175 The Missing Link!! Specialist Nurse-Led Education for Parents of Children With Atopic Eczema

BACKGROUND: Australia's rate of children with food allergy is still on an upward trend. In infants the earliest manifestation is usually atopic eczema. Australian Bureau of Statistics National Health Survey (ABNHS, 2007–2008, p.305) reported hayfever, allergic rhinitis and asthma in the top 10 most commonly reported long-term conditions for children and young people. Early effective management of eczema is essential. Australia's medical model means long wait for allergy appointments with a specialist, limiting review appointment availability. Following diagnosis of atopic eczema and treatment recommendations by a clinical immunologist/allergist or dermatologist, parents report having many unanswered questions -contributing to anxiety and confusion. They feel overwhelmed that eczema is incurable and long-term management and constant vigilance is required. Many feel a lack of support and despair. Education, demonstration and support by a nurse specialist in eczema management at a Children's hospital in Adelaide has improved outcomes and reduced the psychosocial burden of the condition. Parents and children receive 30 minutes explanation, demonstration of required treatments and an individualised, written eczema action/care plan. The education sessions use a conceptual framework based on Social Cognitive Theory where active participation, goal setting and forward planning enhance understanding assisting the long-term behavioural changes needed to master eczema management effectively. The families are reviewed by the nurse several weeks later to review progress and answer questions that have arisen over the preceding weeks. The education sessions are tailored to the individual family needs, encourage self-management and aim for increased confidence to self-regulate the condition as it waxes and wanes. METHODS: Twenty-two families in a novel clinic at Children's Youth and Women's Health Service, Adelaide undertook a pre-post intervention questionnaire surveys. RESULTS: All 22 families (2009) reported that the service had assisted their understanding, enhanced management and compliance and called for expansion as soon as possible. A research project is scheduled in the near future to expand the service within the recommendations of the South Australian Chronic Diseases Action Plan 2009-2018. CONCLUSIONS: Specialist nurse's support assists parents to gain the required practical skills, understanding increased confidence and compliance with their recommended treatments.