Smartphone apps for caregivers of children with atopic dermatitis : user profile, app scope and co-design

• Main Author: Xu, Xiaomeng
• Other Authors: Josip Car
• Format: Thesis-Doctor of Philosophy
• Language: English
• Published: Nanyang Technological University 2020
• Subjects: Science::Medicine
• Online Access: https://hdl.handle.net/10356/137738
• Institution: Nanyang Technological University

Atopic dermatitis, also called eczema, is a chronic inflammatory skin condition that affects up to 20.8% of children in Singapore. The symptoms of atopic dermatitis manifest as intractable itching, skin damage, soreness, and result in sleep loss which can be varying in its severity and it commonly affects the quality of life and causes financial burden. Current models of health care delivery do not optimally support self-/caregiver-management of the condition outwit the consultation nor the variability of the disease in-between consultations to support clinical decision making when the patient’s management of disease is reviewed by a clinician. My thesis comprises of several interwoven studies in different overlapping phases. Firstly, cross-sectional studies among paediatric patients, their caregivers, and family as a whole in the Singapore population, examining whether socio-demographic factors (ethnicity, education, occupation, accommodation type) are associated with the quality of life indicators, and how severity of atopic dermatitis impacts patients’, caregivers’ and families’ quality of life. Secondly, concordance between caregiver-reported and physician-rated severity of atopic dermatitis in children with atopic dermatitis was examined and to assess potential explanatory factors. Thirdly, the systematic assessment of existing smartphone apps for atopic dermatitis management identified important gaps in both features and content of the transparency and reliability of health information disseminated via these apps. Fourthly, an app co-design exercise was conducted with carers of children with atopic dermatitis, healthcare professionals and researchers through a series of face-to-face workshops with the eventual development of a wireframe prototype for atopic dermatitis self-/caregiver-management. Above phases can be an early step in developing evidence for digital health interventions to provide digital, tailored support for self-management among children with atopic dermatitis and their caregivers. My PhD thesis explores the role that apps could play in improving the care for children with atopic dermatitis and management of their disease. The research captures the views of parents, children with atopic dermatitis and their clinicians about functions and features of a smartphone app that could support healthcare delivery for this target group, co-design of an app, investigation of changes needed to clinical pathways and processes to achieve digital ‘transformation’ by not only moving from paper to a digital platform but ultimately transforming overall processes and experience of care and a range of outcomes.