Search

Objectives: Digital interventions are increasingly used to support behaviour change. In the prevention of chronic work-related skin diseases, the sustainable implementation of appropriate skin protection behaviour following tertiary individual prevention is important. However, there exists no intervention to support the maintenance of these behaviour changes until now. We report the systematic development of a technology-based maintenance programme to support patients to sustainably implement skin protection behaviour and to overcome barriers. Design: Complex intervention development based on a five-step multi-methods process. Setting: Tertiary individual prevention of work-related skin disease in Germany. Methods: Intervention development comprised the following steps--literature review, qualitative focus groups with stakeholders, quantitative assessment of the patients' needs, development of a programme theory, and intervention development and concept validation. Results: We developed a concept for a complex intervention based on results from the literature review, with seven reviews meeting the criteria; qualitative focus groups involving three dermatologists, five health educators, two psychologists and three employees of an accident insurance institution; and a quantitative needs assessment with 72 patients. Key requirements were derived from this process: for example, the need to develop an app to self-monitor skin protection behaviour and skin condition and to inform the individual about ways of dealing with barriers encountered during the uptake and maintenance of skin protection behaviour. In addition, patients will participate in an individual goal-setting exercise to identify individual behavioural goals. Conclusion: A technology-based approach to the prevention of work-related skin diseases was developed. During the process of development, the perspectives of relevant stakeholders and the target group were considered in a participatory way.

Tertiary Individual Prevention is an interprofessional inpatient rehabilitation programme offered to workers affected by work-related skin diseases. Health educational interventions aiming at changing skin protection behaviour are a pivotal component of the programme. This paper aims at characterizing the content of the educational interventions of the interprofessional inpatient rehabilitation programme and at reporting the mechanisms and functions for behaviour change. We retrospectively analysed existing health educational interventions with document analyses and field observations. The intervention was described using the Template of Intervention Description and Replication (TIDieR). For the intervention content, the Behaviour Change Technique (BCT) Taxonomy (v1) was applied. To characterize the intervention in detail, the BCTs were then mapped to the intervention functions, the COM-B model (Capability, Opportunity, Motivation) and the Theoretical Domains Framework (TDF) from the Behaviour Change Wheel (BCW). The health educational interventions consist of seven components. Five are delivered in a group and two as tailored face-to-face counselling. We identified 23 BCTs in 10 groups. The most common used BCTs are "instruction on how to perform skin protection behaviour," "salience of consequences," "information about skin health," and "demonstration of skin protection behaviour." To initiate the process of behaviour change in skin protection behaviour by the individuals, changes are required in all three behavioural sources (Capability, Opportunity, Motivation) and primarily in the theoretical constructs "behavioural regulation," "skills," and "beliefs about consequences." For this purpose, the five intervention functions "enablement," "training," "education," "modelling," and "persuasion" are used. Health educational interventions to change skin protection behaviour consists of different BCTs, mechanisms of change and intervention functions. This work helps to better understand the mechanisms and means of behaviour change and enables replication in other settings. In the future, the intervention programme should be extended to include BCTs addressing domains for behaviour changes which have not yet been included to maintain the new behaviour in the long-term. Finally, we recommend to report more elements of the rehabilitation programme (e.g. psychological interventions) in a standardized manner by frameworks used in this paper. [ABSTRACT FROM AUTHOR]

Background: A programme based on health education has been developed to prevent foot dermatoses (FD) in patients with work‐related skin diseases (WRSD). Objective: To evaluate the effectiveness of the programme in a prospective cohort study (OCCUPES). Methods: Six and 12 months after completing the programme, follow‐up questionnaires were sent to 231 patients with WRSD and FD. Assessments included occupational footwear and foot care, self‐reported disease course, and health‐related quality of life. Results: Response to follow‐ups was >70%. Wearing functional socks and changing footwear and socks during one work shift increased (all p < 0.001). Complaints about occupational footwear decreased, including sweating and exposure to moisture/wetness. More than 60% reported improved FD while quality of life significantly increased. After 12 months, all foot symptoms were less frequent, including itch (p = 0.009), pain when walking (p = 0.005), pain in rest (p = 0.015) and smell (p = 0.001). The programme received very good ratings by the participants. Conclusions: The intervention was effective in improving occupational footwear, foot care and preventive behaviour. It resulted in a reduced burden of FD and should be implemented in the general care of patients with WRSD. [ABSTRACT FROM AUTHOR]

