Top

Systematic Reviews

Published in:

01-12-2021 | Allergic Contact Dermatitis | Research

Illness perceptions of adults with eczematous skin diseases: a systematic mixed studies review

Authors: Marc Rocholl, Michaela Ludewig, Carola Brakemeier, Swen Malte John, Annika Wilke

Published in: Systematic Reviews | Issue 1/2021

Abstract

Background

Eczematous skin diseases, e.g., atopic dermatitis or contact dermatitis, are associated with a high disease burden, a significant impact on quality of life and a higher risk for anxiety and depression. Therefore, coping strategies are of interest. In order to understand coping processes, it is necessary to examine the patients’ perspectives on their illness. The aim of this systematic mixed studies review is to investigate the illness perceptions of patients with eczematous skin diseases to get a better understanding of their coping processes.

Methods

We performed a systematic literature search in PubMed, The Cochrane Library, PsycInfo, PSYNDEX, CINAHL, Web of Science, and Scopus until February 20, 2019. Both qualitative and quantitative studies were included in the review. Two independent reviewers conducted data extraction and carried out a narrative synthesis. We assessed study quality with the Mixed Methods Appraisal Tool.

Results

Three qualitative and four quantitative studies were included in the systematic review. We found different methodological approaches for investigating illness perceptions: guided interviews, focus group interviews as well as standardized questionnaires, e.g., the Brief Illness Perception Questionnaire. All studies report suspected causes of the skin disease, such as endogenous and exogenous causes (namely, psychological or occupational factors). We found long timeline beliefs as well as various perceived and experienced social, economic, and psychological consequences. Our analysis reveals complex emotional representations in patients with eczematous skin diseases, in particular impairment of emotional well-being, and feelings of shame or helplessness. Qualitative and quantitative data were predominantly complementary and convergent.

Conclusion

Patients with eczematous skin diseases have complex illness representations regarding their disease. These representations interrelate with the coping behavior of patients. Therefore, medical professionals should consider them for counseling and treatment.

Systematic review registration

PROSPERO 2018 CRD42018109217.

Available only for authorised users

Wollenberg A, Oranje A, Deleuran M, Simon D, Szalai Z, Kunz B, et al. ETFAD/EADV Eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients. J Eur Acad Dermatol Venereol. 2016;30(5):729–47. https://doi.org/10.1111/jdv.13599.PubMedCrossRef

Ring J, Alomar A, Bieber T, Deleuran M, Fink-Wagner A, Gelmetti C, et al. Guidelines for treatment of atopic eczema (atopic dermatitis) part I. J Eur Acad Dermatol Venereol. 2012;26(8):1045–60. https://doi.org/10.1111/j.1468-3083.2012.04635.x.PubMedCrossRef

Coenraads P-J. Hand eczema. N Engl J Med. 2012;367(19):1829–37. https://doi.org/10.1056/NEJMcp1104084.PubMedCrossRef

Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387(10023):1109–22. https://doi.org/10.1016/S0140-6736(15)00149-X.PubMedCrossRef

Rashid RS, Shim TN. Contact dermatitis. BMJ. 2016;353:i3299.PubMedCrossRef

Johansen JD, Aalto-Korte K, Agner T, Andersen KE, Bircher A, Bruze M, et al. European Society of Contact Dermatitis guideline for diagnostic patch testing - recommendations on best practice. Contact Derm. 2015;73(4):195–221. https://doi.org/10.1111/cod.12432.CrossRef

Skoet R, Zachariae R, Agner T. Contact dermatitis and quality of life: a structured review of the literature. Br J Dermatol. 2003;149(3):452–6. https://doi.org/10.1046/j.1365-2133.2003.05601.x.PubMedCrossRef

Hoare C, Li Wan Po A, Williams H. Systematic review of treatments for atopic eczema. Health Technol Assess. 2000;4(37):1–191.PubMedPubMedCentralCrossRef

Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014;70(2):338–51. https://doi.org/10.1016/j.jaad.2013.10.010.PubMedCrossRef

10.

