experience of the ADAPT CP, resources and implementation strategies according to the Implementation Outcomes Framework. This study focused on identifying measurable outcome criteria, prior to data collection for the trial, which is currently in progress. Principal Findings: We translated each implementation outcome into clearly defined and measurable criteria, noting whether each addressed the ADAPT CP, resources or implementation strategies, or a combination of the three. A consensus process defined measures for the primary outcome (adherence) and secondary (implementation) outcomes; this process included literature review, discussion and clear measurement parameters. Based on our experience, we present an approach that could be used as a guide for other researchers and clinicians seeking to define success in their work. Conclusions: Defining and operationalizing success in real-world implementation yields a range of methodological challenges and complexities that may be overcome by iterative review and engagement with end users. A clear understanding of how outcomes are defined and measured, based on a strong theoretical framework, is crucial to meaningful measurement and outcomes. The conceptual approach described in this article could be generalized for use in other studies. Trial Registration: The ADAPT Program to support the management of anxiety and depression in adult cancer patients: a cluster randomized trial to evaluate different implementation strategies of the Clinical Pathway for Screening, Assessment and Management of Anxiety and Depression in Adult Cancer Patients was prospectively registered with the Australian New Zealand Clinical Trials Registry Registration Number: ACTRN12617000411347.
Collapse
Affiliation(s)
- Heather L Shepherd
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, Sydney, NSW, Australia
| | - Liesbeth Geerligs
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
| | - Phyllis Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, Sydney, NSW, Australia
| | - Lindy Masya
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
| | - Joanne Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
| | - Melanie Price
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, Sydney, NSW, Australia
| | - Thomas F Hack
- Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, Canada.,Psychosocial Oncology & Cancer Nursing Research, St. Boniface Hospital Research Centre, Winnipeg, MB, Canada
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Tim Luckett
- Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Melanie Lovell
- HammondCare Northern Sydney, Greenwich, NSW, Australia.,Northern Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Brian Kelly
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Philip Beale
- Cancer Services for the Sydney Local Health District (Incorporating Royal Prince Alfred, Concord and Canterbury Hospitals), Sydney, NSW, Australia
| | - Peter Grimison
- Chris O'Brien Lifehouse, Camperdown, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Tim Shaw
- Charles Perkins Centre, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, UTS Business School, University of Technology Sydney, Sydney, NSW, Australia
| | - Nicole M Rankin
- Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
4
|
Bauer A, Rönsch H, Elsner P, Dittmar D, Bennett C, Schuttelaar MA, Lukács J, John SM, Williams HC. Interventions for preventing occupational irritant hand dermatitis. Cochrane Database Syst Rev 2018; 4:CD004414. [PMID: 29708265 PMCID: PMC6494486 DOI: 10.1002/14651858.cd004414.pub3] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Occupational irritant hand dermatitis (OIHD) causes significant functional impairment, disruption of work, and discomfort in the working population. Different preventive measures such as protective gloves, barrier creams and moisturisers can be used, but it is not clear how effective these are. This is an update of a Cochrane review which was previously published in 2010. OBJECTIVES To assess the effects of primary preventive interventions and strategies (physical and behavioural) for preventing OIHD in healthy people (who have no hand dermatitis) who work in occupations where the skin is at risk of damage due to contact with water, detergents, chemicals or other irritants, or from wearing gloves. SEARCH METHODS We updated our searches of the following databases to January 2018: the Cochrane Skin Specialised Register, CENTRAL, MEDLlNE, and Embase. We also searched five trials registers and checked the bibliographies of included studies for further references to relevant trials. We handsearched two sets of conference proceedings. SELECTION CRITERIA We included parallel and cross-over randomised controlled trials (RCTs) which examined the effectiveness of barrier creams, moisturisers, gloves, or educational interventions compared to no intervention for the primary prevention of OIHD under field conditions. