A Family-Centered Approach to Managing AD

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Atopic Dermatitis (AD) frequently persists from childhood into adolescence and adulthood. Its symptoms disrupt daily routines, social interactions, and emotional well-being, creating a ripple effect on family dynamics.¹ Managing a chronic condition like AD during a transitional stage, such as adolescence, adds unique complexities.Adolescents with AD may experience embarrassment and low self-esteem due to visible skin symptoms, which can contribute to feelings of isolation on top of already existing sleep deprivation, diminished concentration, and poor academic performance.^1-2 These challenges elevate the risk of anxiety, depression, and behavioral issues, further compounding the burden of living with AD.Considering the factors of AD that affect individuals as well as close family, a recent review aimed to summarize this impact as well as suggest care plans based on its findings.³

Family Dynamics and the Burden of Caregiving

The review noted the effects of AD extend beyond the adolescent, significantly impacting family members who often serve as primary caregivers. Parents commonly report sleep disturbances and heightened stress levels due to the demands of caregiving. Researchers found feelings of helplessness and guilt are prevalent, especially when observing the adolescent's discomfort. They found the strain of managing AD can disrupt family cohesion and reduce time for shared activities, intensifying the emotional toll on all family members.

The severity of AD often dictates the level of caregiving required. Mild cases may necessitate regular skincare routines and occasional medical visits, while moderate to severe cases involve intensive treatment regimens and frequent medical consultations. The review also recognized the significance of financial burdens, encompassing both direct medical expenses and indirect costs, such as work absenteeism. Families may also face social limitations, as the demands of caregiving reduce opportunities for leisure and community engagement.

Psychosocial Impacts of AD

The psychosocial effects of AD are far-reaching, according to research found during the review. Adolescents with AD often struggle to build and maintain peer relationships due to stigma, further isolating them socially. This isolation exacerbates emotional distress and creates a cycle of withdrawal and psychological burden. Researchers noted that families, in turn, may experience reduced social interaction and leisure opportunities, compounding the overall impact of AD on their lives.

The Role of Holistic, Evidence-Based Care

The review found addressing the multifaceted challenges posed by AD requires a comprehensive, evidence-based approach. Nurses are pivotal in integrating physical, psychological, and social care into treatment plans. Thorough assessment, monitoring treatment adherence, and providing tailored health education are essential components of effective care. It noted nurses also offer critical psychosocial support, helping families manage the emotional complexities associated with chronic disease.

Researchers noted using standardized taxonomies such as the North American Nursing Diagnosis Association International taxonomy, along with Nursing Outcomes Classification and Nursing Interventions Classification, facilitates consistent and individualized care. These frameworks ensure that care plans address both immediate needs and long-term management strategies, enhancing outcomes for adolescents and their families.

Health Education and Empowerment

The review stated that health education is a cornerstone of effective AD management. Educating adolescents and their families about disease triggers, treatment options, and coping strategies empowers them to take an active role in managing the condition. It also noted promoting self-care and fostering autonomy are particularly critical during adolescence, a developmental stage where independence is key.

Interdisciplinary Collaboration for Comprehensive Support

The findings of the review underscore the need for interdisciplinary collaboration. Dermatologists, nurses, psychologists, and social workers must work together to address the diverse needs of adolescents with AD and their families. It stated that this collaborative approach ensures that physical symptoms are managed effectively while psychosocial and financial challenges are also addressed.

Future Directions and Recommendations

The review suggested that future research should focus on developing targeted interventions for adolescents with AD and their families. Psychosocial support programs, family counseling, and stress management strategies could provide valuable insights into improving care outcomes. Additionally, itstated that exploring ways to alleviate the financial burden of AD management is essential to reduce stress on families.

Conclusion

AD has a profound impact on adolescents and their families, affecting their physical health, emotional well-being, and social relationships. Adolescents face unique challenges in managing their condition during a critical developmental period, while families grapple with caregiving demands and emotional strain. Researchers found that holistic care that integrates evidence-based interventions, interdisciplinary collaboration, and robust health education is essential. By adopting a family-centered approach, they stated that healthcare providers can better address the complexities of AD and support both patients and their families in navigating its challenges.

References

1. Langan SM, Irvine AD, Weidinger S. Atopic dermatitis [published correction appears in Lancet. 2020 Sep 12;396(10253):758. doi: 10.1016/S0140-6736(20)31825-0]. Lancet. 2020;396(10247):345-360. doi:10.1016/S0140-6736(20)31286-1
2. Brew BK, Söderberg J, Lundholm C, et al. Academic achievement of adolescents with asthma or atopic disease. Clin Exp Allergy. 2019;49(6):892-899. doi:10.1111/cea.13371
3. Vicho-de-la-Fuente N, Martinez-Santos AE, Rodríguez-González R, et al. Impact of atopic dermatitis on adolescents and families: A mixed-method systematic review. J Adv Nurs. 2024. doi:10.1111/jan.16652