Eckert L, Gupta S, Amand C, Gadkari A, Mahajan P, Gelfand JM. Impact of atopic dermatitis on health-related quality of life and productivity in adults in the United States: an analysis using the National Health and Wellness Survey. J Am Acad Dermatol. 2017;77:274–9 e3.PubMedCrossRef

11.

Böhm D, Stock Gissendanner S, Finkeldey F, John SM, Werfel T, Diepgen TL, et al. Severe occupational hand eczema, job stress and cumulative sickness absence. Occup Med (Lond). 2014;64(7):509–15. https://doi.org/10.1093/occmed/kqu076.PubMedCrossRef

12.

Holm EA, Wulf HC, Stegmann H, Jemec GBE. Life quality assessment among patients with atopic eczema. Br J Dermatol. 2006;154(4):719–25. https://doi.org/10.1111/j.1365-2133.2005.07050.x.PubMedCrossRef

13.

Hutchings CV, Shum KW, Gawkrodger DJ. Occupational contact dermatitis has an appreciable impact on quality of life. Contact Derm. 2001;45(1):17–20.20. https://doi.org/10.1034/j.1600-0536.2001.045001017.x.CrossRef

14.

Kadyk DL, McCarter K, Achen F, Belsito DV. Quality of life in patients with allergic contact dermatitis. J Am Acad Dermatol. 2003;49(6):1037–48. https://doi.org/10.1016/S0190-9622(03)02112-1.PubMedCrossRef

15.

Boehm D, Schmid-Ott G, Finkeldey F, John SM, Dwinger C, Werfel T, et al. Anxiety, depression and impaired health-related quality of life in patients with occupational hand eczema. Contact Derm. 2012;67(4):184–92. https://doi.org/10.1111/j.1600-0536.2012.02062.x.CrossRef

16.

Thyssen JP, Hamann CR, Linneberg A, Dantoft TM, Skov L, Gislason GH, et al. Atopic dermatitis is associated with anxiety, depression, and suicidal ideation, but not with psychiatric hospitalization or suicide. Allergy. 2018;73(1):214–20. https://doi.org/10.1111/all.13231 .PubMedCrossRef

17.

Schonmann Y, Mansfield KE, Hayes JF, Abuabara K, Roberts A, Smeeth L, et al. Atopic eczema in adulthood and risk of depression and anxiety: a population-based cohort study. J Allergy Clin Immunol Pract. 2020;8(1):248–57,e16. https://doi.org/10.1016/j.jaip.2019.08.030.PubMedPubMedCentralCrossRef

18.

Bao Q, Chen L, Lu Z, Ma Y, Guo L, Zhang S, et al. Association between eczema and risk of depression: a systematic review and meta-analysis of 188,495 participants. J Affect Disord. 2018;238:458–64. https://doi.org/10.1016/j.jad.2018.05.007.PubMedCrossRef

19.

Ring J, Zink A, Arents BWM, Seitz IA, Mensing U, Schielein MC, et al. Atopic eczema: burden of disease and individual suffering - results from a large EU study in adults. J Eur Acad Dermatol Venereol. 2019;33(7):1331–40. https://doi.org/10.1111/jdv.15634.PubMedCrossRef

20.

Leventhal H, Diefenbach M, Leventhal EA. Illness cognition: using common sense to understand treatment adherence and affect cognition interactions. Cogn Ther Res. 1992;16(2):143–63. https://doi.org/10.1007/BF01173486.CrossRef

21.

Petrie KJ, Weinman J. Why illness perceptions matter. Clin Med (Lond). 2006;6(6):536–9. https://doi.org/10.7861/clinmedicine.6-6-536.PubMedPubMedCentralCrossRef

22.

Diefenbach MA, Leventhal H. The common-sense model of illness representation: theoretical and practical considerations. J Soc Distress Homeless. 1996;5(1):11–38. https://doi.org/10.1007/BF02090456.CrossRef

23.

Leventhal H, Meyer D, Nerenz DR. The common sense representation of illness danger. In: Rachmann S, editor. Contributions to medical psychology. New York: Pergamon Press; 1980. p. 7–30.