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by Cochrane. The primary outcomes were signs and symptoms of OIHD developed during the trials, and the frequency of treatment discontinuation due to adverse effects. MAIN RESULTS We included nine RCTs involving 2888 participants without occupational irritant hand dermatitis (OIHD) at baseline. Six studies, including 1533 participants, investigated the effects of barrier creams, moisturisers, or both. Three studies, including 1355 participants, assessed the effectiveness of skin protection education on the prevention of OIHD. No studies were eligible that investigated the effects of protective gloves. Among each type of intervention, there was heterogeneity concerning the criteria for assessing signs and symptoms of OIHD, the products, and the occupations. Selection bias, performance bias, and reporting bias were generally unclear across all studies. The risk of detection bias was low in five studies and high in one study. The risk of other biases was low in four studies and high in two studies.The eligible trials involved a variety of participants, including: metal workers exposed to cutting fluids, dye and print factory workers, gut cleaners in swine slaughterhouses, cleaners and kitchen workers, nurse apprentices, hospital employees handling irritants, and hairdressing apprentices. All studies were undertaken at the respective work places. Study duration ranged from four weeks to three years. The participants' ages ranged from 16 to 67 years.Meta-analyses for barrier creams, moisturisers, a combination of both barrier creams and moisturisers, or skin protection education showed imprecise effects favouring the intervention. Twenty-nine per cent of participants who applied barrier creams developed signs of OIHD, compared to 33% of the controls, so the risk may be slightly reduced with this measure (risk ratio (RR) 0.87, 95% confidence interval (CI) 0.72 to 1.06; 999 participants; 4 studies; low-quality evidence). However, this risk reduction may not be clinically important. There may be a clinically important protective effect with the use of moisturisers: in the intervention groups, 13% of participants developed symptoms of OIHD compared to 19% of the controls (RR 0.71, 95% CI 0.46 to 1.09; 507 participants; 3 studies; low-quality evidence). Likewise, there may be a clinically important protective effect from using a combination of barrier creams and moisturisers: 8% of participants in the intervention group developed signs of OIHD, compared to 13% of the controls (RR 0.68, 95% CI 0.33 to 1.42; 474 participants; 2 studies; low-quality evidence). We are uncertain whether skin protection education reduces the risk of developing signs of OIHD (RR 0.76, 95% CI 0.54 to 1.08; 1355 participants; 3 studies; very low-quality evidence). Twenty-one per cent of participants who received skin protection education developed signs of OIHD, compared to 28% of the controls.None of the studies addressed the frequency of treatment discontinuation due to adverse effects of the products directly. However, in three studies of barrier creams, the reasons for withdrawal from the studies were unrelated to adverse effects. Likewise, in one study of moisturisers plus barrier creams, and in one study of skin protection education, reasons for dropout were unrelated to adverse effects. The remaining studies (one to two in each comparison) reported dropouts without stating how many of them may have been due to adverse reactions to the interventions. We judged the quality of this evidence as moderate, due to the indirectness of the results. The investigated interventions to prevent OIHD probably cause few or no serious adverse effects. AUTHORS' CONCLUSIONS Moisturisers used alone or in combination with barrier creams may result in a clinically important protective effect, either in the long- or short-term, for the primary prevention of OIHD. Barrier creams alone may have slight protective effect, but this does not appear to be clinically important. The results for all of these comparisons were imprecise, and the low quality of the evidence means that our confidence in the effect estimates is limited. For skin protection education, the results varied substantially across the trials, the effect was imprecise, and the pooled risk reduction was not large enough to be clinically important. The very low quality of the evidence means that we are unsure as to whether skin protection education reduces the risk of developing OIHD. The interventions probably cause few or no serious adverse effects.We conclude that at present there is insufficient evidence to confidently assess the effectiveness of interventions used in the primary prevention of OIHD. This does not necessarily mean that current measures are ineffective. Even though the update of this review included larger studies of reasonable quality, there is still a need for trials which apply standardised measures for the detection of OIHD in order to determine the effectiveness of the different prevention strategies.
