Objectives
Since January 2015, squamous cell carcinoma or multiple actinic keratosis of the skin caused by natural ultraviolet irradiation (UVR) is recognized as occupational disease in Germany. ...Interventions which improve the sun protection behavior of outdoor workers are urgently needed. When developing preventive interventions, the attitudes of target groups need to be taken into consideration. Therefore, outdoor workers’ perceptions and attitudes were investigated.
Methods
Seven guided, problem‐centered qualitative interviews with healthy male outdoor workers were conducted. A qualitative content analysis was used to analyze the data.
Results
We found an underestimation of the perceived skin cancer risk in the seven outdoor workers and heterogeneous attitudes toward the usage of sun‐protective measures. Participants stated that the feasibility of technical sun‐protective measures depends on the size of the working area. While using a headgear seemed common, none of the participants stated using additional neck protection. Wearing long‐sleeved shirts and long trousers were considered problematic. The interviews revealed important requirements for sun‐protective clothes, especially in terms of different materials. Although the usage of sunscreen was common, our interviewees seemed to apply it wrongly.
Conclusion
Risk perceptions of outdoor workers and their attitudes toward sun protection measures may influence the factual UV protection behavior in the workplace. Structures to facilitate the implementation of technical and organizational sun‐protective measures seem to be necessary. Educational interventions and clear instructions which are tailored to the individual needs and attitudes of outdoor workers are required to improve the UV protection behavior and to avoid common mistakes.
Occupational skin diseases (OSD) in the form of hand eczema (HE) are a common work-related disease. Illness perceptions as presented in Leventhal's Common-Sense Model (CSM) are important for ...patients' self-management of diseases. Understanding these illness perceptions is essential for patient communicating. No quantitative or qualitative studies which investigated subjective illness perceptions in patients with occupational HE utilized the CSM as theoretical framework. The Objective of this study is to investigate illness perceptions of patients with occupational hand eczema (HE) using the CSM.
We applied an exploratory qualitative approach and conducted purposive sampling. Thirty-six patients with occupational HE were interviewed using an interview guide based on the dimensions of the CSM, including coherence and emotional representation. All participants participated in a three-week inpatient program at a clinic specialized on occupational dermatology. One interview had to be excluded before analysis, since one participant's diagnosis was retrospectively changed from ICD to tinea and hence did not match the inclusion criteria. Thirty-five interviews were transcribed verbatim and analyzed. Data was analyzed deductively and inductively using qualitative text analysis. MAXQDA 2018 (Verbi, Berlin, Germany), a software for qualitative data analysis, was applied for coding and summarizing of results. All dimensions of the CSM were explored for occupational HE.
Several sub-categories could be identified. Participants named a variety of causes in different areas (e. g. external irritants and other hazardous factors, psycho-social factors, allergies, having a 'bad immune system' or lifestyle). The great impact of the disease on the participants' life is shown by the wide range of consequences reported, affecting all areas of life (i. e. psychological, physical, occupational, private). Considering coherence, an ambivalence between comprehensibility and non-comprehensibility of the disease is apparent.
The complexity of illness perceptions presented in this paper is relevant for those involved in HE patient education and counseling, e. g, health educators, dermatologists, and, occupational physicians. Future research might further investigate specific aspects of illness perceptions in patients with occupational HE, especially considering the complexity of coherence and overlapping dimensions (i. e. emotional representation and psychological consequences).
