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

PLOS ONE · 7 authors, 3 centres

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This qualitative study explored the illness perceptions of 35 German patients with occupational hand eczema using Leventhal's Common-Sense Model. The central finding is that patients hold complex and varied perceptions regarding the causes, symptoms, timeline, consequences, and controllability of their disease.

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This qualitative study used guided interviews with 35 patients attending an inpatient rehabilitation program to explore illness perceptions of occupational hand eczema based on the Common-Sense Model. Participants identified a wide range of perceived causes, including external irritants like water, allergies, and lifestyle factors. They described the disease timeline as often cyclical, with some developing personal 'warning systems' for symptom flare-ups. Patients reported numerous symptoms and significant consequences affecting psychological, physical, occupational, and private life. Perceived controllability focused on specific measures like using creams. A key finding is that due to combined diagnoses, patients identified different influential aspects of their disease. Limitations include the sample being from a specialized clinic with prior educational exposure, which may not represent all patients.

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other

SPECIALTY

dermatology

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ORIGINAL PAPER

PMC10180686

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

PLOS ONE

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ABSTRACT

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).

CITATION EXPORT

Anna-Sophie Buse, Annika Wilke, Swen Malte John et al.. Illness perceptions of occupational hand eczema in German patients based on the common-sense model of self-regulation: A qualitative study. PLOS ONE. (2023). https://doi.org/10.1371/journal.pone.0285791

AUTHORS

7 · 3 CENTRES

Anna-Sophie Buse, Annika Wilke, Swen Malte John, Andreas Hansen, Aiggan Tamene, Aiggan Tamene, Aiggan Tamene

1Department of Dermatology, Environmental Medicine and Health Theory, Institute for Health Research and Education, University of Osnabrück, Osnabrück, Germany
2Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany
3Wachemo University, ETHIOPIA