Knowledge, attitudes and behaviour in everyday life with chronic hand eczema: a qualitative study

Abstract

Chronic hand eczema is a common disease that may impact quality of life and have occupational and social consequences. Self-management is pivotal, both in handling acute eruptions and avoiding relapses. However, little is known about how people with hand eczema self-manage and integrate their disease into everyday life. To explore the knowledge, attitudes and everyday life behaviours of patients with chronic hand eczema in order to generate insights about barriers in self-management. Qualitative, semistructured, focus group interviews were carried out. Twenty-three people with hand eczema participated in the four group sessions. The content of the interviews was analysed according to a template of concepts, categories and codes. Patients felt they lacked knowledge about the causes of eczema and how best to manage it. They perceived it as a complex condition, yet only simple solutions were offered. The patients found it difficult to apply preventive strategies in everyday life. They wanted to take an active role in their course of illness, but experienced barriers such as discomfort from emollient treatment or feelings of stigmatization. The patients stated that the need to focus constantly on prevention was energy-consuming. Self-management support in chronic hand eczema needs to be individualized in order to provide specific knowledge relevant to the patient, so that the patient has realistic expectations concerning the course of disease and can adopt new habits that minimize effort in preventive behaviour.