Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Nov 15;7(11):e017731.
doi: 10.1136/bmjopen-2017-017731.

'When it goes back to my normal I suppose': a qualitative study using online focus groups to explore perceptions of 'control' among people with eczema and parents of children with eczema in the UK

Laura M Howells  1 , Joanne R Chalmers  1 , Fiona Cowdell  2 , Sonia Ratib  1 , Miriam Santer  3 , Kim S Thomas  1
Affiliations

'When it goes back to my normal I suppose': a qualitative study using online focus groups to explore perceptions of 'control' among people with eczema and parents of children with eczema in the UK

Laura M Howells et al. BMJ Open. .

Abstract

Objective: To inform the development of a core outcome set for eczema by engaging with people with eczema and parents of children with eczema to understand their experiences and understanding of the concept 'eczema control'.

Design: 37 participants took part in a total of six semi-structured online focus groups held in a typed chatroom with 5-7 participants per group. Three groups involved adults with eczema and three groups involved parents of children with eczema. Framework analysis was used for data analysis.

Setting: A community-based sample was recruited from across the UK via social media and email.

Participants: 19 adults aged 17-61 years (15/19 female, 16/19 white) and 18 parents of children with eczema aged 9 months-17 years (9/18 female, 18/19 white).

Results: Four main themes were identified:(1) 'Commonalities and differences in the experiences of control': a reduction in symptoms such as itch and sleep loss characterised eczema control, but what level was acceptable differed across participants;(2) 'Eczema control goes beyond the skin': psychological factors, social factors, the constant scratching and the impact on everyday activities are a variety of ways an individual can be impacted;(3) 'Stepping up and down of treatment': participants' stepped-up treatment in response to loss of control, but several factors complicated this behaviour. Control needed to be maintained after stepped-up treatment ended to be acceptable; and (4) 'How to measure control': self-report was generally preferred to allow frequent measurements and to capture unobservable features. Although most thought their eczema needed to be measured frequently, many also felt that this was not always realistic or desirable.

Conclusions: 'Eczema control' is a complex experience for people with eczema and parents of children with the condition. These experiences could have important implications on how long-term control should be measured in eczema clinical trials and clinical practice.

Keywords: dermatology; eczema; qualitative research.

PubMed Disclaimer

Conflict of interest statement

Competing interests: LMH, KST and JC are members of the Harmonising Outcome Measures in Eczema (HOME) long-term control working group.

Figures

Figure 1
Figure 1
Recruitment procedure.
Figure 2
Figure 2
Mapping of the thematic framework.
See this image and copyright information in PMC

References

    1. Schofield J, Grindlay D, Williams H. Skin conditions in the UK: a health care needs assessment. University of Nottingham: Centre of Evidence Based Dermatology, 2009.
    1. Zuberbier T, Orlow SJ, Paller AS, et al. Patient perspectives on the management of atopic dermatitis. J Allergy Clin Immunol 2006;118:226–32. 10.1016/j.jaci.2006.02.031 - DOI - PubMed
    1. Schmitt J, Spuls P, Boers M, et al. Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting. Allergy 2012;67:1111–7. 10.1111/j.1398-9995.2012.02874.x - DOI - PubMed
    1. Barbarot S, Rogers NK, Abuabara K, et al. Strategies used for measuring long-term control in atopic dermatitis trials: A systematic review. J Am Acad Dermatol 2016;75:1038–44. 10.1016/j.jaad.2016.05.043 - DOI - PubMed
    1. Langan SM, Schmitt J, Williams HC, et al. How are eczema ‘flares’ defined? A systematic review and recommendation for future studies. Br J Dermatol 2014;170:548–56. 10.1111/bjd.12747 - DOI - PubMed