Collapse
Affiliation(s)
- Andrea Bauer
- University Hospital Carl Gustav Carus, Technical University DresdenDepartment of DermatologyFetscherstr. 74DresdenGermany01307
| | - Henriette Rönsch
- University Hospital Carl Gustav Carus, Technical University DresdenDepartment of DermatologyFetscherstr. 74DresdenGermany01307
| | - Peter Elsner
- Friedrich Schiller UniversityDepartment of Dermatology and AllergologyErfurter Strasse 35JenaGermanyD 07743
| | - Daan Dittmar
- University Medical Center GroningenDepartment of DermatologyHanzeplein 1GroningenNetherlands9713 GZ
| | - Cathy Bennett
- Coventry UniversityCentre for Innovative Research Across the Life Course (CIRAL)Richard Crossman BuildingGosford StreetCoventryUKCV1 5FB
| | | | - Judit Lukács
- University Hospital JenaDepartment of DermatologyErfurter Str. 35JenaGermany07743
| | - Swen Malte John
- University of OsnabrueckDepartment of Dermatology, Environmental Medicine, Health TheorySedanstr 115OsnabrueckGermanyDE 49069
| | - Hywel C Williams
- University of NottinghamCentre of Evidence Based DermatologyQueen's Medical CentreDerby RoadNottinghamUKNG7 2UH
| | | |
Collapse
|
5
|
Lund TT, Agner T. Hand Eczema: Treatment Options. CURRENT TREATMENT OPTIONS IN ALLERGY 2017. [DOI: 10.1007/s40521-017-0148-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
6
|
Pickett K, Loveman E, Kalita N, Frampton GK, Jones J. Educational interventions to improve quality of life in people with chronic inflammatory skin diseases: systematic reviews of clinical effectiveness and cost-effectiveness. Health Technol Assess 2016; 19:1-176, v-vi. [PMID: 26502807 DOI: 10.3310/hta19860] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Inflammatory skin diseases include a broad range of disorders. For some people, these conditions lead to psychological comorbidities and reduced quality of life (QoL). Patient education is recommended in the management of these conditions and may improve QoL. OBJECTIVES To assess the clinical effectiveness and cost-effectiveness of educational interventions to improve health-related quality of life (HRQoL) in people with chronic inflammatory skin diseases. DATA SOURCES Twelve electronic bibliographic databases, including The Cochrane Library, MEDLINE and EMBASE, were searched to July 2014. Bibliographies of retrieved papers were searched and an Advisory Group contacted. REVIEW METHODS Systematic reviews were conducted following standard methodologies. Clinical effectiveness studies were included if they were undertaken in people with a chronic inflammatory skin condition. Educational interventions that aimed to, or could, improve HRQoL were eligible. Studies were required to measure HRQoL, and other outcomes such as disease severity were also included. Randomised controlled trials (RCTs) or controlled clinical trials were eligible. For the review of cost-effectiveness, studies were eligible if they were full economic evaluations, cost-consequence or cost analyses. RESULTS Seven RCTs were included in the review of clinical effectiveness. Two RCTs focused on children with eczema and their carers. Five RCTs were in adults. Of these, two were of people with psoriasis, one was of people with acne and two were of people with a range of conditions. There were few similarities in the interventions (e.g. the delivery mode, the topics covered, the duration of the education), which precluded any quantitative synthesis. Follow-up ranged from 4 weeks to 12 months, samples sizes were generally small and, overall, the study quality was poor. There appeared to be positive effects on HRQoL in participants with psoriasis in one trial, but no difference between groups in another trial in which participants had less severe psoriasis. Carers of children in one RCT of eczema showed improvement in HRQoL; however, in a RCT evaluating a website intervention there were no demonstrable effects on HRQoL. Neither the RCT in those adults with acne nor the RCT in those adults with mixed skin conditions demonstrated an effect on HRQoL. One RCT reported subgroups with atopic dermatitis or psoriasis and education was effective for psoriasis only. Other outcomes also showed mixed results. It is unclear how clinically meaningful any of the observed improvements are. Three studies of cost-effectiveness were included. The interventions, comparators and populations varied across the studies and, overall, the studies provided limited information on cost-effectiveness. The studies did provide detailed information on resources and costs that could be useful to inform a future cost-effectiveness evaluation in this area. LIMITATIONS The application of the inclusion criterion around whether the interventions were aimed at improving HRQoL or the inference that they could improve HRQoL was difficult as information was rarely reported. CONCLUSIONS There is uncertainty regarding whether educational interventions addressing issues that could improve HRQoL in people with chronic skin conditions are effective. Tentative conclusions about the best approach to delivering these kinds of interventions are that face-to-face, group, sessions may be beneficial; however, text messages may also be effective. Delivery over a period of time and by a multidisciplinary team may also be associated with positive outcomes. There is uncertainty over whether or not educational interventions are cost-effective. STUDY REGISTRATION This study is registered as PROSPERO CRD42014007426. FUNDING The National Institute for Health Research Health Technology Assessment programme.
