Childhood eczema is an inflammatory skin disease that causes major disruption of the quality of life of both children and their parent caregivers. Repeated failure in treatment options and unpredictable outbreak of the disease not only create emotional disturbance for children, but also induce tremendous parental stress and caregiving burden for the parents. Apart from conventional pharmacological approaches, education programs have been developed for children with eczema and their parent caregivers in the past decades. However, most of them emphasise treatment compliances and disease management, and the psychosocial needs of the eczema families have generally been neglected. Furthermore, the outcomes of the existing education programs are also inconclusive, while empirical evidence on the effectiveness of these programs remains limited.
Integrative Body-Mind-Spirit (IBMS) is a holistic psychosocial intervention model that has been proved effective in improving the physical, psychosocial and spiritual wellbeing of people with different kinds of illness. The current study aims to apply a customised IBMS protocol to enhance the quality of life of children with eczema and their parent caregivers.
The IBMS protocol was customised to facilitate the expression of emotion, and enhance psychological resilience of the children with eczema. For the parents, the protocol focused on self-appreciation, mutual support and personal growth in the caregiving process. Families of children with eczema were randomised into intervention and control groups, where families in intervention group attended a six-session 3-hour weekly customised IBMS intervention. For children participants, Pediatric Allergic Disease Quality of Life Questionnaire (PADQLQ) was used to measure their overall quality of life. For parent participants, Perceived Stress Scale (PSS), Patient Health Questionnaire (PHQ9), Generalized Anxiety Disorder (GAD7) were used to measure their stress, depression and anxiety level. These psychosocial parameters were measured before (T0), and immediately after (T1) the intervention. Outcome of measurements were compared between intervention group and control group.
Data from 259 parent-child dyads (132 in intervention group, 127 in control group) were successfully collected for analysis. For children participants, significant improvements were identified in the scores of PADQLQ Activities [t(60)=2.781, p=0.007], PADQLQ Symptoms [t(58)=2.989, p=0.004]. For parent participants, significant improvements were identified in the scores of PSS [t(108)=6.169, p=0.000], PHQ9 [t(106)=4.434, p=0.000], and GAD7 [t(108)=3.71, p=0.000].
Conclusions and Implications
Psychosocial intervention based on IBMS can significantly improve the quality of life of children with eczema, reduce perceived stress, depression and anxiety levels of their parent caregivers. Result of the study presents a practical guideline for future psychosocial intervention research studies and community health program development. It also provides concrete empirical evidence on the effectiveness of the IBMS program for eczema families, which identifies a theory-based and evidence-based psychosocial therapeutic direction in addition to conventional pharmacological approaches.