الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 256 |  |  |
| | | from | 256 | | |
Abstract
Summary
Eczema is a chronic inflammatory disorder characterized by eczematous skin lesions, itch, skin pain, sleep disturbances, and multiple atopic and non-atopic comorbidities, all of which can lead to significant morbidity. Eczema is a heterogeneous disorder with variable intensity and extent of lesions, frequency, and intensity of symptoms (Campos et al., 2022)
Eczema can influence on a range of areas, including emotional and mental health, physical activity, social functioning, sleep disturbance, decreased work productivity, financial expenditure, leisure activities, and family-relationships. Patients with skin diseases experience a wide range of symptoms ranging from trivial problems to major handicaps which affect their quality of life so there are specific instruments for measuring QOL in adults. Because QOL is an important we call attention to assess the patients by use many tools to reach optimum quality of life (Lindh, & Bradley, 2022).
Eczema has been shown to have an impact on quality of life (QoL) in patients. Quality of life is defined by the World Health Organization Quality of Life (WHO-QoL) Group10 as “individuals’ perceptions of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns (Weigandt et al., 2023)
This study aimed to assess the quality of life for patients with eczema through: assessing the patients’ level of knowledge about eczema, assessing the patients’ level of practice regarding caring of skin, assessing the patients’ level of severity of eczema, assessing level of anxiety and depression for those patients and assessing quality of life for patients with eczema tool IV
Research design:
A descriptive exploratory study. Descriptive exploratory research design is a research design that explores and explains an individual, group or a situation and conducted for formulating a problem for more clear investigation (Surbhi, 2017).
Setting:
The study was conducted at Dermatological clinic at Dairut Central Hospital in Assiut. It is a multi-specialty hospital which provides health services to Assuit Governorate and surrounding areas. Dermatological clinic is located on the ground floor. It consists of 1 room for examination with bed capacity 1 bed. The clinic working from (Saturday to Thursday from 9 Am to 2 Pm).
Subjects:
Purposive sample of 74 patients from both gender, were selected according to sensitive analysis in relation to the total number of eczema patients 300 who attending to outpatient dermatologic clinic (2021-2022) at Dairut hospital. The sample size was calculated according to the study design, objectives of the study and review of past literature and at power 80% and confidence level 95% by the following equation:
𝑛= (𝑁× (1−𝑝)) / ({[𝑁−1×(𝑑^2÷𝑧^2 )]+𝑝(1−𝑝)})
N→ population size = 300
z→ value for 90% confidence limits = 1.645
d→ margin errors = 0.05
p → proportion population =0.5
n=300×0.5(1−0.5) / {[300−1× (0.0025÷2.7060)] + 0.5(1−0.5)} = 74 patients
Tools of data collection: six tools were used to conduct the study as the following
Tool (I): Patients interviewing questionnaire:
This tool was developed by the investigator after reviewing the literature and consisted of three parts:
Part (1): Socio demographic characteristics such as; age, sex, social status, educational level, work, type of work, living with, place of residence, family income level and smoking at home.
Part (2): Patients history: it concerned with patients past medical history and family history.
Part (3): Patients knowledge: it was developed based on review of the previous literatures and it concerned with patients level of knowledge regarding eczema and was adopted by (Kim et al., 2015) and. It consists of 10 questions with total score 10.
Toll (II): Level of attitude of patients with eczema was adopted by (Mollerup et al., 2013), it concerned with assessing the patient’s level of attitude regarding eczema. It consists of 17 statements with total sore = 85.
Tool (III) : Observational check list to assess patients’ level of practice regarding care of eczema.it was developed by investigator according to recent literature review and consists of 10 statements with total score 10 (Mitchell, 2022).
Tool (IV): SCORAD scale: This tool was adopted by (Lee et al., 2021). Was used to assess the level of severity of eczema. It consists of three items as; Total SCORAD index (extent area of the affected body& intensity of the affected body surface& apparent symptoms), total objective SCORAD (surface area of the affected body& signs of the affected body surface) and total subjective symptoms (TIS).
Tool (V): Dermatology life quality index (DLQI): Tool was adopted from Micali, (2017) to assess quality of life for patients with eczema with total score (195). It consists of three dimensions physical side (15 statements), social and family aspect (11 statements) and psychological side (13 statements).
