title: Experiences of carers managing childhood eczema and their views on its treatment: a qualitative study.
abstract: BACKGROUND
  Childhood eczema causes significant impact on quality of life for some families, yet non-concordance with treatment is common.
  
  
  OBJECTIVE
  To explore parents' and carers' views of childhood eczema and its treatment.
  
  
  METHODS
  Qualitative interview study in primary care in the south of England.
  
  
  METHODS
  Carers of children aged ≤5 years with a recorded diagnosis of eczema, who reported that eczema was still a problem, were invited to participate. Thirty-one parents were interviewed from 28  families.
  
  
  RESULTS
  Many parents expressed frustration with both medical care and prescribed treatments. They felt their child's suffering was not 'taken seriously', and experienced messages about a 'trial and error' prescribing approach and assurance  that their child would 'grow out of it' as a further 'fobbing off', or dismissal. Many carers were ambivalent about eczema treatments, mainly topical corticosteroids but also emollients. Dietary exclusions as a potential cure were of interest to most families, although  they perceived healthcare professionals as uninterested in this. Families varied in the extent to which they felt able to manage eczema and the length of time taken to gain control. In some instances, this was linked to not understanding advice or receiving conflicting advice from different  healthcare providers.
  
  
  CONCLUSIONS
  Poor concordance with treatments seems unsurprising in the presence of such dissonance between carers' and healthcare providers' agendas. Acknowledging the impact of the condition, greater attention to how key messages are delivered and  addressing carers' treatment beliefs are likely to improve engagement with effective self-care.
authors.affiliation: Primary Medical Care, Aldermoor Health Centre, University of Southampton, Southampton. m.santer@soton.ac.uk
authors.forename: Miriam
authors.initials: M
authors.lastname: Santer
authors.forename: Hana
authors.initials: H
authors.lastname: Burgess
authors.forename: Lucy
authors.initials: L
authors.lastname: Yardley
authors.forename: Steven
authors.initials: S
authors.lastname: Ersser
authors.forename: Sue
authors.initials: S
authors.lastname: Lewis-Jones
authors.forename: Ingrid
authors.initials: I
authors.lastname: Muller
authors.forename: Catherine
authors.initials: C
authors.lastname: Hugh
authors.forename: Paul
authors.initials: P
authors.lastname: Little
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D002675:Child, Preschool; D004032:Diet; D004485:Eczema / Q000523:psychology / Q000628:therapy*; D004643:Emollients / Q000627:therapeutic use; D004739:England; D005194:Family Practice; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D010817:Physician-Patient Relations
chemical_list: D000305:Adrenal Cortex Hormones; D004643:Emollients