Patient adherence to skin self-examination: Effect of nurse intervention with photographs Journal Article
| Authors: | Oliveria, S. A.; Dusza, S. W.; Phelan, D. L.; Ostroff, J. S.; Berwick, M.; Halpern, A. C. |
| Article Title: | Patient adherence to skin self-examination: Effect of nurse intervention with photographs |
| Abstract: | Background: Results from a single case-control study suggest that skin self-examination (SSE) has the potential to reduce mortality from melanoma by 63%. Despite these encouraging results, SSE rates are low. Few prospective studies of interventions to increase SSE in high-risk cohorts have been performed. The purpose of this study was to assess the impact of a brief nurse-delivered intervention using digital photographs on patients' adherence to performing SSE. Design setting/participants: Patients at high risk for melanoma skin cancer (five or more dysplastic nevi) (N=100) were recruited from the outpatient Pigmented Lesion Clinic at Memorial Sloan-Kettering Cancer Center. All participants had baseline whole-body digital photography as part of their clinical evaluation. Intervention: Patients were randomized: Group A (n =49) received a teaching intervention (physician and nurse education module) with a photo book (personal whole-body photographs compiled in the form of a booklet, with nurse instruction on how to use the photographs); and Group B (n =51) received the teaching intervention only without a photo book. Main outcome/measures: Self-administered questionnaires were provided at three intervals: baseline, post-teaching intervention, and at the 4-month post-baseline visit. To assess adherence with SSE, patients were asked, "How many times in the past 4 months did you (or someone else) usually, thoroughly examine your skin?" Results: In Group A (teaching intervention with photo book), 10.2% of the patients at baseline reported skin examination three or more times during the past 4 months, while 61.2% reported skin examination three or more times at the 4-month follow-up (p =0.039 for paired comparison). In Group B (teaching intervention only), nearly 20% of the patients at baseline reported skin examination three or more times during the past 4 months, while 37% reported skin examination three or more times at the 4-month follow-up (p =0.63). The increase in reported skin examination was compared between the two groups (>51% v >17.6%, p =0.001). Conclusions: The results suggest that a brief nurse-delivered intervention is effective at increasing patient adherence with SSE. Utilizing digital photographs as an adjunct to screening appeared to increase patient adherence to performing SSE. © 2004 American Journal of Preventive Medicine. |
| Keywords: | adolescent; adult; controlled study; aged; middle aged; major clinical study; cancer risk; cancer patient; follow up; follow-up studies; nursing; melanoma; skin neoplasms; patient education; questionnaires; questionnaire; cancer center; statistical significance; medical education; skin examination; outpatient department; patient compliance; outcomes research; physician; new york city; dysplastic nevus; high risk population; photography; skin care; clinical examination; self examination; self-examination; self care; pamphlets; dysplastic nevus syndrome; humans; human; male; female; article |
| Journal Title: | American Journal of Preventive Medicine |
| Volume: | 26 |
| Issue: | 2 |
| ISSN: | 0749-3797 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2004-02-01 |
| Start Page: | 152 |
| End Page: | 155 |
| Language: | English |
| DOI: | 10.1016/j.amepre.2003.10.006 |
| PROVIDER: | scopus |
| PUBMED: | 14751328 |
| DOI/URL: | |
| Notes: | Am. J. Prev. Med. -- Cited By (since 1996):39 -- Export Date: 16 June 2014 -- CODEN: AJPME -- Source: Scopus |
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