Primary Care and Population Science, Faculty of Medicine, University of Southampton, Southampton, U.K.
Academic Unit of Psychology, Faculty of Social and Human Sciences, University of Southampton, Southampton, U.K.
Br J Dermatol. 2017 Jun;176(6):1500-1507. doi: 10.1111/bjd.15130. Epub 2017 Feb 3.
Childhood eczema is very common and can have substantial impact on quality of life. One of the main treatments is topical corticosteroids, but these are often underused by parents and carers for reasons that include concerns about safety.
To explore understandings and concerns about topical corticosteroids among parents and carers of children with eczema who had posted messages in online forums.
A qualitative study of messages and their resultant discussions about topical corticosteroids for childhood eczema posted by parents and carers on two U.K.-based discussion forums.
Ninety-five forum users involved in 27 discussions relating to topical corticosteroid use in childhood eczema were identified dating from 2003 to 2015. Analysis of discussions highlighted three themes: (i) diverse beliefs about the use of topical corticosteroids; (ii) uncertainty and confusion about using and applying topical corticosteroids; and (iii) seeking to resolve conflicting advice received offline and advice on navigating health services. People expressed a general sense of cautiousness about topical corticosteroids, wide-ranging concerns and considerable confusion, for instance about potency or safe duration of use. They sought advice from other forum users who they perceived as having experiential expertise. Some posts attempted to reassure that topical corticosteroids were safe if used correctly, but overall the discussions seemed likely to amplify existing concerns.
Given the prevalence of concerns and uncertainties about topical corticosteroids, signposting parents and carers of children with eczema towards detailed, credible information about how to use topical corticosteroids safely would be beneficial. In the absence of such information, parents and carers are likely to turn to online discussion forums where, although much useful support and advice can be found, the credibility of advice cannot be assured.
儿童湿疹非常常见，会对生活质量产生重大影响。主要治疗方法之一是局部皮质类固醇，但由于担心安全性，父母和照顾者经常使用不足。
探索在网上论坛上发布信息的湿疹儿童的父母和照顾者对局部皮质类固醇的理解和担忧。
对英国两个基于论坛的关于儿童湿疹局部皮质类固醇使用的信息及其相关讨论进行定性研究。
确定了 95 名论坛用户参与了 2003 年至 2015 年间与儿童湿疹局部皮质类固醇使用相关的 27 次讨论。讨论分析突出了三个主题：（i）对局部皮质类固醇使用的不同看法；（ii）对使用和应用局部皮质类固醇的不确定性和困惑；（iii）寻求解决线下收到的相互矛盾的建议和医疗服务导航建议。人们对局部皮质类固醇表示普遍谨慎，对其存在广泛的担忧和相当大的困惑，例如关于效力或安全使用时间。他们向其他论坛用户寻求建议，这些用户被认为具有经验专业知识。有些帖子试图让人们放心，如果正确使用，局部皮质类固醇是安全的，但总的来说，这些讨论似乎有可能放大现有的担忧。
鉴于对局部皮质类固醇存在担忧和不确定性，为湿疹儿童的父母和照顾者指明方向，提供有关如何安全使用局部皮质类固醇的详细、可信信息将是有益的。在缺乏此类信息的情况下，父母和照顾者可能会转向在线讨论论坛，虽然在那里可以找到很多有用的支持和建议，但无法保证建议的可信度。
