ATOPIC dermatitis (AD) is a chronic, relapsing inflammatory skin disease marked by intense itching, eczematous lesions and xerosis. Its lifetime prevalence now exceeds 20% globally, with rising incidence reported in developing regions and in China. Although 1–3% of adults are affected worldwide, there is no definitive cure; management focuses on symptom control and quality of life. Standard treatments, topical therapies and oral antihistamines, can be inadequate or poorly tolerated, highlighting the need for complementary nursing interventions.
This study evaluated a clustered nursing care model, delivered via an online platform, for adults with AD. Clustered care (or care bundles) combines several evidence-based practices implemented together to improve outcomes. The programme provided personalised support, real-time monitoring and feedback, education for patients and families, and practical guidance on skin care and environmental management irrespective of geography.
After three months, participants receiving the online clustered care showed significantly lower itch severity than controls (p<0.05). The intervention guided patients to manage triggers, optimise temperature and humidity, avoid allergens, and maintain adequate nutrition, all measures that can bolster skin barrier function and reduce pruritus. Consistent emollient use was emphasised to repair the barrier, limit transepidermal water loss and mitigate dryness-driven scratching.
Disease severity, assessed by SCORAD components (lesion intensity, affected area and subjective symptoms), was also significantly reduced in the intervention group (p < 0.05). Prompt lesion care, cleansing and appropriate topical regimens, likely accelerated healing and curtailed pain, limiting the itch–scratch cycle that exacerbates AD.
Sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI), improved meaningfully versus controls (p < 0.05). Multifaceted strategies included relaxation techniques before bedtime (e.g., calming music), optimised sleep environments, structured itch-management protocols (cold compresses, targeted topicals, trigger avoidance) and timely wound care. These measures reduced nocturnal scratching and awakenings, improving sleep continuity and overall rest.
In sum, an online, nurse-led clustered care model offers accessible, continuous, and comprehensive support that complements medical treatment. By integrating education, barrier repair, trigger control and sleep hygiene into a single, reliable package, the approach reduced itch, lowered SCORAD scores and improved sleep in adults with AD. These findings support wider adoption of digital, bundle-based nursing interventions to enhance long-term outcomes in this burdensome condition.
Reference
Wang R et al. The impact of clustered care on itch severity and sleep quality in patients with atopic dermatitis via an online platform. Acta Derm Venereol. 2025;105:adv43525. Published 2025 Aug 5. doi:10.2340/actadv.v105.43525.