Collapse
Affiliation(s)
| | - Emma Loveman
- Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK
| | - Neelam Kalita
- Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK
| | - Geoff K Frampton
- Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK
| | - Jeremy Jones
- Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK
| |
Collapse
|
7
|
Madan I, Parsons V, Cookson B, English J, Lavender T, McCrone P, Murphy C, Ntani G, Rushton L, Smedley J, Williams H, Wright A, Coggon D. A behavioural change package to prevent hand dermatitis in nurses working in the national health service (the SCIN trial): study protocol for a cluster randomised controlled trial. Trials 2016; 17:145. [PMID: 26987818 PMCID: PMC4797222 DOI: 10.1186/s13063-016-1255-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 02/17/2016] [Indexed: 11/25/2022] Open
Abstract
Background Hand dermatitis can be a serious health problem in healthcare workers. While a range of skin care strategies and policy directives have been developed in recent years to minimise the risk, their effectiveness and cost-effectiveness remain unclear. Evidence now suggests that psychological theory can facilitate behaviour change with respect to improved hand care practices. Therefore, we will test the hypothesis that a behavioural change intervention to improve hand care, based on the Theory of Planned Behaviour and implementation intentions, coupled with provision of hand moisturisers, can produce a clinically useful reduction in the occurrence of hand dermatitis, when compared to standard care, among nurses working in the UK National Health Service (NHS) who are particularly at risk. Secondary aims will be to assess impacts on participants’ beliefs and behaviour regarding hand care. In addition, we will assess the cost-effectiveness of the intervention in comparison with normal care. Methods/Design We will conduct a cluster randomised controlled trial at 35 NHS hospital trusts/health boards/universities, focussing on student nurses with a previous history of atopic disease or hand eczema and on nurses in intensive care units. Nurses at ‘intervention-light’ sites will be managed according to what would currently be regarded as best practice, with provision of an advice leaflet about optimal hand care to prevent hand dermatitis and encouragement to contact their occupational health (OH) department early if hand dermatitis occurs. Nurses at ‘intervention-plus’ sites will additionally receive a behavioural change programme (BCP) with on-going active reinforcement of its messages, and enhanced provision of moisturising cream. The impact of the interventions will be compared using information collected by questionnaires and through standardised photographs of the hands and wrists, collected at baseline and after 12 months follow-up. In addition, we will assemble relevant economic data for an analysis of costs and benefits, and collect information from various sources to evaluate processes. Statistical analysis will be by multi-level regression modelling to allow for clustering by site, and will compare the prevalence of outcome measures at follow-up after adjustment for values at baseline. The principal outcome measure will be the prevalence of visible hand dermatitis as assessed by the study dermatologists. In addition, several secondary outcome measures will be assessed. Discussion This trial will assess the clinical and cost effectiveness of an intervention to prevent hand dermatitis in nurses in the United Kigdom. Trial registration ISRCTN53303171: date of registration, 21 June 2013.
