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Managing childhood atopic dermatitis: exploring caregivers’ barriers and facilitators to treatment adherence at a public hospital in the Western Cape, South Africa
Thesis (MA)--Stellenbosch University, 2022
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| Format: | Thesis |
| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2022
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| _version_ | 1867613932513918976 |
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| access_status_str | Open Access |
| author | Field, Courtney Anne |
| author2 | Roomaney, Rizwana |
| author_browse | Field, Courtney Anne Roomaney, Rizwana |
| author_facet | Roomaney, Rizwana Field, Courtney Anne |
| author_sort | Field, Courtney Anne |
| collection | Thesis |
| description | Thesis (MA)--Stellenbosch University, 2022 |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/124786 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:43:59.926Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/124786 Managing childhood atopic dermatitis: exploring caregivers’ barriers and facilitators to treatment adherence at a public hospital in the Western Cape, South Africa Field, Courtney Anne Roomaney, Rizwana Lachman, Anusha Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology. Atopic dermatitis Caregivers Clinical health psychology Patient compliance UCTD Thesis (MA)--Stellenbosch University, 2022 ENGLISH SUMMARY: Atopic dermatitis (AD), also known as eczema, is a non-threatening chronic inflammatory skin disease that has an onset in early childhood. Due to AD’s early age of onset, the burden of care is placed on the caregiver. The pathophysiology of AD is of abnormal skin barrier functioning, with itchy skin, known as pruritis, as the most prevalent symptom. Globally, AD affects 20% of children, and it is estimated that 18% of children in South Africa have the skin disease. Treatment is aimed at skin management through the application of creams and the monitoring of skin triggers. Treatment adherence is a vital aspect in maintaining skin functioning in AD. The reasons for adherence and non-adherence to AD treatment were sparse in the published literature. Thus, this study aimed to explore AD caregivers’ barriers and facilitators to treatment adherence. This qualitative study used a semi-structured interview guide that was formulated based on research objectives and aimed to explore AD caregivers’ experiences, treatment experiences, barriers and facilitators to treatment adherence, and the extent to which AD caregivers had the capability, opportunity and motivation to adhere to treatment as well as the caregiver/child relationship. Through purposive sampling, 20 AD caregivers were interviewed on average for 38 minutes at the Dermatology Allergy/Eczema Clinic at the Tygerberg Hospital in the Western Cape. Each interview was audio recorded and transcribed verbatim for data analysis via the ATLAS.ti computer program. The data was analysed through thematic analysis in an inductive and deductive manner. Inductive analysis allowed for the themes and sub-themes to be constructed from the given transcript. Deductive analysis linked the data to the two theoretical frameworks, namely, Attachment Theory and the Capability, Opportunity, and Motivation Model of Behaviour (COM-B). Six themes and 24 sub-themes were constructed that captured AD caregivers’ barriers and facilitators to treatment adherence. The six themes were: (1) symptoms Stellenbosch University of AD; (2) impact on the child; (3) physical experiences of caring; (4) range of emotions; (5) barriers to treatment adherence; and (6) facilitators to treatment adherence. The findings indicated that the caregivers experienced both barriers and facilitators, which influenced the adherence to treatment for their child with AD. The major barrier to treatment adherence was the primary health care (PHC) facilities. Caregivers were not provided with adequate AD knowledge, treatment skills, and treatment products at PHC clinics. Conversely, the main facilitator to treatment adherence was the Dermatology Allergy/Eczema Clinic at the Tygerberg Hospital because caregivers received sufficient AD information, treatment skills, and treatment products there. AD education was the deciding factor for caregiver’s adherence to treatment. Without the crucial AD knowledge provided, caregivers were unable to adhere to treatment; however, AD education led to increased treatment adherence. Other barriers to treatment adherence were the physical and emotional burden of care and a possible insecure attachment style between the child with AD and their caregiver. Supporting facilitators to treatment adherence were a possible secure attachment style, social support, and innovative care. Overall, caregivers experienced a wide array of barriers and facilitators to treatment adherence of their child with AD. AFRIKAANS OPSOMMING: Atopiese dermatitis (AD), ook bekend as ekseem, is ‘n nie-bedreigende chroniese inflammatoriese velsiekte wat gedurende vroeë kinderjare ontstaan. As gevolg van die vroeë ouderdom waarop AD begin, is die onus van sorg op die versorger. Die patofisiologie van AD bestaan uit abnormale funksionering van die velversperring, met jeukerige vel, wat as pruritis bekendstaan, die mees algemene simptoom. AD affekteer globaal 20% van alle kinders en daar word geskat dat 18% van