Subjective illness perceptions in individuals with occupational skin disease: a qualitative investigation

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.

Semi-structured guided interviews with 50 patients with OSD were conducted. Data was subjected to qualitative content analysis.

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.

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.