Collapse
Affiliation(s)
- Ira Madan
- Guy's and St Thomas' NHS Foundation Trust, Occupational Health Service, St Thomas' Hospital, Westminster Bridge Rd, London, SE1 7EH, UK.
| | | | | | - John English
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | | | | | | | | | - Julia Smedley
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | | | | |
Collapse
|
8
|
Bruinewoud AM, van der Meer EWC, van der Gulden JWJ, Anema JR, Boot CRL. Role models in a preventive program for hand eczema among healthcare workers: a qualitative exploration of their main tasks and associated barriers and facilitators. BMC DERMATOLOGY 2015; 15:14. [PMID: 26289357 PMCID: PMC4545924 DOI: 10.1186/s12895-015-0033-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 08/04/2015] [Indexed: 11/25/2022]
Abstract
Background Role models often play a role when implementing guidelines in healthcare. However, little is known about how role models perform their respective roles, or about which factors may hamper or enhance their functioning. The aim of the present study was therefore to investigate how role models perform there role as a part of a multifaceted implementation strategy on the prevention of hand eczema, and to identify barriers and facilitators for the performing of their role. Methods The role models were selected to become a role model and received a role model training. All role models worked at a hospital. In total, 19 role models, were interviewed. A topic list was used focussing on how the role models performed their role and what they experienced to be facilitators and barriers for their role. After coding the interviews, the codes were divided into themes. Results This study shows that the main tasks perceived by the role models were to raise awareness, to transfer information, to interact with colleagues about hand eczema, to provide material, and to perform coordinating tasks. Barriers and facilitators were whether the role suited the participant, affinity with the topic, and risk perception. Conclusions Most role models performed only the tasks they learned during their training. They mentioned a wide range of barriers and facilitators for the performing of their role. To enhance the functioning of the role models, a suggestion would be to select role models by taking into account prior coaching experience. Trial registration Trial registration number: NTR2812
Collapse
Affiliation(s)
- Anne M Bruinewoud
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Esther W C van der Meer
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Joost W J van der Gulden
- Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Johannes R Anema
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. .,Body@Work, Research Center Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, The Netherlands. .,Research Center for Insurance Medicine AMC-UWV-VU University Medical Center, Amsterdam, The Netherlands.
| | - Cécile R L Boot
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. .,Body@Work, Research Center Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, The Netherlands.
| |
Collapse
|
9
|
Abstract
BACKGROUND Health care workers (HCWs) are at increased risk of irritant contact dermatitis due to frequent hand washing and use of alcohol gel. This has increased the incidence of occupational skin diseases. AIMS To evaluate hand dermatitis in HCWs in our hospital by means of a survey which also examined trends of exposure and the utility of patch testing. METHODS HCWs diagnosed with hand dermatitis in our contact dermatitis clinic from January 2011 to July 2012 were included. Information was collected retrospectively from medical notes, computer records and the database of the British Cutaneous Allergy Society. RESULTS A total of 69 HCWs were diagnosed with hand dermatitis, with a prevalence of ~4%. The majority were female and the clinical areas in which they worked were diverse. About 98% (68) had irritant contact dermatitis, and hand washing was the commonest cause of symptoms. About 75% (51) had irritant dermatitis exclusively. Patch test was positive in 42% with the commonest reaction to nickel, followed by formaldehyde. Associated atopy was found in less than half of the cases. CONCLUSIONS Irritant hand dermatitis is prevalent in HCWs in this setting. Patch testing is useful to identify any additional allergic element in such cases.
