Characteristics of men aged 50 years or older who do not take up skin self-examination following an educational intervention

School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
Journal of the American Academy of Dermatology (Impact Factor: 4.45). 07/2012; 67(1):e57-8. DOI: 10.1016/j.jaad.2011.10.019
Source: PubMed
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    ABSTRACT: Early detection of cutaneous melanoma results in reduced morbidity and mortality. Although screening by physicians has been shown effective, the role of skin self-examination (SSE) in melanoma secondary prevention is less well studied. Various methods and educational strategies have been implemented to empower patients to perform efficacious SSEs. Patient demographics play an important role in their likelihood to examine their own skin and ability to detect melanoma. Visual aids such as total body photography and dermoscopy, which have improved physician exams, are becoming elements accessible to patients for augmentation of self-exam. This review examines the literature of SSE in melanoma detection.
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    ABSTRACT: IntroductionThe Skin Self-Examination Attitude Scale (SSEAS) is a brief measure that allows for the assessment of attitudes in relation to skin self-examination. This study evaluated the psychometric properties of the SSEAS using Item Response Theory (IRT) methods in a large sample of men¿¿¿50 years in Queensland, Australia.MethodsA sample of 831 men (420 intervention and 411 control) completed a telephone assessment at the 13-month follow-up of a randomized-controlled trial of a video-based intervention to improve skin self-examination (SSE) behaviour. Descriptive statistics (mean, standard deviation, item¿total correlations, and Cronbach¿s alpha) were compiled and difficulty parameters were computed with Winsteps using the polytomous Rasch Rating Scale Model (RRSM). An item person (Wright) map of the SSEAS was examined for content coverage and item targeting.ResultsThe SSEAS have good psychometric properties including good internal consistency (Cronbach¿s alpha¿=¿0.80), fit with the model and no evidence for differential item functioning (DIF) due to experimental trial grouping was detected.Conclusions The present study confirms the SSEA scale as a brief, useful and reliable tool for assessing attitudes towards skin self-examination in a population of men 50 years or older in Queensland, Australia. The 8-item scale shows unidimensionality, allowing levels of SSE attitude, and the item difficulties, to be ranked on a single continuous scale. In terms of clinical practice, it is very important to assess skin cancer self-examination attitude to identify people who may need a more extensive intervention to allow early detection of skin cancer.
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    ABSTRACT: Skin-self examination (SSE) training interventions can increase understanding of melanoma early detection criteria and promote SSE. However, there remains a need to evaluate whether intervention participants can apply such early detection skills to accurately identify concerning, or potentially malignant, pigmented lesions during full body SSE. We assessed SSE accuracy using data from a randomized control trial of a SSE skills training intervention designed to promote partner-assisted SSE among melanoma patients. In the trial, patient-partner pairs were administered the training intervention and performed monthly SSE to identify, evaluate, and track concerning pigmented skin lesions. Patients received a total body skin examination by a dermatologist approximately 4-months post-intervention. SSE accuracy was assessed as the correspondence between the specific concerning pigmented lesions identified by 274 study pairs during SSE with those identified during dermatological examination. We also examined whether lesions that were biopsied during the study were identified prior to biopsy during SSE. Approximately 3 in 4 of the concerning lesions identified by pairs during SSE were also identified during the dermatological exam. There were 81 biopsies performed during the study and pairs had identified 73% of the corresponding lesions during SSE. Of the 5 melanoma detected, 3 were identified during SSE. Melanoma patients and partner taught to do SSE using an evidence-based program developed a high degree of correspondence with the study dermatologist in identifying concerning lesions. This study provides novel evidence that supports the accuracy of full-body SSE for the patient identification of concerning lesions. Copyright © 2015, American Association for Cancer Research.
    No preview · Article · Jun 2015 · Cancer Epidemiology Biomarkers & Prevention