The eczema school

Education for parents of children with atopic eczema.

Atopic eczema is a disease that affects young children; consequently, it is a stress factor for the entire family.

The disease is chronic and its treatment is complicated. Apart from the medical treatment with creams and tablets, changes in lifestyle are often necessary to keep the eczema under control and to avoid flare-ups. To ensure successful treatment, trust and cooperation is needed between the parents of children with atopic eczema and the care team. Over the past ten years many places have begun to offer educational course to the parents of children with atopic eczema in order to increase their understanding of their children’s disease and to increase their knowledge of how to deal with the disease. Some courses are held at eczema ‘schools’, where there is group education and counselling. Other forms of education can be through a consultation with a nurse, where the emphasis is on the practicalities of dealing with the disease. The need for such education was revealed in a study from England in which it was shown that 38% of parents of children who had been treated with both a mild and a strong steroid cream were unable to tell which cream was which (Charman CR et al. Br J Dermatol 2000; 142: 931-6). A Japanese study showed that compliance with a doctor-initiated treatment depended partly on a good doctor-patient relationship and partly on the severity of the disease (the worse the disease the better the compliance) (Ohya Y and Williams H. J Invest Dermatol 2001; 117: 852-7). A good relationship between the patient and the one giving the treatment can be supported through an educational programme directed towards individual patients or groups of patients. A recent study has shown that group education of eczema patients benefits both the way they treat their disease and their overall ability to deal with it (Staab D et al. Pediatr Allergy Immunol 2002; 13: 84-90).Whether the education also improves the patient’s quality of life is unclear, but a tendency towards better life quality was shown in a new scientific study (Chinn Dj, Poyner T and Sibley G. Br J Dermatol 2002; 146: 432-439).

In line with other dermatology departments in Denmark, Gentofte dermatology department has been offering educational courses since 1996 to parents of children with atopic eczema. The course consists of a standard consultation with a doctor followed by a talk with a nurse who advises on skin care. Parents receive printed information about the disease and may borrow an information video if they wish. They also have the possibility of attending an evening meeting at the eczema ‘school’. This is a three-hour meeting covering points such as how atopic eczema develops and its complications, treatment and prevention. Time is set aside for any questions that may arise and parents have the opportunity of talking with others who are in a similar situation to their own. The care-management team views these educational programmes as way of building up a good relationship with the parents. For the parents, they increase their knowledge of the disease and gain greater confidence in the treatment (Olsen J. Forældrene på skolebænken. Månedsskrift for praktisk lægegerning 2001: 79: 291-95).
 

Atopic eczema in children is a complicated disease without clear causes and where treatment often seems difficult. However, making sure that the treatment is carried out consistently gives significant results and a pronounced reduction of the symptoms. It is therefore particularly important with this disease to establish a good relationship between the parents and the care-management team. One way of doing this is through the educational programmes for parents, for example, at the eczema ‘school’.

This article was published in the journal Astma-Allergi