24.

Leventhal H, Phillips LA, Burns E. The common-sense model of self-regulation (CSM): a dynamic framework for understanding illness self-management. J Behav Med. 2016;39(6):935–46. https://doi.org/10.1007/s10865-016-9782-2.PubMedCrossRef

25.

Hagger MS, Orbell S. A meta-analytic review of the common-sense Model of Illness Representations. Psychol Health. 2003;18(2):141–84. https://doi.org/10.1080/088704403100081321.CrossRef

26.

Broadbent E, Wilkes C, Koschwanez H, Weinman J, Norton S, Petrie KJ. A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychol Health. 2015;30(11):1361–85. https://doi.org/10.1080/08870446.2015.1070851.PubMedCrossRef

27.

Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60(6):631–7. https://doi.org/10.1016/j.jpsychores.2005.10.020.PubMedCrossRef

28.

Scharloo M, Kaptein AA, Weinman J, Bergman W, Vermeer BJ, Rooijmans HG. Patients’ illness perceptions and coping as predictors of functional status in psoriasis: a 1-year follow-up. Br J Dermatol. 2000;142(5):899–907. https://doi.org/10.1046/j.1365-2133.2000.03469.x.PubMedCrossRef

29.

Fortune DG, Richards HL, Main CJ, Griffiths CE. What patients with psoriasis believe about their condition. J Am Acad Dermatol. 1998;39(2):196–201. https://doi.org/10.1016/S0190-9622(98)70074-X.PubMedCrossRef

30.

Nordbø ECA, Aamodt G, Ihlebæk CM. Subjective health complaints in individuals with psoriasis and psoriatic arthritis: associations with the severity of the skin condition and illness perceptions - a cross-sectional study. Int J Behav Med. 2017;24(3):438–46. https://doi.org/10.1007/s12529-017-9637-4.PubMedCrossRef

31.

Firooz A, Bouzari N, Fallah N, Ghazisaidi B, Firoozabadi MR, Dowlati Y. What patients with vitiligo believe about their condition. Int J Dermatol. 2004;43(11):811–4. https://doi.org/10.1111/j.1365-4632.2004.02059.x.PubMedCrossRef

32.

Firooz A, Firoozabadi MR, Ghazisaidi B, Dowlati Y. Concepts of patients with alopecia areata about their disease. BMC Dermatol. 2005;5(1):1. https://doi.org/10.1186/1471-5945-5-1.PubMedPubMedCentralCrossRef

33.

Rocholl M, John SM, Wilke A, Ludewig M, Böhm C. Illness perceptions of adults with eczematous skin diseases: a systematic review of quantitative and qualitative studies. PROSPERO 2018 CRD42018109217. 2018. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018109217. Accessed 30 Apr 2021.

34.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097.PubMedPubMedCentralCrossRef

35.

Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. https://doi.org/10.1186/s13643-016-0384-4.PubMedPubMedCentralCrossRef

36.

Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, et al. Guidance on the conduct of narrative synthesis in systematic reviews: a product from the ESRC methods programme: Lancaster University; 2006. https://doi.org/10.13140/2.1.1018.4643.CrossRef

37.

Arai L, Britten N, Popay J, Roberts H, Petticrew M, Rodgers M, et al. Testing methodological developments in the conduct of narrative synthesis: a demonstration review of research on the implementation of smoke alarm interventions. Evidence & Policy. 2007;3(3):361–83. https://doi.org/10.1332/174426407781738029.CrossRef

38.

Hagger MS, Koch S, Chatzisarantis NLD, Orbell S. The common sense model of self-regulation: meta-analysis and test of a process model. Psychol Bull. 2017;143(11):1117–54. https://doi.org/10.1037/bul0000118.PubMedCrossRef

39.

Weinman J, Petrie KJ, Moss-Morris R, Horne R. The illness perception questionnaire: a new method for assessing the cognitive representation of illness. Psychol Health. 1996;11(3):431–45. https://doi.org/10.1080/08870449608400270.CrossRef

40.

