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儿童特应性皮炎教育项目的扩展实施

Extended implementation of educational programs for atopic dermatitis in childhood.

作者信息

Ahrens Birgit, Staab Doris

机构信息

Department of Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany.

出版信息

Pediatr Allergy Immunol. 2015 May;26(3):190-196. doi: 10.1111/pai.12358.

Abstract

Children with atopic dermatitis (AD) suffer from chronic relapsing inflammatory skin lesions accompanied by insatiable itching, dryness, excoriated skin, or even (super-)infections. This burden impairs the quality of life of affected children and their families. Due particularly to the recurrent course of the disease, patients often lose confidence in treatment and fear side effects of steroids. Family education programs for AD have been established in the last decades to provide appropriate education and psychosocial support. However, the need for long-lasting strategies in treatment and prevention has even increased. Recent findings not only underline the importance of an intact skin barrier in regard to acute therapy but also suggest that an impairment of skin barrier integrity promotes the development of subsequent atopic diseases in the course of the atopic march. Moreover, in addition to the psychosocial burden due to stigmatized appearance or sleep disturbance, new observations document an increased presence of psychosomatic comorbidities in patients with AD. We reviewed recent educational interventions regarding the theoretical background and here will discuss the heterogeneous approaches of existing programs in childhood. Despite high variations of educational strategies, an overriding aim should be the broader integration of supporting programs in the treatment of children with AD to empower the affected child and its caregiver's to obtain the best possible care, quality of life, and to promote (secondary) prevention.

摘要

患有特应性皮炎(AD)的儿童会遭受慢性复发性炎症性皮肤损伤,伴有难以抑制的瘙痒、皮肤干燥、皮肤破损,甚至(超级)感染。这种负担损害了患病儿童及其家庭的生活质量。特别是由于疾病的复发过程,患者常常对治疗失去信心,并担心类固醇的副作用。在过去几十年中,已经建立了针对AD的家庭教育项目,以提供适当的教育和心理社会支持。然而,对治疗和预防的长期策略的需求甚至有所增加。最近的研究结果不仅强调了完整皮肤屏障在急性治疗方面的重要性,还表明皮肤屏障完整性受损会促进特应性进程中后续特应性疾病的发展。此外,除了因外观受歧视或睡眠障碍导致的心理社会负担外,新的观察结果表明AD患者中心身共病的发生率有所增加。我们回顾了近期有关理论背景的教育干预措施,并将在此讨论儿童现有项目的不同方法。尽管教育策略存在很大差异,但一个首要目标应该是将支持项目更广泛地纳入AD儿童的治疗中,以使受影响的儿童及其照顾者能够获得尽可能好的护理、生活质量,并促进(二级)预防。

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