Collapse
Affiliation(s)
- M Malik
- Derby Teaching Hospitals NHS Foundation Trust, London Road Community Hospital, London Road, Derby DE1 2QY, UK,
| | - J English
- Circle, NHS Treatment Centre, Nottingham NG7 2FT, UK
| |
Collapse
|
10
|
van der Meer EWC, van der Gulden JWJ, van Dongen D, Boot CRL, Anema JR. Barriers and facilitators in the implementation of recommendations for hand eczema prevention among healthcare workers. Contact Dermatitis 2015; 72:325-36. [PMID: 25739424 PMCID: PMC5024051 DOI: 10.1111/cod.12331] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 11/04/2014] [Accepted: 11/16/2014] [Indexed: 11/28/2022]
Abstract
Background Evidence‐based recommendations are available for the prevention of hand eczema among healthcare workers. However, the implementation of these recommendations is not always successful. Objectives To identify barriers and facilitators in the implementation of recommendations for the prevention of hand eczema among healthcare workers alongside a randomized controlled trial. Methods A qualitative study was performed in which 19 healthcare workers were interviewed. The interview transcripts were open coded and also coded by means of a template by two researchers to identify relevant barriers and facilitators. Results Most barriers and facilitators reported for the recommendations were found at the level of the innovation (e.g. the recommendations), whereas for the guideline as a whole, multiple levels (socio‐political, organization, user, and facilities) were identified. Conclusions To enhance the implementation of recommendations for the prevention of hand eczema in a healthcare setting, having knowledge about these recommendations seems to be an important first step. In addition, maintaining the attention of the subject, testing the products beforehand and close collaboration with the infection control department might enhance implementation. Furthermore, it is important that the recommendations fit in with the work of the healthcare workers. When the implementation of the recommendations is prepared, these points should be taken into account.
Collapse
Affiliation(s)
- Esther W C van der Meer
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, van der Boechorststraat 7, 1007MB, Amsterdam, The Netherlands
| | | | | | | | | |
Collapse
|
11
|
Weistenhöfer W, Wacker M, Bernet F, Uter W, Drexler H. Occlusive gloves and skin conditions: is there a problem? Results of a cross-sectional study in a semiconductor company. Br J Dermatol 2015; 172:1058-65. [PMID: 25319754 DOI: 10.1111/bjd.13481] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although there is poor scientific evidence that working with occlusive gloves is as damaging as wet work, prolonged glove occlusion is considered to be a risk factor for developing hand eczema similar to wet work. OBJECTIVES To assess the effects of wearing occlusive gloves during the whole working day, without exposure to any additional hazardous substances, on skin condition and skin barrier function. METHODS We investigated 323 employees of a semiconductor production company in Germany: 177 clean-room workers wearing occlusive gloves during the whole shift (exposed group) and 146 employees working in administration (control group). A standardized interview was performed, the skin condition of both hands was studied using the quantitative skin score HEROS, and transepidermal water loss (TEWL) and stratum corneum hydration were measured. RESULTS There was no significant difference in skin condition between the two subgroups. Values for TEWL and corneometry were significantly higher in exposed participants (P < 0·05). However, the TEWL values were similar to control values if participants took off the occlusive gloves at least 30 min before the measurement. Hence, the effect of occlusion on skin barrier function seems to be transient. CONCLUSIONS Prolonged wearing of occlusive gloves with clean hands and without exposure to additional hazardous substances does not seem to affect the skin negatively.
Collapse
Affiliation(s)
- W Weistenhöfer
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, University of Erlangen-Nuremberg, D-91054, Erlangen, Germany
| | | | | | | | | |
Collapse
|
12
|
van der Meer EWC, Boot CRL, van der Gulden JWJ, Knol DL, Jungbauer FHW, Coenraads PJ, Anema JR. Hands4U: the effects of a multifaceted implementation strategy on hand eczema prevalence in a healthcare setting. Results of a randomized controlled trial. Contact Dermatitis 2014; 72:312-24. [DOI: 10.1111/cod.12313] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 09/18/2014] [Accepted: 09/23/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Esther W. C. van der Meer