Background: Occupational skin diseases (OSD) in the form of hand eczema (HE) are a common work-related disease. Illness perceptions as presented in Leventhal's Common-Sense Model (CSM) are important for patients' self-management of diseases. Understanding these illness perceptions is essential for patient communicating. No quantitative or qualitative studies which investigated subjective illness perceptions in patients with occupational HE utilized the CSM as theoretical framework. The Objective of this study is to investigate illness perceptions of patients with occupational hand eczema (HE) using the CSM. Methods: We applied an exploratory qualitative approach and conducted purposive sampling. Thirty-six patients with occupational HE were interviewed using an interview guide based on the dimensions of the CSM, including coherence and emotional representation. All participants participated in a three-week inpatient program at a clinic specialized on occupational dermatology. One interview had to be excluded before analysis, since one participant's diagnosis was retrospectively changed from ICD to tinea and hence did not match the inclusion criteria. Thirty-five interviews were transcribed verbatim and analyzed. Data was analyzed deductively and inductively using qualitative text analysis. MAXQDA 2018 (Verbi, Berlin, Germany), a software for qualitative data analysis, was applied for coding and summarizing of results. All dimensions of the CSM were explored for occupational HE. Results: Several sub-categories could be identified. Participants named a variety of causes in different areas (e. g. external irritants and other hazardous factors, psycho-social factors, allergies, having a 'bad immune system' or lifestyle). The great impact of the disease on the participants' life is shown by the wide range of consequences reported, affecting all areas of life (i. e. psychological, physical, occupational, private). Considering coherence, an ambivalence between comprehensibility and non-comprehensibility of the disease is apparent. Discussion: The complexity of illness perceptions presented in this paper is relevant for those involved in HE patient education and counseling, e. g, health educators, dermatologists, and, occupational physicians. Future research might further investigate specific aspects of illness perceptions in patients with occupational HE, especially considering the complexity of coherence and overlapping dimensions (i. e. emotional representation and psychological consequences). [ABSTRACT FROM AUTHOR]

Background: Glove liners (GLs) made of cotton (COT) are worn under impermeable gloves to prevent occlusion effects. Semipermeable GLs made of Sympatex (SYM) might be an alternative. Objectives: To evaluate the acceptance of GLs (COT/SYM) in health care workers (HCWs) with work‐related skin diseases (WRSDs). Methods: One hundred sixty‐one HCWs with WRSDs were asked to wear GLs in combination with occlusive gloves for 10 ±2 weeks under workplace conditions. A questionnaire was applied to compare acceptance and usability of the respective glove combinations and previously used protective gloves (PUGs). Results: A total of 120 data sets were available (SYM: n = 65, 77.4%; COT: n = 55, 71.4%). Both GLs provided a significantly lower sweating sensation, more pleasant climate, comfortable wearing experience, and moist or dry feeling on the skin compared to PUGs. SYM‐GLs performed significantly better than COT‐GLs regarding mobility of hands, sensitivity, and sense of touch. COT‐GLs were significantly better than SYM‐GLs in the categories fit, donning and doffing, and material contact. Conclusions: Both GLs did not impair work performance, were applicable in various areas of health care activities, and were preferred over PUGs. Our results indicate that SYM‐GLs are an alternative to COT‐GLs and thus may contribute to current prevention strategies. [ABSTRACT FROM AUTHOR]

