Educational Interventions for the Management of Children with Dry Skin

  • Steven J. Ersser
  • Noreen Heer Nicol


This chapter highlights the importance of the education of patients and parents of children with dry skin, especially when chronic. Education is the primary means to address the problems of treatment adherence and the common lack of knowledge, skill and confidence required to largely self-manage this problem. The need to give attention to appropriate daily skin care routine of the parent/child and integrate moisturizer use within this practice is highlighted. The chapter reinforces the importance of structured education, parental involvement within the educational process and their confidence in the process as key success elements. The nature of educational interventions is examined, including the format, timing, rationale and location of the educational process with illustrations of common and new practices, resources and key messages. A summary is given of some of the key evidence on the educational process related to managing dry skin, especially in the case of eczema. Evidence-based education for effective moisturiser use the treatment of dry skin in the absence of other skin disease. Some suggestions for further research are given. Finally, the key learning points are summarised.


Atopic Eczema Educational Intervention Skin Barrier Skin Care Exchange Health Information 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Bandura A (1977) Social learning theory. Prentice Hall, Englewood CliffsGoogle Scholar
  2. 2.
    Bandura A (1989) Human agency in social cognitive theory. Am Psychol 44(9):1174–1184CrossRefGoogle Scholar
  3. 3.
    Bandura A (1997) Self-efficacy: the exercise of control. Freeman, New YorkGoogle Scholar
  4. 4.
    Bath-Hextall FJ, Birnie AJ, Ravenscroft JC, Williams HC (2010) Interventions to reduce Staphylococcus aureus in the management of atopic eczema: an updated Cochrane review. Br J Dermatol 163(1):12–26PubMedGoogle Scholar
  5. 5.
    Beresford A (2002) Psoriasis Association Members Questionnaire Survey. Psoriasis Association, NorthamptonGoogle Scholar
  6. 6.
    Boguniewicz M, Nicol NH (2008) General management of patients with atopic dermatitis. In: Reitamo S, Luger TA, Steinhoff M (eds) Textbook of atopic dermatitis. Informa UK Ltd, Andover, pp 147–164CrossRefGoogle Scholar
  7. 7.
    Boguniewicz M, Nicol NH, Kelsay K, Leung DYM (2008) A multidisciplinary approach to evaluation and treatment of atopic dermatitis. Semin Cutan Med Surg 27(2):115–127PubMedCrossRefGoogle Scholar
  8. 8.
    Chinn DJ, Poyner T et al (2002) Randomized controlled trial of a single dermatology nurse consultation in primary care on the quality of life of children with atopic eczema. Br J Dermatol 146(3):432–439PubMedCrossRefGoogle Scholar
  9. 9.
    Ersser SJ (2010) Helping patients make the most of their treatment. In: Penzer R, Ersser SJ (eds) Principles of skin care: a guide for nurses and other health care professionals. Wiley-Blackwell, OxfordGoogle Scholar
  10. 10.
    Ersser SJ, Cowdell F, Latter SM, Healy E (2010) ­Self-management experiences in adults with mild-moderate psoriasis: an exploratory study and implications for improved support. Br J Dermatol 163(5):1044–1049Google Scholar
  11. 11.
    Ersser SJ, Farasat H, Jackson K, Dennis H, Hind M (2011) Parental Self-Efficacy with Eczema Self-care Index (PASECI tool), Unpublished document. University of Hull, Hull, UKGoogle Scholar
  12. 12.
    Ersser SJ, Latter S et al (2007) Psychological and educational interventions for atopic eczema in children. Cochrane Database Syst Rev (3), Art. No.: CD004054. doi:  10.1002/14651858. CD004054.pub2
  13. 13.
    Ersser SJ, Maguire S, Nicol N, Penzer R, Peters J (2009) Best practice in emollient therapy; a statement for health care professionals, 2nd edition. Dermatol Nurs (Suppl) 8(3):1–22Google Scholar
  14. 14.
    Ersser SJ, Nicol NH (2010) The challenges of evidence-based practice for the dermatology nurse: when should you believe what is being presented? Dermatol Nurs 22(1):1–3Google Scholar
  15. 15.
    Ersser SJ, Surridge H et al (2002) What criteria do patients use when judging the effectiveness of psoriasis management? J Eval Clin Pract 8(4):367–376PubMedCrossRefGoogle Scholar
  16. 16.