- Department of Public and Occupational Health EMGO Institute for Health and Care Research, VU University Medical Centre van der Boechorststraat 7 1081 BT Amsterdam The Netherlands
| | - Cécile R. L. Boot
- Department of Public and Occupational Health EMGO Institute for Health and Care Research, VU University Medical Centre van der Boechorststraat 7 1081 BT Amsterdam The Netherlands
- Body©Work, Research Centre Physical Activity, Work and Health, TNO‐VU University Medical Centre van der Boechorststraat 7 1081 BT Amsterdam The Netherlands
| | - Joost W. J. van der Gulden
- Department of Primary and Community Care Centre for Family Medicine, Geriatric care and Public Health, Radboud University Nijmegen Medical Centre PO Box 9101 6500 HB Nijmegen The Netherlands
| | - Dirk L. Knol
- Department of Epidemiology and Biostatistics EMGO Institute for Health and Care Research, VU University Medical Centre De Boelelaan 1118 1081 HZ Amsterdam The Netherlands
| | - Frank H. W. Jungbauer
- Department of Occupational Health University Medical Centre Groningen, University of Groningen Hanzeplein 1 9713GZ, Groningen The Netherlands
| | - Pieter Jan Coenraads
- Dermatology Department University Medical Centre Groningen, University of Groningen Hanzeplein 1 9713GZ, Groningen The Netherlands
| | - Johannes R. Anema
- Department of Public and Occupational Health EMGO Institute for Health and Care Research, VU University Medical Centre van der Boechorststraat 7 1081 BT Amsterdam The Netherlands
- Body©Work, Research Centre Physical Activity, Work and Health, TNO‐VU University Medical Centre van der Boechorststraat 7 1081 BT Amsterdam The Netherlands
- Research Centre for Insurance Medicine AMC‐UWV‐VU University Medical Centre van der Boechorststraat 7 1081 BT Amsterdam The Netherlands
| |
Collapse
|
13
|
Gelot P, Avenel-Audran M, Balica S, Bensefa L, Crépy MN, Debons M, Ammari H, Milpied B, Raison N, Vigan M, Weibel N, Stalder JF, Bernier C. Éducation thérapeutique du patient dans l’eczéma chronique des mains. Ann Dermatol Venereol 2014; 141 Suppl 1:S127-42. [DOI: 10.1016/s0151-9638(14)70150-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
14
|
van der Meer EWC, Boot CRL, Twisk JWR, Coenraads PJ, Jungbauer FHW, van der Gulden JWJ, Anema JR. Hands4U: the effectiveness of a multifaceted implementation strategy on behaviour related to the prevention of hand eczema-a randomised controlled trial among healthcare workers. Occup Environ Med 2014; 71:492-9. [PMID: 24828091 PMCID: PMC4078713 DOI: 10.1136/oemed-2013-102034] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objectives To investigate the effects of a multifaceted implementation strategy on behaviour, behavioural determinants, knowledge and awareness of healthcare workers regarding the use of recommendations to prevent hand eczema. Methods The Hands4U study is a randomised controlled trial. A total of 48 departments (n=1649 workers) were randomly allocated to the multifaceted implementation strategy or the control group (minimal implementation strategy). Within the departments designated to the multifaceted implementation strategy, participatory working groups were set up to enhance the implementation of the recommendations for hand eczema. In addition, working group members were trained to become role models, and an education session was given within the department. Outcome measures were awareness, knowledge, receiving information, behaviour and behavioural determinants. Data were collected at baseline, with a 3- and 6-month follow-up. Results Statistically significant effects were found after 6 months for awareness (OR 6.30; 95% CI 3.41 to 11.63), knowledge (B 0.74; 95% CI 0.54 to 0.95), receiving information (OR 9.81; 95% CI 5.60 to 17.18), washing hands (B −0.40; 95% −0.51 to −0.29), use of moisturiser (B 0.29; 95% CI 0.20 to 0.38), cotton under gloves (OR 3.94; 95% CI 2.04 to 7.60) and the overall compliance measure (B 0.14; 95% CI 0.02 to 0.26), as a result of the multifaceted implementation strategy. No effects were found for behavioural determinants. Conclusions The multifaceted implementation strategy can be used in healthcare settings to enhance the implementation of recommendations for the prevention of hand eczema. Trial registration number NTR2812.
