Quality standard

Quality statement 3: Psychological wellbeing and quality of life

Quality statement 3: Psychological wellbeing and quality of life

Quality statement

Children with atopic eczema have their (and their families') psychological wellbeing and quality of life discussed and recorded at each eczema consultation.

Rationale

Healthcare practitioners should adopt a holistic approach when assessing a child's atopic eczema at each eczema consultation, taking into account the severity of the atopic eczema and the impact on the child's quality of life. Atopic eczema can have a negative psychological effect on children and their families or carers. Discussing and recording the impact of the atopic eczema (even if its physical severity is mild) on psychological and psychosocial wellbeing and quality of life is an essential part of a holistic approach, and can inform treatment strategies.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that children with atopic eczema have their (and their families') psychological wellbeing and quality of life discussed and recorded at each eczema consultation.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from written clinical protocols.

Process

The proportion of eczema consultations with children with atopic eczema at which their (and their families') psychological wellbeing and quality of life is discussed and recorded.

Numerator – the number of consultations in the denominator at which children's (and their families') psychological wellbeing and quality of life is discussed and recorded.

Denominator – the number of eczema consultations with children with atopic eczema.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

What the quality statement means for different audiences

Service providers ensure that local arrangements are in place for children with atopic eczema and their families to be asked about their psychological wellbeing and quality of life, and for this to be recorded at each eczema consultation.

Healthcare practitioners ensure that children with atopic eczema and their families are asked their psychological wellbeing and quality of life, and that this is recorded at each eczema consultation.

Commissioners ensure that they commission services with local arrangements for children with atopic eczema and their families to be asked about their psychological wellbeing and quality of life, and for this to be recorded at each eczema consultation.

Children with atopic eczema and their families or carers are asked about how they are feeling and how the eczema is affecting their lives on a day-to-day basis, and have this recorded at each eczema consultation.

Source guidance

Atopic eczema in under 12s: diagnosis and management. NICE guideline CG57 (2007, updated 2023), recommendations 1.2.1.1, 1.2.1.4 and 1.2.1.5

Definitions of terms used in this quality statement

Psychological wellbeing and quality of life

Healthcare practitioners should adopt a holistic approach when assessing a child's atopic eczema at each consultation. Healthcare practitioners should take account of the child's quality of life, including everyday activities and sleep, and psychosocial wellbeing, as well as the physical severity of their condition. There is not necessarily a direct relationship between the severity of atopic eczema and its impact on quality of life. Even mild atopic eczema can have a negative impact on psychological and psychosocial wellbeing and quality of life.

The guideline defines the impact of atopic eczema on quality of life and psychosocial wellbeing as follows:

  • None: no impact on quality of life.

  • Mild: little impact on everyday activities, sleep and psychosocial wellbeing.

  • Moderate: moderate impact on everyday activities and psychosocial wellbeing, frequently disturbed sleep.

  • Severe: severe limitation of everyday activities and psychosocial functioning, nightly loss of sleep.

The guideline recommends that healthcare practitioners take into account the impact of atopic eczema on parents or carers as well as the child.

In the opinion of the Topic Expert Group, the impact of atopic eczema on families or carers should be recorded in the notes of the child who has atopic eczema. [Adapted from NICE's guideline on atopic eczema in under 12s, recommendations 1.2.1.1, 1.2.1.4 and expert opinion]