Department of Allergology and Occupational Dermatology, Dermatologikum Hamburg, Hamburg, Germany.
Department of Dermatology, Environmental Medicine, Health Theory, University of Osnabrueck, Osnabrueck, Germany.
J Eur Acad Dermatol Venereol. 2015 Sep;29(9):1724-31. doi: 10.1111/jdv.12975. Epub 2015 Feb 4.
Occupational hand eczema (OHE) is associated with impaired health-related quality of life (QoL) and mental distress. Interdisciplinary inpatient rehabilitation measures in the framework of tertiary individual prevention (TIP) offered by the German employers' liability insurance associations include dermatological treatment, education and psychological interventions.
To investigate the effects of interdisciplinary inpatient rehabilitation in the framework of TIP on mental health in patients with severe OHE and the relationships between recovery of OHE and improvement of mental health and QoL.
A total of 122 patients participated in the study. A test battery consisting of the German versions of the Hospital Anxiety and Depression Scale (HADS-D), the Dermatology Life Quality Index (DLQI), the Short Form Health Survey-36 (SF-36) and the Trier Inventory for the Assessment of Chronic Stress (TICS) was applied at the time of admission (T1) and 3 weeks after dismissal (T2). Severity of hand eczema was assessed with the Osnabrueck Hand Eczema Severity Index (OHSI).
All parameters improved significantly from T1 to T2. A relationship was established between the improvement of QoL and recovery of OHE, while there was no such relationship between the improvement of mental distress and improvement of OHE. Nonresponders had significantly more cumulative days of sickness at T1.
Our data underscore the importance of psychological interventions in addition to dermatological treatment in the framework of prevention measures for OHE. These measures should be applied at an early stage of OHE prior to the occurrence of sick leave.
职业性手部湿疹（OHE）与健康相关生活质量（QoL）受损和精神困扰有关。德国雇主责任保险协会提供的三级个体预防（TIP）框架内的跨学科住院康复措施包括皮肤病治疗、教育和心理干预。
调查 TIP 框架内跨学科住院康复对严重 OHE 患者心理健康的影响，以及 OHE 恢复与心理健康和 QoL 改善之间的关系。
共有 122 名患者参与了这项研究。在入院时（T1）和出院后 3 周（T2），使用由德国版本的医院焦虑和抑郁量表（HADS-D）、皮肤病生活质量指数（DLQI）、简短健康调查-36 量表（SF-36）和慢性应激评估特里尔量表（TICS）组成的测试包进行评估。手部湿疹的严重程度用奥斯纳布吕克手部湿疹严重程度指数（OHSI）评估。
所有参数均从 T1 到 T2 显著改善。QoL 的改善与 OHE 的恢复之间存在关系，而精神困扰的改善与 OHE 的恢复之间不存在这种关系。无反应者在 T1 时有明显更多的累积病假天数。
我们的数据强调了在 OHE 预防措施框架内，除了皮肤病治疗外，心理干预的重要性。这些措施应在 OHE 发生病假之前的早期阶段应用。
