A service evaluation of the Eczema Education Programme: an analysis of child, parent and service impact outcomes

Background The systematic support of parents of children with eczema is essential in effective disease management. The few existing support models have a limited evidence base. This paper reports the outcome-orientated service evaluation of an original, extensive, social learning-theory based, nurse-led Eczema Education Programme (EEP). Objectives To evaluate the EEP using specified child and parental outcomes and service impact data. Methods From a sample of 257 parent-child dyads attending the EEP, a pretest-post-test design evaluated its child impact using health-related quality of life measures (Infants' Dermatitis Quality of Life index, which includes a small dermatitis severity element, and Children's Dermatology Life Quality Index), severity measures (Patient Orientated Eczema Measure), a new parental measure (Parental Self-Efficacy in Eczema Care Index) and service impact data based on general practitioner (GP) attendance patterns pre- and postintervention. Results Statistically significant impacts were observed on infant quality of life (P<0 center dot 001), child quality of life (P=0 center dot 027), disease severity (P<0 center dot 001) and parental self-efficacy (P<0 center dot 001). Improvements in child quality of life, parental efficacy and service impact were also evident from qualitative data. The cumulative total of all GP visits for selected participants post-EEP reduced by 62%. Conclusions The EEP appears to be an effective model of delivering structured education to parents of children with eczema, and one generalizable to other multiethnic metropolitan populations. As a noncontrolled study, this rigorous service evaluation highlights the model's significance and the case for an evaluative multicentre randomized controlled trial of this educational intervention to inform a nurse-led programme of care.