IntroductionKnowing about a risk factor is not sufficient to ensure corresponding behaviour as additional psychological factors play a role. Self-efficacy is one of the major factors. This also ...applies to physical activity and exercise behaviour, which is a major public health topic in both primary and secondary prevention. The amount of research on self-efficacy in exercise behaviour is high yet remains uncharted. This protocol presents the research design for two systematic evidence maps on self-efficacy in exercise behaviour in (1) primary prevention and (2) secondary prevention. These maps will thus provide a comprehensive overview over the current state in published empirical research as a starting point for future researchers.Methods and analysisThe databases Medline (via PubMed) and PsycINFO (via EbscoHost) will be searched using the search terms ‘self-efficacy’ and any of the search terms ‘sport’ and ‘exercise’ in titles and abstracts. All empirical research studies which have measured self-efficacy in relation to exercise behaviour will be included. The primary prevention systematic evidence map will aggregate all studies on healthy humans and the secondary prevention systematic evidence map will include all studies on humans with a pre-existing condition. We will extract and present the data points authors, title, year, sample size (N), age groups, surveyed sport and method of measuring self-efficacy in both systematic evidence maps. Moreover, we will extract and present the target group in the systematic evidence map on primary prevention and the pre-existing condition in the systematic evidence map on secondary prevention. In addition to a data table, we will create freely accessible evidence maps in the form of graphs.Ethics and disseminationSince this is a protocol, an ethics approval is not required for the presented and planned work. The results of the two systematic evidence maps will be disseminated via publication in international peer-reviewed journals. In addition, data will be shared in detail via the Open Science Framework platform.
Objective
To outline the development and pilot testing of a patient counseling approach for individual sun protection for patients in outdoor professions diagnosed with squamous cell carcinoma or ...multiple actinic keratosis due to solar UV radiation. This is a secondary prevention measure as part of the standard procedure of patient care by the respective statutory accident insurance.
Methods
Results of guideline-based qualitative interviews with seven outdoor workers and a search of literature formed the basis for the counseling approach, which was compiled in a manual. Interdisciplinary experts (dermatologists and educators) reviewed and consented the final manual. The pilot testing was conducted in consecutive steps (N
1
= 36 patients and N
1
= 2 counselors; N
4
= 12 patients and N
4
= 6 counselors). The first two stages of the revised guideline ‘Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare (CReDECI 2)’ serve as background and structure for presenting the results.
Results
The ‘counseling approach for individual sun protection (ILB: Individuelle Lichtschutz-Beratung)’ consists of seven general and eight add-on modules. These can be combined and tailored according to the patient’s individual needs. Interactive, educational components (e.g. haptic experiments) are crucial elements of the counseling approach.
Conclusions
The special requirements of outdoor workers are hardly taken into consideration in Germany, even though the interest for an improved sun protection behavior of some occupational groups is high. The advantage of the presented approach is that the heterogeneous needs of patients can be specifically addressed with its various modules.
Zusammenfassung
Hintergrund
In Außenberufen beschäftigte Personen (z. B. Straßenbauer*innen) sind solarer UV-Strahlung in hohem Maße ausgesetzt. Um die Entstehung von berufsbedingtem Hautkrebs zu ...verhindern, sind Präventionsmaßnahmen unerlässlich.
Ziel
Das Ziel der Projekte „ForMulA UV 1.0 & 2.0“ war die Entwicklung und Pilotierung sowie die formative Evaluation eines wissenschaftlich fundierten, standardisierten, zielgruppenspezifischen Curriculums als Fortbildungsprogramm für Multiplikator*innen in Außenberufen.
Material und Methoden
Im Rahmen der Curriculumsentwicklung wurde die wissenschaftliche Literatur zu schulungs- und beratungsrelevanten Inhalten aufbereitet. Zur Erfassung der Bedürfnisse von Multiplikator*innen wurden Fokusgruppendiskussionen durchgeführt. Auf dieser Grundlage erfolgte die Konzeption, die durch einen Expertenworkshop validiert und im Rahmen einer Pilotveranstaltung umgesetzt wurde.
Ergebnisse
Im gesamten Entwicklungsprozess zeigten sich heterogene Bedürfnisse und Anforderungen (z. B. Tiefe der Inhalte) der Zielgruppen, d. h. sowohl auf der Ebene der im Freien Beschäftigten als auch auf der Ebene verschiedener Gruppen von Multiplikator*innen (z. B. Fachkräfte für Arbeitssicherheit, Arbeitsmediziner*innen). Zum Projektende liegt ein nach dem „template for intervention, description and replication“ (TIDieR) aufgearbeitetes, wissenschaftlich fundiertes, zielgruppenorientiertes Curriculum vor.