Moss-Morris R, Weinman J, Petrie K, Horne R, Cameron L, Buick D. The Revised Illness Perception Questionnaire (IPQ-R). Psychol Health. 2002;17(1):1–16. https://doi.org/10.1080/08870440290001494.CrossRef

41.

Farmer T, Robinson K, Elliott SJ, Eyles J. Developing and implementing a triangulation protocol for qualitative health research. Qual Health Res. 2006;16(3):377–94. https://doi.org/10.1177/1049732305285708.PubMedCrossRef

42.

Foster RL. Addressing epistemologic and practical issues in multimethod research: a procedure for conceptual triangulation. ANS Adv Nurs Sci. 1997;20(2):1–12. https://doi.org/10.1097/00012272-199712000-00002.PubMedCrossRef

43.

O'Cathain A, Murphy E, Nicholl J. Three techniques for integrating data in mixed methods studies. BMJ. 2010;341(sep17 1):c4587. https://doi.org/10.1136/bmj.c4587.PubMedCrossRef

44.

Hong QN, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, et al. Mixed Methods Appraisal Tool (MMAT), version 2018. Registration of Copyright (#1148552): Canadian Intellectual Property Office, Industry Canada. 2018. http://mixedmethodsappraisaltoolpublic.pbworks.com/w/file/fetch/127916259/MMAT_2018_criteria-manual_2018-08-01_ENG.pdf. Accessed 30 Apr 2021.

45.

Hong QN, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, et al. The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Educ Inform. 2018;34:285–91.CrossRef

46.

Bathe A, Diepgen TL, Matterne U. Subjective illness perceptions in individuals with occupational skin disease: a qualitative investigation. Work. 2012;43(2):159–69. https://doi.org/10.3233/WOR-2012-1365.PubMedCrossRef

47.

Zack B, Arrandale VH, Holness DL. Workers with hand dermatitis and workplace training experiences: A qualitative perspective. Am J Ind Med. 2017;60(1):69–76. https://doi.org/10.1002/ajim.22654.PubMedCrossRef

48.

Mollerup A, Johansen JD, Thing LF. Knowledge, attitudes and behaviour in everyday life with chronic hand eczema: a qualitative study. Br J Dermatol. 2013;169(5):1056–65. https://doi.org/10.1111/bjd.12524.PubMedCrossRef

49.

Mollerup A, Veien NK, Johansen JD. An analysis of gender differences in patients with hand eczema - everyday exposures, severity, and consequences. Contact Derm. 2014;71(1):21–30. https://doi.org/10.1111/cod.12206.CrossRef

50.

Wittkowski A, Richards HL, Griffiths CEM, Main CJ. Illness perception in individuals with atopic dermatitis. Psychol Health Med. 2007;12(4):433–44. https://doi.org/10.1080/13548500601073928 .PubMedCrossRef

51.

Benyamini Y, Goner-Shilo D, Lazarov A. Illness perception and quality of life in patients with contact dermatitis. Contact Derm. 2012;67(4):193–9. https://doi.org/10.1111/j.1600-0536.2012.02071.x.CrossRef

52.

Březinová E, Nečas M, Vašků V. Quality of life and psychological disturbances in adults with atopic dermatitis in the Czech Republic. J Biol Regul Homeost Agents. 2017;31:227–33.PubMed

53.

Simpson EL, Hanifin JM. Atopic dermatitis. Med Clin North Am. 2006;90(1):149–67. https://doi.org/10.1016/j.mcna.2005.09.002 .PubMedCrossRef

54.

Mathias CGT. Contact dermatitis and workers' compensation: criteria for establishing occupational causation and aggravation. J Am Acad Dermatol. 1989;20(5):842–8. https://doi.org/10.1016/S0190-9622(89)70096-7.PubMedCrossRef

55.

Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derma Venereol. 1980;60:44–7.

56.

Mollerup A, Veien NK, Johansen JD. Effectiveness of the healthy skin clinic--a randomized clinical trial of nurse-led patient counselling in hand eczema. Contact Derm. 2014;71(4):202–14. https://doi.org/10.1111/cod.12243.CrossRef

57.

