A self-report questionnaire to detect hand dermatitis in nurses

TY - JOUR

T1 - A self-report questionnaire to detect hand dermatitis in nurses

AU - Parsons, V.

AU - Williams, H. C.

AU - English, J.

AU - Llewellyn, J.

AU - Ntani, G.

AU - Madan, I.

PY - 2020/12/30

Y1 - 2020/12/30

N2 - BACKGROUND: Hand dermatitis is highly prevalent among nurses due to their frequent exposure to wet work. Providing cost-effective dermatological health surveillance for this occupational group presents a challenge to health service providers. AIMS: To ascertain the predictive value of nurses' self-assessment of whether they had current hand dermatitis using a screening questionnaire when compared with the assessment made by a dermatologist of the nurses' hand photographs. METHODS: We conducted a cross-sectional study comparing the self-report decision made by student and intensive care nurses using a single hand dermatitis screening question with the clinical assessment of their hand photographs made by dermatologists using a standardized photographic guide. RESULTS: We analysed data collected at study baseline (n = 1599). The results showed that the screening question had a high negative predictive value (91%; 95% CI 89-93), but a low positive predictive value (39%; 95% CI 34-45). It demonstrated acceptable accuracy in distinguishing those with and without the disease (area under the receiver operator curve = 0.7) and had a high specificity (86%; 95% CI 84-88) but a sensitivity of only 52% (95% CI 46-59) in identifying hand dermatitis. CONCLUSIONS: We found that nurses were able to accurately self-assess themselves as not having any signs of hand dermatitis. By contrast, they were less able to accurately self-assess positive cases suggesting under-recognition of early disease. We propose that a questionnaire containing a single hand dermatitis screening question should be considered as a tool for screening out clear cases as part of a workplace health surveillance programme for detecting hand dermatitis.

AB - BACKGROUND: Hand dermatitis is highly prevalent among nurses due to their frequent exposure to wet work. Providing cost-effective dermatological health surveillance for this occupational group presents a challenge to health service providers. AIMS: To ascertain the predictive value of nurses' self-assessment of whether they had current hand dermatitis using a screening questionnaire when compared with the assessment made by a dermatologist of the nurses' hand photographs. METHODS: We conducted a cross-sectional study comparing the self-report decision made by student and intensive care nurses using a single hand dermatitis screening question with the clinical assessment of their hand photographs made by dermatologists using a standardized photographic guide. RESULTS: We analysed data collected at study baseline (n = 1599). The results showed that the screening question had a high negative predictive value (91%; 95% CI 89-93), but a low positive predictive value (39%; 95% CI 34-45). It demonstrated acceptable accuracy in distinguishing those with and without the disease (area under the receiver operator curve = 0.7) and had a high specificity (86%; 95% CI 84-88) but a sensitivity of only 52% (95% CI 46-59) in identifying hand dermatitis. CONCLUSIONS: We found that nurses were able to accurately self-assess themselves as not having any signs of hand dermatitis. By contrast, they were less able to accurately self-assess positive cases suggesting under-recognition of early disease. We propose that a questionnaire containing a single hand dermatitis screening question should be considered as a tool for screening out clear cases as part of a workplace health surveillance programme for detecting hand dermatitis.

KW - Hand dermatitis

KW - hand photographs

KW - health surveillance

KW - occupational health

KW - questionnaire

KW - self-report

UR - http://www.scopus.com/inward/record.url?scp=85099323958&partnerID=8YFLogxK

U2 - 10.1093/occmed/kqaa188

DO - 10.1093/occmed/kqaa188

M3 - Article

C2 - 33219375

AN - SCOPUS:85099323958

SN - 0962-7480

VL - 70

SP - 645

EP - 648

JO - Occupational medicine (Oxford, England)

JF - Occupational medicine (Oxford, England)

IS - 9

ER -