CLINICAL REPORT
329 ActaDV ActaDV Advances in dermatology and venereology Acta Dermato-Venereologica
Effects of a Hybrid Education Programme for Korean Mothers of Children with Atopic Dermatitis
Je-Bog YOO 1, Jennie C. DE GAGNE 2, Seung-Hyeon S. JEONG 3 and Chan-Woo JEONG 4
1
Department of Nursing, Gyeongnam National University of Science and Technology School of Nursing, South Korea, 2 Duke University School of Nursing, Durham, North Carolina, USA, 3 Seoul International School, Gyeonggi-do, South Korea, and 4 JF Dermatology Clinic, Seoul, South Korea
Atopic dermatitis( AD), a common childhood skin disorder, can limit a child’ s learning and physical activities. South Korean mothers, as primary caregivers, experience anxiety and helplessness when caring for their ill children. The aim of this study was to develop a hybrid AD education programme( consisting of a faceto-face session followed by 8 online sessions) and evaluate its effects on anxiety, caregiving efficacy and caregiving behaviour among mothers of children with AD. Twenty mothers of patients with AD treated in a South Korean hospital received one on-site session and 8 weekly online modules. After the intervention, mothers’ mean ± standard deviation anxiety reduced( from 50.3 ± 14.2 to 31.7 ± 6.3 points, t = 5.75, p < 0.001). Their caregiving efficacy and caregiving behaviour improved significantly, from 18.3 ± 3.5 to 29.4 ± 3.2 points( t = – 9.64, p < 0.001) and from 47.7 ± 7.7 to 78.8 ± 4.9 points( t = – 14.4, p < 0.001), respectively. The effects of the hybrid education programme for this population were significant. Healthcare providers should consider examining the programme nationwide, including in rural areas, while investigating its long-term effects.
Key words: atopic dermatitis; caregiving behaviour; caregiving efficacy; hybrid education programme; mother’ s anxiety.
Accepted Dec 6, 2017; Epub ahead of print Dec 12, 2017 Acta Derm Venereol 2018; 98: 329 – 334.
Corr: Je-Bog Yoo, Department of Nursing, Gyeongnam National University of Science and Technology, Gyeongsangnam-do, South Korea. E-mail: jbyoo @ gntech. ac. kr
The rate of prevalence atopic dermatitis( AD) in
South Korea has been increasing as a result of environmental contamination, consumption of instant foods( e. g. ramen), and the westernization of diets( 1). According to data from the National Health Insurance Service( 2), in 2014 a total of 86.9 million individuals were treated for atopic diseases; 54.5 million for allergic rhinitis, 22 million for asthma, and 10.4 million for AD incidence. Toddlers and pre-school children are disproportionately affected by AD, and in 2011, 41.7 % of these children were diagnosed with AD, suggesting the need for management of AD symptoms in children under the age of 7 years( 3). Poor dermatological conditions can affect children’ s relationships with peers at school( 4), as well as the quality of life of patients with AD and their parents( 5). Hospitalization is necessary when AD is accompanied by viral, bacterial, or fungal infections
( 6). This, in turn, can inhibit the child’ s normal growth and developmental process. Given this evidence, the importance of managing atopic diseases in children has been increasingly emphasized in recent years( 5, 7).
Adopting a healthy lifestyle involves making the right choices regarding diet, exercise, and medication, and such choices are important for managing AD( 8). In South Korean culture, mothers assume the role of care of their children, especially for those with chronic illnesses( 9). Thus, mothers are in the unique position of ensuring that their children comply with their treatment plans( 10). However, mothers of children with AD experience high anxiety and psychological pain due to feelings of responsibility and uncertainty about their children’ s illness( 6, 11). Formal AD education and support have proven effective in helping mothers deal with anxiety by improving their knowledge and confidence( 12).
Online learning is recognized as an optimal method for providing health education because of its accessibility, ease of use, economic efficiency, and availability to a large number of people( 13, 14). Due to the expansion of the learning environment to online education, parents of children with AD can use online learning methods to overcome obstacles to attendance at in-person educational programmes, such as lack of time, responsibilities at home and work, and physical and psychological difficulties( 15, 16). Thus, mothers of children with AD may benefit from a standardized online education programme about disease management. However, a combination of online and offline education may be more effective than online learning alone to improve learning outcomes from the viewpoint of holistic education( 17). Despite the fact that the review from 2014 by Ersser et al.( 18) contained 10 studies showing that educational and psychological approaches helped caregivers to provide better at-home care for their children with AD, the studies lacked detail about intervention design. Therefore, it remains difficult to assess which intervention works best for this population. In addition, only a few of the studies included in Ersser et al.’ s review addressed the topic of eHealth and how it can benefit patients with AD and their families. Moreover, in their pilot randomized controlled trial on self-care for families of children with eczema, using web-based interventions and healthcare professional support, Santer et al.( 19) concluded that a full-scale study was feasible by quantifying the effective ness of the intervention for this particular population. Therefore, the
This is an open access article under the CC BY-NC license. www. medicaljournals. se / acta Journal Compilation © 2018 Acta Dermato-Venereologica. doi: 10.2340 / 00015555-2862 Acta Derm Venereol 2018; 98: 329 – 334