Susitaival P, Flyvholm M-A, Meding B, Kanerva L, Lindberg M, Svensson A, et al. Nordic Occupational Skin Questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure. Contact Derm. 2003;49(2):70–6. https://doi.org/10.1111/j.0105-1873.2003.00159.x.CrossRef

58.

Arents BWM, Mensing U, Seitz IA, Wettemann N, Fink-Wagner AH, de Carlo G, et al. Atopic eczema score of emotional consequences - a questionnaire to assess emotional consequences of atopic eczema. Allergo J Int. 2019;28(7):277–88. https://doi.org/10.1007/s40629-019-0098-y.CrossRef

59.

Wittkowski A, Richards HL, Williams J, Main CJ. Factor analysis of the Revised Illness Perception Questionnaire in adults with atopic dermatitis. Psychol Health Med. 2008;13(3):346–59. https://doi.org/10.1080/13548500701487697.PubMedCrossRef

60.

Lerbaek A, Kyvik KO, Ravn H, Menné T, Agner T. Incidence of hand eczema in a population-based twin cohort: genetic and environmental risk factors. B J Dermatol. 2007;157(3):552–7.

61.

Thyssen JP, Linneberg A, Menné T, Nielsen NH, Johansen JD. The effect of tobacco smoking and alcohol consumption on the prevalence of selfreportedhand eczema: a cross-sectional population-based study. B J Dermatol. 2010;162(3):619-26.

62.

Antonov D, Schliemann S, Elsner P. Occupational skin products. In: John SM, Johansen JD, Rustemeyer T, Elsner P, Maibach HI, editors. Kanerva’s Occupational Dermatology. Cham: Springer International Publishing; 2020. p. 713–30. https://doi.org/10.1007/978-3-319-68617-2_112.CrossRef

63.

Wollenberg A, Barbarot S, Bieber T, Christen-Zaech S, Deleuran M, Fink-Wagner A, et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol. 2018;32(5):657–82. https://doi.org/10.1111/jdv.14891.PubMedCrossRef

64.

Institute of Medicine (US) Committee on Standards for Systematic Reviews of Comparative Effectiveness Research. Standards for finding and assessing individual studies. In: Eden J, Levit L, Berg A, Morton S, editors. Finding what works in health care: standards for systematic reviews. Washington (DC): National Academies Press (US); 2011. p. 81–153.

65.

Pluye P, Hong QN. Combining the power of stories and the power of numbers: mixed methods research and mixed studies reviews. Annu Rev Public Health. 2014;35(1):29–45. https://doi.org/10.1146/annurev-publhealth-032013-182440.PubMedCrossRef

66.

Hong QN, Pluye P. A conceptual framework for critical appraisal in systematic mixed studies reviews. J Mix Methods Res. 2018;37:155868981877005.

Title: Illness perceptions of adults with eczematous skin diseases: a systematic mixed studies review
Authors: Marc Rocholl
Michaela Ludewig
Carola Brakemeier
Swen Malte John
Annika Wilke
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Allergic Contact Dermatitis
Atopic Dermatitis
Published in: Systematic Reviews / Issue 1/2021
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-021-01687-5

At a glance: The STEP trials

Springer Medicine

Illness perceptions of adults with eczematous skin diseases: a systematic mixed studies review

Abstract

Background

Methods

Results

Conclusion

Systematic review registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Systematic review registration

Please log in to get access to this content

Other articles of this Issue 1/2021

A mega-aggregation framework synthesis of the barriers and facilitators to linkage, adherence to ART and retention in care among people living with HIV

Mapping evidence on standards and quality of care for older persons in long-term care facilities: a scoping review protocol

Theoretical approaches to process evaluations of complex interventions in health care: a systematic scoping review protocol

Initiatives addressing precarious employment and its effects on workers’ health and well-being: a protocol for a systematic review

Biomechanical adaptation to post-stroke visual field loss: a systematic review

Screening for depression in children and adolescents: a protocol for a systematic review update