A Qualitative Enquiry into the Lived Experiences of Adults with Atopic Dermatitis

Abstract

Background: atopic dermatitis (AD) has been related to poorer health-related quality of life (HRQoL) in adults and there is lack of qualitative research that explores how this long-term condition affects the lives of adults. The purpose of this study was to explore the impact of AD on the HRQoL of adults through semi-structured interviews. Study design: this was a qualitative study using semi-structured interviews. Methods: adults with a clinical diagnosis of AD were recruited by advertising on a university campus and through social media sites. All participants completed a screening questionnaire on AD diagnosis, treatment, duration, and severity. Semi-structured interviews were conducted either face-to-face or on the telephone then audio-taped, transcribed verbatim, and analysed using thematic analysis. Results: the study group (n=19) consisted of 10 White and nine Black and ethnic minority participants, aged 19–52, of whom 18 were female. Three superordinate themes emerged from the analysis: 1) visibility of AD; 2) threats to inner sense of self; and 3) contrasting reactions and support from others. There were qualitative differences in the narratives of those who were diagnosed with AD at an early age compared to a later age, and across ethnic groups. Conclusions: AD has a great impact on the QoL of adults. Participants in this study discussed issues that have not been reported in quantitative research, particularly around the lack of understanding of the psychological impact of AD and the stigma attached to it. Consideration of these factors may enhance disease management and improve HRQoL. Understanding and recognition of AD as a complex long-term condition involving significant psychosocial impact is crucial. The findings from this study suggest more integrated and accessible psychological support is required for people with AD. Males were under-represented in this study, and further exploration of the impact on AD in males is needed.