Primary health care nurses’ experiences of treating children with atopic eczema in Gauteng, South Africa

Abstract

Background: The prevalence of atopic eczema has increased in most African countries, including South Africa. Most patients with allergic conditions are seen by non-allergy trained healthcare workers, a situation that is also true for South Africa. The aim of this study was to explore and describe the experiences of primary health care (PHC) nurses in managing children with atopic eczema in a district of Gauteng.

Methods: A qualitative, explorative, descriptive, contextual design with phenomenology approach was used. The study population included nurses in PHC clinics in Gauteng who were selected by purposive sampling method. Data saturation determined the sample size, which occurred after three focus group discussions and four in-depth individual interviews. Data was analysed according to Tesch’s steps of qualitative data analysis. Lincoln and Guba’s model for trustworthiness and the ethical measures employed according to the Medical Research Council for South Africa.

Results: Three themes were identified: the effects of childhood atopic eczema; treatment challenges and recommendations. The second theme (treatment challenges) will be discussed in this article. In this theme, six categories were identified, namely: difficult assessment and diagnosis; drug management; low knowledge levels of PHC nurses; health education; ineffective referral system and limited treatment protocols.

Conclusion: This research highlighted many challenges experienced by PHC nurses in the management of childhood atopic eczema that may contribute to poor control of the disease in these children. Management guidelines were developed and are currently piloted. The results will be reported in future articles.