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