    Eysenbach G, Till J (2001) Ethical issues in qualitative research on internet communities. Br Med J 323(7321):1103–1105CrossRefGoogle Scholar
  17. 17.
    Fischer G (1996) Compliance problems in paediatric atopic eczema. Australas J Dermatol 37(Suppl 1):S10–S13PubMedCrossRefGoogle Scholar
  18. 18.
    Krueger G, Koo J et al (2001) The impact of psoriasis on quality of life – Results of a 1998 National Psoriasis Foundation Patient-Membership Survey. Arch Dermatol 137(3):280–284PubMedGoogle Scholar
  19. 19.
    Medicines Partnership (2003) Medicines partnership project evaluation toolkit. Medicines Partnership, LondonGoogle Scholar
  20. 20.
    Mitchell T, Paige D, Spowart K (1998) Eczema and your child: a parent’s guide. Class Publishing, LondonGoogle Scholar
  21. 21.
    Nicol NH (1987) Atopic Dermatitis: The (wet) wrap-up. Am J Nurs 87:1560–1563PubMedGoogle Scholar
  22. 22.
    Nicol NH (2005) Use of moisturizers in dermatologic disease: The role of healthcare providers in optimizing treatment outcomes. Cutis 76(suppl 6):26–31PubMedGoogle Scholar
  23. 23.
    Nicol NH (2011) Efficacy and safety considerations in topical treatments for atopic dermatitis. Pediatric Nursing 37(6):295–302Google Scholar
  24. 24.
    Nicol NH, Boguniewicz M (2008) Successful strategies in atopic dermatitis management. Dermatol Nurs (Suppl):3–18Google Scholar
  25. 25.
    Nicol NH, Ersser SJ (2010) The role of the nurse ­educator in managing atopic dermatitis. In: Boguniewicz M (ed) Immunology and Allergy Clinics of North America: atopic dermatitis. Saunders/Elsevier, Philadelphia, 30(3):369–383Google Scholar
  26. 26.
    Nicol NH, Huether SE (2010) Alterations of the integument in children. In: McCance KL, Huether SE, Brasher VL, Rote NS (eds) Pathophysiology – the biologic basics for disease in adults and children, 6th edn. Mosby-Year Book, Inc, St. Louis, pp 1573–1607Google Scholar
  27. 27.
    Niebel G, Kallweit C et al (2000) Direct versus video-based parental education in the treatment of atopic eczema in children. A controlled pilot study [Direkte versus videovermittelte Elternschulung bei atopischem Ekzem im Kindesalter als Erganzung facharztlicher Behandlung. Eine Kontrollierte Pilotstudie]. Hautarzt 51:401–411PubMedCrossRefGoogle Scholar
  28. 28.
    Pena-Robichaux V, Kvedar JC, Watson AJ (2010) Text messages as a reminder aid and educational tool in adults and adolescents with atopic dermatitis: a pilot study. Dermatol Res Pract Article ID: 894258:6 doi: 10.1155/2010/894258
  29. 29.
    Royal Pharmaceutical Society of Great Britain (1997) From compliance to concordance: achieving shared goals in medicine taking. Report of the working group at the Royal Pharmaceutical Society which enquired into the causes of medicine taking problems, RPSGB, LondonGoogle Scholar
  30. 30.
    Santer M, Little P, Yardley L, Lewis-Jones S, Ersser SJ et al (2011-ongoing) National Institute for Health Research (UK) funded study (unpublished) proposal. Supporting parents and carers of children with eczema: development of a web-based intervention and pilot RCT. University of Southampton, UKGoogle Scholar
  31. 31.
    Staab D, Diepgen TL et al (2006) Age related structured educational programmes for the management of atopic dermatitis in children and adolescents: multicentre randomised controlled trial. Br Med J 332:933–938CrossRefGoogle Scholar
  32. 32.
    Staab D, von Rueden U et al (2002) Evaluation of a parental training program for the management of atopic dermatitis. Pediatr Allergy Immunol 13:84–90PubMedCrossRefGoogle Scholar
  33. 33.
    Surridge HR (2005) Exploring parental needs and knowledge when caring for a child with eczema. Exchange. The National Eczema Society, LondonGoogle Scholar
  34. 34.
    Taal E, Rasker E et al (1993) Health status, adherence with health recommendations, self -efficacy and social support in patients with rheumatoid arthritis. Patient Educ Couns 20:63–76PubMedCrossRefGoogle Scholar
  35. 35.
    Tessier C (2010) Management and security of health information on mobile devices. AHIMA Press, ChicagoGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Faculty of Health and Social CareUniversity of HullHullUK
  2. 2.Professional DevelopmentChildren’s Hospital ColoradoDenverUSA
  3. 3.National Jewish HealthDenverUSA
  4. 4.Clinical SciencesUniversity of ColoradoDenverUSA

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