Faculty of Health and Social Care, University of Hull, Dearne Building, Hull, HU6 7RX, U.K.
Br J Dermatol. 2013 Sep;169(3):629-36. doi: 10.1111/bjd.12414.
The systematic support of parents of children with eczema is essential in effective disease management. The few existing support models have a limited evidence base. This paper reports the outcome-orientated service evaluation of an original, extensive, social learning-theory based, nurse-led Eczema Education Programme (EEP).
To evaluate the EEP using specified child and parental outcomes and service impact data.
From a sample of 257 parent-child dyads attending the EEP, a pretest-post-test design evaluated its child impact using health-related quality of life measures (Infants' Dermatitis Quality of Life index, which includes a small dermatitis severity element, and Children's Dermatology Life Quality Index), severity measures (Patient Orientated Eczema Measure), a new parental measure (Parental Self-Efficacy in Eczema Care Index) and service impact data based on general practitioner (GP) attendance patterns pre- and postintervention.
Statistically significant impacts were observed on infant quality of life (P < 0·001), child quality of life (P = 0·027), disease severity (P < 0·001) and parental self-efficacy (P < 0·001). Improvements in child quality of life, parental efficacy and service impact were also evident from qualitative data. The cumulative total of all GP visits for selected participants post-EEP reduced by 62%.
The EEP appears to be an effective model of delivering structured education to parents of children with eczema, and one generalizable to other multiethnic metropolitan populations. As a noncontrolled study, this rigorous service evaluation highlights the model's significance and the case for an evaluative multicentre randomized controlled trial of this educational intervention to inform a nurse-led programme of care.
在有效的疾病管理中，对患有湿疹的儿童的家长进行系统性支持至关重要。现有的少数支持模式的证据基础有限。本文报告了基于原始的、广泛的社会学习理论的、以护士为主导的湿疹教育计划（EEP）的面向结果的服务评估结果。
使用特定的儿童和父母结局以及服务影响数据来评估 EEP。
在参加 EEP 的 257 对父母-子女样本中，采用预测试-后测试设计，使用与健康相关的生活质量测量（婴儿湿疹生活质量指数，其中包括一个小的湿疹严重程度元素，以及儿童皮肤病生活质量指数）、严重程度测量（患者导向的湿疹量表）、一个新的父母测量（湿疹护理自我效能父母量表）和基于普通科医生（GP）就诊模式的服务影响数据，对其进行儿童影响评估。这些数据在干预前后进行了测量。
观察到婴儿生活质量（P < 0·001）、儿童生活质量（P = 0·027）、疾病严重程度（P < 0·001）和父母自我效能（P < 0·001）均有统计学显著影响。从定性数据中也可以看出儿童生活质量、父母效能和服务影响的改善。所有选定参与者在 EEP 后的 GP 就诊总数减少了 62%。
EEP 似乎是一种向患有湿疹的儿童家长提供结构化教育的有效模式，并且可以推广到其他多民族大都市人群。作为一项非对照研究，本严格的服务评估强调了该模型的意义以及对该教育干预进行评估性多中心随机对照试验的必要性，以提供一种基于护士的护理方案。