Keywords: allergic contact dermatitis; case report; dithiocarbamates; gloves; nitrile/neoprene rubber; polyethylene; rubber accelerators; thiurams EN allergic contact dermatitis case report dithiocarbamates gloves nitrile/neoprene rubber polyethylene rubber accelerators thiurams 321 322 2 03/16/22 20220401 NES 220401 CASE REPORT A 44-year-old woman with atopic diathesis who worked as a cleaner of hospital beds presented with longstanding hand dermatitis. The shorter PE glove - despite having almost the same length as the disposable protective glove - tended to slip causing direct skin contact at the wrist with the protective glove containing dithiocarbamates (Figure 1C). [Extracted from the article]

Background Objectives Methods Results Conclusions Comfort gloves are used in the management of hand dermatoses.To compare the acceptance and tolerability of comfort gloves made of different materials in patients with hand dermatoses and their effects on skin lesions.In a prospective multicenter study, 284 patients with hand dermatoses were invited to wear either a cotton glove (COT) or a semipermeable Sympatex glove underneath a cotton glove (SYM/COT) for two subsequent phases of 19 consecutive nights each. A total of 88 controls were asked not to wear any comfort gloves overnight. The severity of skin lesions over time was examined. Questionnaires were used to assess health‐related quality of life (HRQoL) and acceptance and tolerability of the gloves.The hand dermatoses improved in all groups. No substantial intergroup differences regarding severity and HRQoL were observed. SYM/COT received better ratings regarding climate conditions and tactility while COT showed superiority in fit, wearing comfort, and practicality.We confirmed that SYM/COT and COT are well tolerated and accepted suggesting that SYM/COT is a good alternative for COT as comfort gloves in patients with hand dermatoses. Individual requirements, needs, and preferences may direct the material choice. [ABSTRACT FROM AUTHOR]

Sustainability is becoming increasingly important in healthcare and has moved into focus at various levels. This article aims to provide an overview of guiding principles, concepts, and target systems of sustainability and to transfer these to occupational dermatology. Current and future starting points are outlined for various levels, e.g., politics, research, industry, and patient care, in order to link sustainability and occupational dermatology in a structured and systematic way and to transform the structures of patient care in occupational dermatology care towards sustainability. Using the specific example of protective gloves, which is a pivotal personal protective measure to prevent work-related hand eczema, starting points, potentials, and challenges are analyzed and specific possibilities and perspectives for more ecologically sustainable action are presented., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Background and Objectives: Outdoor workers are at increased risk of developing non-melanoma skin cancer. We aimed to address the lack of validated German-language measurement instruments for outdoor workers' sun safety behavior and knowledge by compiling and validating two questionnaires., Participants and Methods: By expert consensus, items for the assessment of protective behavior (OccuSun) were compiled based on existing instruments. For knowledge, a translation of the Skin Cancer and Sun Knowledge (SCSK) scale was selected. After a pre-test, a validation study including 68 outdoor workers (62% female) was conducted in 2020., Results: The retest reliability was r = 0.93 (95% confidence interval: 0.86-0.96) for the protection score and r s = 0.78 (0.67-0.86) for the knowledge score. Protective behaviors were correlated with respective diary data (0.38 ≤ r s  ≤ 0.74, p < 0.001) and skin pigmentation changes (-0.23 ≥ r s ≥ -0.42, 0.007 ≤ p ≤ 0.165) but not with self-reported sunburn frequency (0.21 ≥ r s ≥ -0.04)., Conclusions: Among German outdoor workers, two questionnaires for the assessment of sun protection behavior (OccuSun) and knowledge (SCSK) demonstrated good reliability. The OccuSun had generally good validity. Both instruments are fit for subsequent validation to determine their sensitivity to change., (© 2024 The Authors. Journal der Deutschen Dermatologischen Gesellschaft published by John Wiley & Sons Ltd on behalf of Deutsche Dermatologische Gesellschaft.)