kinders in Suid-Afrika hierdie velsiekte het. Behandeling is gemik op velsorg deur middel van die aanwending van room en die monitor van velprikkels. Behandelingnakoming is ‘n noodsaaklike aspek in terme van die handhawing van gesonde velfunksionering by AD-pasiënte. Die redes vir nakoming en nie-nakoming ten opsigte van AD-behandeling in die gepubliseerde literatuur is skaars. Hierdie studie is dus daarop gemik om AD-versorgers se hindernisse en fasiliteerders ten opsigte van behandelingnakoming te ondersoek. Hierdie kwalitatiewe studie het ‘n semi-gestruktureerde onderhoudgids gebruik wat op die basis van die navorsingsoogmerke geformuleer is, met die doelwit om AD-versorgers se ervarings, behandelingservarings, hindernisse en fasiliteerders ten opsigte van behandelingnakoming, sowel as die mate waartoe AD-versorgers beskik het oor die vaardighede, geleenthede en motivering om behandeling na te kom en die versorger/kind verhouding, te ondersoek. Aan die hand van doelverwante monsterneming is onderhoude gevoer met 20 AD-versorgers, vir gemiddeld 38 minute elk, by die Dermatologie Allergie/Ekseemkliniek by Tygerberg Hospitaal in die Wes-Kaap. Daar is ‘n klankopname van elke onderhoud gemaak, en dit is verbatim getranskribeer vir data-analise via die ATLAS.TI rekenaarprogram. Die data is deur middel van tematiese analise beide induktief en deduktief ontleed. Induktiewe analise het dit moontlik gemaak om die temas en subtemas vanuit die gegewe transkripsie te identifiseer. Deduktiewe analise het die data gekoppel aan die twee teoretiese raamwerke, naamlik, Bindingsteorie en die kapasiteit-, geleentheid- en motiveringsmodel van gedrag (COM-B). Ses temas en 24 subtemas, wat AD-versorgers se hindernisse en fasiliteerders ten opsigte van behandelingnakoming gedokumenteer het, is identifiseer. Die ses temas was, (1) simptome van AD; (2) die impak op die kind; (3) fisieke ervarings rondom versorging; (4) spektrum van emosies; (5) hindernisse ten opsigte van behandelingnakoming; en (6) fasiliteerders ten opsigte van behandelingnakoming. Die bevindings het aangedui dat die versorgers beide hindernisse en fasiliteerders ervaar het wat die nakoming van behandeling vir hulle kind met AD beïnvloed het. Die belangrikste hindernis ten opsigte van behandelingnakoming het plaasgevind op die vlak van primêre gesondheidsorg (PGS) fasiliteite. Versorgers is nie by PGS-klinieke voorsien van genoegsame AD-kennis, behandelingsvaardighede en behandelingsprodukte nie. Aan die ander kant is die belangrikste fasiliteerder ten opsigte van behandelingnakoming identifiseer by die Dermatologie Allergie/Ekseem kliniek by Tygerberg Hospitaal, aangesien versorgers genoegsame AD-inligting, behandelingsvaardighede en behandelingsprodukte daar ontvang het. AD-opvoeding was die toonaangewende faktor vir versorgers se nakom van behandeling. Sonder die verskaffing van kernbelangrike AD-kennis was versorgers nie in staat om behandelingnakoming toe te pas nie; AD-opvoeding het egter gelei tot verhoogde behandelingnakoming. Ander hindernisse ten opsigte van behandelingnakoming was die fisieke en emosionele las van versorging en ‘n moontlik onseker bindingstyl tussen die kind met AD en hulle versorger. Ondersteunende fasiliteerders ten opsigte van behandelingnakoming was ‘n moontlik sekure bindingstyl, sosiale ondersteuning en innoverende versorging. Oor die algemeen het versorgers ‘n uitgebreide reeks hindernisse en fasiliteerders ervaar ten opsigte van behandelingnakoming vir hulle kind met AD. Masters 2022-02-18T12:39:05Z 2022-04-29T09:33:06Z 2022-02-18T12:39:05Z 2022-04-29T09:33:06Z 2022-04 Thesis http://hdl.handle.net/10019.1/124786 en_ZA xxiv, 178 pages : illustrations application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Atopic dermatitis Caregivers Clinical health psychology Patient compliance UCTD Field, Courtney Anne Managing childhood atopic dermatitis: exploring caregivers’ barriers and facilitators to treatment adherence at a public hospital in the Western Cape, South Africa |
| title | Managing childhood atopic dermatitis: exploring caregivers’ barriers and facilitators to treatment adherence at a public hospital in the Western Cape, South Africa |
| title_full | Managing childhood atopic dermatitis: exploring caregivers’ barriers and facilitators to treatment adherence at a public hospital in the Western Cape, South Africa |
| title_fullStr | Managing childhood atopic dermatitis: exploring caregivers’ barriers and facilitators to treatment adherence at a public hospital in the Western Cape, South Africa |
| title_full_unstemmed | Managing childhood atopic dermatitis: exploring caregivers’ barriers and facilitators to treatment adherence at a public hospital in the Western Cape, South Africa |
| title_short | Managing childhood atopic dermatitis: exploring caregivers’ barriers and facilitators to treatment adherence at a public hospital in the Western Cape, South Africa |
| title_sort | managing childhood atopic dermatitis exploring caregivers barriers and facilitators to treatment adherence at a public hospital in the western cape south africa |
| topic | Atopic dermatitis Caregivers Clinical health psychology Patient compliance UCTD |
| url | http://hdl.handle.net/10019.1/124786 |
| work_keys_str_mv | AT fieldcourtneyanne managingchildhoodatopicdermatitisexploringcaregiversbarriersandfacilitatorstotreatmentadherenceatapublichospitalinthewesterncapesouthafrica |