Collapse
Affiliation(s)
- Esther W C van der Meer
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands Body@Work, Research Center Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Health Sciences Section Methodology and Applied Biostatistics, VU University, Amsterdam, The Netherlands
| | - Pieter Jan Coenraads
- Dermatology Department, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Frank H W Jungbauer
- Department of Occupational Health, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Joost W J van der Gulden
- Department of Primary and Community Care, Centre for Family Medicine, Geriatric care and Public Health, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Johannes R Anema
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands Body@Work, Research Center Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, The Netherlands Research Center for Insurance Medicine AMC-UMCG-UWV-VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
15
|
Johannisson A, Pontén A, Svensson Å. Prevalence, incidence and predictive factors for hand eczema in young adults - a follow-up study. BMC DERMATOLOGY 2013; 13:14. [PMID: 24164871 PMCID: PMC3819704 DOI: 10.1186/1471-5945-13-14] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 10/22/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND Hand eczema is common in the general population and affects women twice as often as men. It is also the most frequent occupational skin disease. The economic consequences are considerable for society and for the affected individuals. METHODS To investigate the prevalence and incidence of hand eczema and to evaluate risk factors for development of hand eczema in young adults. Subjects and methods; This is a prospective follow-up study of 2,403 young adults, 16 - 19 years old in 1995 and aged 29 - 32 years, 13 years later, in 2008. They completed a postal questionnaire that included questions regarding one-year prevalence of hand eczema, childhood eczema, asthma, rhino-conjunctivitis and factors considered to affect hand eczema such as hand-washing, washing and cleaning, cooking, taking care of small children and usage of moisturisers. These factors were evaluated with the multinominal logistic regression analysis. RESULTS The one-year prevalence of hand eczema was 15.8% (females 20.3% and males 10.0%, p < 0.001). The incidence was 11.6 cases per 1000 person-years (females 14.3 and males 5.2, p < 0.001). Childhood eczema was the most important risk factor for hand eczema. The odds ratios were 13.17 when having hand eczema 1995 and 2008 compared to 5.17 in 2008 (p < 0.001). A high frequency of hand washing was important in predicting hand eczema only when having 1-year prevalence 2008, OR 1.02 (p = 0.038). CONCLUSIONS After 13 years an increased 1-year prevalence of hand eczema was found. The significant risk factors for hand eczema changed over time from endogenous to exogenous factors.
Collapse
Affiliation(s)
- Arne Johannisson
- Department of Health Sciences, Lund University, Box 157, 221 00 Lund, Sweden.
| | | | | |
Collapse
|
16
|
Visser MJ, Verberk MM, Campbell LE, McLean WHI, Calkoen F, Bakker JG, van Dijk FJH, Bos JD, Kezic S. Filaggrin loss-of-function mutations and atopic dermatitis as risk factors for hand eczema in apprentice nurses: part II of a prospective cohort study. Contact Dermatitis 2013; 70:139-50. [PMID: 24102300 PMCID: PMC4357292 DOI: 10.1111/cod.12139] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 07/05/2013] [Accepted: 07/21/2013] [Indexed: 12/03/2022]
Abstract
Background/objectives Environmental exposure and personal susceptibility both contribute to the development of hand eczema. In this study, we investigated the effect of loss-of-function mutations in the filaggrin gene (FLG), atopic dermatitis and wet work exposure on the development of hand eczema in apprentice nurses. Methods Dutch apprentice nurses were genotyped for the four most common FLG mutations; atopic dermatitis and hand eczema history were assessed by questionnaire. Exposure and hand eczema during traineeships were assessed with diary cards. Results The prevalence of hand eczema during traineeships was higher among subjects with a history of hand eczema reported at inclusion. Hand washing during traineeships and at home increased the risk of hand eczema. After adjustment for the effects of exposure and FLG mutations, an odds ratio of 2.5 (90% confidence interval 1.7–3.7) was found for a history of atopic dermatitis. In this study, an increased risk of hand eczema conferred by FLG mutations could not be shown, but subjects with concomitant FLG mutations and atopic dermatitis showed the highest risk of hand eczema during traineeships. Conclusion A history of atopic dermatitis, a history of hand eczema and wet work exposure were the most important factors increasing the risk of hand eczema during traineeships.
Collapse
Affiliation(s)
- Maaike J Visser
- Coronel Institute of Occupational Health, Academic Medical Centre, University of Amsterdam, Amsterdam, Meibergdreef 15, 1105 AZ, The Netherlands
| | | | | | | | | | | | | | | | | |
Collapse
|