Schlussfolgerung
Die Entwicklung eines zielgruppenübergreifenden Konzeptes, das in verschiedenen Berufsfeldern (z. B. Erzieher*innen, Dachdecker*innen) durch unterschiedliche Multiplikator*innen anwendbar ist, stellt eine Herausforderung dar. Modifikationen durch die Multiplikator*innen vor Ort am Arbeitsplatz sind daher essenziell, um zum Erfolg der Präventionsmaßnahmen beizutragen.
Objectives:
Digital interventions are increasingly used to support behaviour change. In the prevention of chronic work-related skin diseases, the sustainable implementation of appropriate skin ...protection behaviour following tertiary individual prevention is important. However, there exists no intervention to support the maintenance of these behaviour changes until now. We report the systematic development of a technology-based maintenance programme to support patients to sustainably implement skin protection behaviour and to overcome barriers.
Design:
Complex intervention development based on a five-step multi-methods process.
Setting:
Tertiary individual prevention of work-related skin disease in Germany.
Methods:
Intervention development comprised the following steps: literature review, qualitative focus groups with stakeholders, quantitative assessment of the patients’ needs, development of a programme theory, and intervention development and concept validation.
Results:
We developed a concept for a complex intervention based on results from the literature review, with seven reviews meeting the criteria; qualitative focus groups involving three dermatologists, five health educators, two psychologists and three employees of an accident insurance institution; and a quantitative needs assessment with 72 patients. Key requirements were derived from this process: for example, the need to develop an app to self-monitor skin protection behaviour and skin condition and to inform the individual about ways of dealing with barriers encountered during the uptake and maintenance of skin protection behaviour. In addition, patients will participate in an individual goal-setting exercise to identify individual behavioural goals.
Conclusion:
A technology-based approach to the prevention of work-related skin diseases was developed. During the process of development, the perspectives of relevant stakeholders and the target group were considered in a participatory way.
Eczematous skin diseases, e.g., atopic dermatitis or contact dermatitis, are associated with a high disease burden, a significant impact on quality of life and a higher risk for anxiety and ...depression. Therefore, coping strategies are of interest. In order to understand coping processes, it is necessary to examine the patients' perspectives on their illness. The aim of this systematic mixed studies review is to investigate the illness perceptions of patients with eczematous skin diseases to get a better understanding of their coping processes.
We performed a systematic literature search in PubMed, The Cochrane Library, PsycInfo, PSYNDEX, CINAHL, Web of Science, and Scopus until February 20, 2019. Both qualitative and quantitative studies were included in the review. Two independent reviewers conducted data extraction and carried out a narrative synthesis. We assessed study quality with the Mixed Methods Appraisal Tool.
Three qualitative and four quantitative studies were included in the systematic review. We found different methodological approaches for investigating illness perceptions: guided interviews, focus group interviews as well as standardized questionnaires, e.g., the Brief Illness Perception Questionnaire. All studies report suspected causes of the skin disease, such as endogenous and exogenous causes (namely, psychological or occupational factors). We found long timeline beliefs as well as various perceived and experienced social, economic, and psychological consequences. Our analysis reveals complex emotional representations in patients with eczematous skin diseases, in particular impairment of emotional well-being, and feelings of shame or helplessness. Qualitative and quantitative data were predominantly complementary and convergent.
Patients with eczematous skin diseases have complex illness representations regarding their disease. These representations interrelate with the coping behavior of patients. Therefore, medical professionals should consider them for counseling and treatment.
PROSPERO 2018 CRD42018109217 .
A prosthetic system should ideally reinstate the bidirectional communication between the user's brain and its end effector by restoring both motor and sensory functions lost after an amputation. ...However, current commercial prostheses generally do not incorporate somatosensory feedback. Even without explicit feedback, grasping using a prosthesis partly relies on sensory information. Indeed, the prosthesis operation is characterized by visual and sound cues that could be exploited by the user to estimate the prosthesis state. However, the quality of this incidental feedback has not been objectively evaluated.
