Stress perception of occupational dermatology patients: a qualitative interview study

Patients suffering from a suspected occupational skin disease (OSD) frequently inform their doctors about substantial stressors in their lives. What features characterize their stress however remain ill defined and underresearched. It was aimed at exploring the patients' perspectives on their individual stressors to define relevant outcomes for future patient-centered care studies.

Qualitative interviews were conducted. Patients with severe hand dermatoses presenting to the division of occupational dermatology were asked 17 open questions on stress that were derived from clinical experience, expert opinions and a preliminary survey of three OSD patients, which were asked about what they felt was important for assessing stress. The results were then processed through qualitative content analysis (summarizing approach).

Sixty-three patients attending a tertiary individual prevention measure were interviewed, 25 were female (39.7%) and the mean age was 49.2 years (SD: 12.0, Min: 21, Max: 63). Interviews took 20 to 45 minutes. Stress was often reported to be job-related (n = 28; 44.4%). Patients reported time pressure (n = 40; 63.5%) or feeling overworked in uncertain (n = 35; 55.6%) and unplannable (n = 16; 25.4%) situations as stressful as well as conflicts (n = 16; 25.4%) and a perceived transgression of personal and professional limits (n = 7; 11.1%). The most frequently reported stress symptoms were irritability (n = 32; 50.8%), nervousness (n = 19; 30.2%), bodily tension (n = 12; 19.0%) and hecticness (n = 11; 17.5%).

Job-related stress appears to play an important role in patients with suspected OSD. It is striking that the reported stress symptoms differ from other studies. Based on this interview study, a standardized set of questions to assess stress in OSD will be developed for future research and guide clinicians in what aspects of the stress experience to look out for in their patients.