Tool (VI): The Hospital Anxiety Depression Scale (standardized tool) is a self-report rating scale of 14 items on a 4-point Likert scale (range 0–3). It was designed to measure anxiety and depression (7 items for each subscale). The total score is the sum of the 14 items, and for each subscale the score is the sum of the respective seven items (ranging from 0–21) (Cassiani-Miranda, 2022).
The results of the study revealed that:
• 60.8% of the studied patients their age ranged between 18 to 30 years, the Mean ± SD of age 32.9±12.9 years. As regard to gender, 58.1% of them are female. In addition, 43.2% of the studied patients were married, 35.1% of the studied patients were Secondary – diploma education. Also 56.8% of the studied patients were not working, and 87.8% of them were living with family. Also 63.5% of them live in the urban and 60.8% of them income level of the family were not enough. In addition, 35.1% of the studied patients were smoking at home.
• 52.7% of the studied patients were visit the clinic from1-3 times during the month. While, 54.1% of them duration of the disease were from 1- 5 years. Also 48.6%of them were complaining from chronic diseases, and 44.4% of them were complaining from chest disease. In addition, 45.9% of them winter affect on the severity of the disease.
• 36.5% of the studied patients had good level of knowledge toward eczema. While, 35.1% of them had average level, and only 28.4% of them had poor level of knowledge of eczema.
• 56.8% of the studied patients had negative attitude of eczema. While, 43.2% of them had positive attitude toward eczema.
• 68.9% of the studied patients had unsatisfactory level of practice. While, 31.1% of them had satisfactory level of practice.
• The highest level of Mean±SD is for surface area of the affected body 18.608±17.6934), while lowest level of Mean±SD is for intensity of the affected body surface (9.7703±5.13795).
• 52.7% of the studied patients had poor level of quality of life and 28.4% of them had average level. While, 18.9% of them had high level of quality of life.
• 32.4% of the studied patients had no level of anxiety and 20.3% of them had mild level. Also 24.3% of them had moderate level. In addition, 23% of them had severe level of anxiety.
• 32.4% of the studied patients had no level of depression and 8.1% of them had mild level. Also 25.7% of them had moderate level. In addition, 33.8% of them had severe level of anxiety.
• There was a statistically highly significant relationship between educational level of the studied patients with their total knowledge at P-Value 0.000.Also there was a statistically significant relationship between age, work and type of work of the studied patients with their total knowledge at P-Value 0.020, 0.026 and 0.024 respectively.
• There was a statistically highly significant relationship between duration of the disease of the studied patients with their total knowledge at P-Value 0.009.
• There was a statistically highly significant relationship between summer with their total of level of severity of allergic dermatitis at P-Value 0.000. Also there was a statistically significant relationship between winter, animals, medicines, food or detergents with their total of level of severity of allergic dermatitis at P-Value 0.022, 0.011, 0.012, 0.047 respectively.
In conclusion, more than one third of the studied patients had good level of knowledge regarding eczema and more than one third of them had average level of knowledge of eczema, while only more than one quarter of them had poor level of knowledge of eczema. Also, more than half of the studied patients had negative attitude of eczema. While, less than half of them had positive attitude of eczema.
As well as, more than two thirds of the studied patients had unsatisfactory level of practice, on other hand, less than one third of them had satisfactory level of practice. In addition , the finding displayed that more than half of the studied patients had poor level of quality of life, and more than one quarter of them had average level, While, less than one fifth of them had high level of quality of life.
In the light of the study finding, it is recommended that:
• Providing health education about food, personal, and environmental hygiene for both patients and their family.
• Planning and conducting health education programs in outpatient clinic for patients about the causes and prevention of eczema episode.
• Regular follow up is needed to ensure the efficiency of management and to diagnosis new site of eczema.
• Fixed poster and pictures at the outpatient clinic and dermatology department to explain well practices that must apply by patients with eczema.
• Educating patients how to deal with eczema to prevent its negative effect on their quality of life.
• Providing emotional support for patients and their relatives.
• Disseminating health education brochure to increase patients’ awareness about eczema and healthy home precautions at outpatient clinics.
Further studies:
• A comparative study between urban and rural knowledge, attitude and practice about eczema can be conducted.
• Effect of educational program for patients with eczema about their disease on their quality of life
• Currying out the study on large sample and in other setting for generalization