title: Subjective illness perceptions in individuals with occupational skin disease: a qualitative investigation.
abstract: OBJECTIVE
  Occupational skin disease (OSD) is the most frequent work-related disease in most industrialised countries and poses a high social, economic and personal burden. However, to date no study has examined the illness perceptions of individuals with refractory OSD.
  
  
  METHODS
  Semi-structured guided interviews with 50 patients with OSD were conducted. Data was subjected to qualitative content analysis.
  
  
  RESULTS
  Most patients were not able to see the prodromal symptom-character of dry skin or the involvement of psychological factors in the formation and maintenance of eczema. Patients rejected a personal accountability for the condition. Before being willing to act upon skin protection measures, external agencies (employer, insurance organisations) have to overcome a variety of perceived barriers. Previous negative experiences with skin protection often lead to the conclusion that these measures, in general, are not efficacious.
  
  
  CONCLUSIONS
  In order to accommodate the needs of patients with OSD, health care providers need to be aware of what these patients' illness cognitions consist of, and how they interact with current preventive efforts. Many details of the patient's perspective are often overlooked, but need to be considered. Failure to do so may mean that well-meant interventions will not reach the addressed audience successfully.
authors.affiliation: Department for Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital Heidelberg, Heidelberg, Germany. anja.bathe@med.uni-heidelberg.de
authors.forename: Anja
authors.initials: A
authors.lastname: Bathe
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Diepgen
authors.forename: Uwe
authors.initials: U
authors.lastname: Matterne
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002908:Chronic Disease / Q000517:prevention & control / Q000523:psychology / Q000628:therapy; D017453:Dermatitis, Irritant / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D005858:Germany; D006229:Hand Dermatoses / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology / Q000628:therapy; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000517:prevention & control; D009786:Occupational Health Services / Q000379:methods*; D010349:Patient Compliance; D010561:Personnel Staffing and Scheduling; D011482:Protective Devices / Q000706:statistics & numerical data; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D017132:Workplace / Q000523:psychology / Q000592:standards