In this study, the psychometric properties of the auditory and visual feedback of prosthesis motion were assessed and compared to that of a vibro-tactile interface. Twelve able-bodied subjects passively observed prosthesis closing and grasping an object, and they were asked to discriminate (experiment I) or estimate (experiment II) the closing velocity of the prosthesis using visual (VIS), acoustic (SND), or combined (VIS + SND) feedback. In experiment II, the subjects performed the task also with a vibrotactile stimulus (VIB) delivered using a single tactor. The outcome measures for the discrimination and estimation experiments were just noticeable difference (JND) and median absolute estimation error (MAE), respectively.
The results demonstrated that the incidental sources provided a remarkably good discrimination and estimation of the closing velocity, significantly outperforming the vibrotactile feedback. Using incidental sources, the subjects could discriminate almost the minimum possible increment/decrement in velocity that could be commanded to the prosthesis (median JND < 2% for SND and VIS + SND). Similarly, the median MAE in estimating the prosthesis velocity randomly commanded from the full working range was also low, i.e., approximately 5% in SND and VIS + SND.
Since the closing velocity is proportional to grasping force in state-of-the-art myoelectric prostheses, the results of the present study imply that the incidental feedback, when available, could be usefully exploited for grasping force control. Therefore, the impact of incidental feedback needs to be considered when designing a feedback interface in prosthetics, especially since the quality of estimation using supplemental sources (e.g., vibration) can be worse compared to that of the intrinsic cues.
Vibrotactile sensation is an essential part of the sense of touch. In this study, the localized vibrotactile sensation of the arm-shoulder region was quantified in 10 able-bodied subjects. For this ...analysis, the six relevant dermatomes (C3-T2) and three segments—the lower arm, the upper arm, and the shoulder region were studied. For psychometric evaluation, tasks resulting in the quantification of sensation threshold, just noticeable difference, Weber fraction, and perception of dynamically changing vibrotactile stimuli were performed. We found that healthy subjects could reliably detect vibration in all tested regions at low amplitude (2–6% of the maximal amplitude of commonly used vibrotactors). The detection threshold was significantly lower in the lower arm than that in the shoulder, as well as ventral in comparison with the dorsal. There were no significant differences in Weber fraction (20%) detectable between the studied locations. A compensatory tracking task resulted in a significantly higher average rectified error in the shoulder than that in the upper arm, while delay and correlation coefficient showed no difference between the regions. Here, we presented a conclusive map of the vibrotactile sense of the healthy upper limb. These data give an overview of the sensory bandwidth that can be achieved with vibrotactile stimulation at the arm and may help in the design of vibrotactile feedback interfaces (displays) for the hand/arm/shoulder-region.
Background: Occupational skin diseases (OSDs) are frequent in professions with exposure to skin hazards. Thus, a health educational intervention for apprentices of high-risk professions was ...conducted. It was the aim of this study to gain insight into possible effects of this intervention. Methods: A one-time skin protection seminar was conducted in 140 apprentices of health-related and non-health-related professions trained cohort (TC). In addition, 134 apprentices of the same occupations were monitored untrained cohort (UTC). The OSD-specific knowledge and the skin condition of the hands were assessed at baseline (T0), after the seminar (T1), and after 6 (T2) and 12 months (T3). Results: The OSD-specific knowledge increased in all cohorts from T0 to T3, but we found a significantly higher knowledge in the TC at T2 (p < 0.001, t = 3.6, df = 196, 95% confidence interval = 0.9, 3.3) and T3 (p < 0.001, t = 3.8, df = 196, 95% confidence interval = 1.0, 3.2) compared to the UTC. Our results indicated a better skin condition of the hands in the TC of the health-related professions but not in the non-health-related professions. Conclusion: The study indicates that an educational intervention may positively influence the disease-specific knowledge and the prevalence of OSD in apprentices. However, definite conclusions cannot be drawn because of the heterogeneous study cohorts and the study design. Future research should aim at tailoring primary prevention to specific target groups, e.g., in view of the duration and frequency of skin protection education, different professions, and gender-specific prevention approaches.
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