Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year
Tóm tắt
Skin cancer is the most common type of cancer in humans and the incidence is increasing worldwide. Our objective was to understanding the needs, experiences and knowledge of individuals with Non Melanoma Skin Cancer (NMSC) from diagnosis up until one year. Patients with NMSC completed questionnaires at diagnosis, treatment, 8 weeks post treatment and 12 months post diagnosis. Body image, psychological morbidity and Quality of Life (QOL) were assessed at each time point, with the exception of QOL that was not assessed at diagnosis. Knowledge of NMSC was assessed at baseline and 8 weeks. A sub-sample of participants was also interviewed to allow a more in-depth exploration of patients’ experiences. 76 participants completed the initial questionnaire, of which 15 were interviewed. Patients were anxious about a diagnosis of skin cancer, however they were no more depressed or anxious than the general population. QOL significantly improved from diagnosis to 8 weeks and from diagnosis to one year. Knowledge of NMSC was poor and did not improve after treatment. Hairdressers were highlighted as playing an important role in raising awareness and encouraging individuals to seek medical help. Most participants were aware of the need to check their skin for suspicious lesions but were not sure what to look for. At one year participants had forgotten their experience and were not overly concerned about skin cancer. There is a need to raise awareness of the signs and symptoms of NMSC. Information on skin cancer needs to be tailored to the individual both at the start of treatment and during the follow up months, ensuring that participants’ needs and expectations are met. Targeting education at individuals in the community who regularly come into contact with skin should help in early identification of NMSC. This is important since skin cancer caught early is easily treatable and delay in presentation leads to larger and more complex lesions which impacts in terms of increased morbidity and increased health care costs.
Tài liệu tham khảo
Martinez J, Otey C: The management of melanoma and nonmelanoma skin cancer: a review for the primary care physician. Mayo Clin Proc 2001,76(12):1253–1265. 10.4065/76.12.1253
Lomas A: A systematic Review of worldwide incidence of Non-melanoma skin cancer. British Journal Dermatology 2012,166(5):1069–1080. 10.1111/j.1365-2133.2012.10830.x
Bath-Hextall F, Leonardi-Bee J, Smith C, Meal A, Hubbard R: Trends in incidence of basal cell carcinoma; Additional evidence from a UK-primary care database study. Int J Cancer 2007, 121: 2105–2108. 10.1002/ijc.22952
Christenson L, Borrowman T, Vachon C, Tellefson M, Otley C, Weaver A, Roenigk R: Incidence of basal cell and squamous cell carcinomas in a population younger than 40 years. JAMA 2005, 294: 681–690. 10.1001/jama.294.6.681
de Vries E, van de Poll-Franse L, Louwman W, de Gruijl F, Coebergh J: Predictions of skin cancer incidence in the Netherlands up to 2015. Br J Dermatol 2005, 152: 481–488. 10.1111/j.1365-2133.2005.06386.x
Skellett A, Hafiji J, Greenberg D, Wright K, Levell N: The incidence of basal cell carcinoma in the under-30s in the UK. Clin Exp Dermatol 2012, 37: 227–229. 10.1111/j.1365-2230.2011.04246.x
Bath-Hextall F, Perkins W, Bong J, Williams H: Interventions for basal cell carcinoma of the skin. Cochrane Database Syst Rev 2007., (1): Art.No.:CD003412.DOI:10.1002/14651858.CD003412.pub2
Lansbury L, Leonardi-Bee J, Perkins W, Goodacre T, Tweed JA, Bath-Hextall FJ: Interventions for non-metastatic squamous cell carcinoma of the skin. Cochrane Database Syst Rev 2010., (4): Art. No.: CD007869. DOI: 10.1002/14651858.CD007869.pub2
Bath-Hextall F, PERKINS W: Skin Cancer Awareness. Geriatric Medicine 2009,39(7):364–400.
National Institute for Health and Clinical Excellence: Improving Outcomes for people with Skin Tumours including Melanoma. London: NICE; 2006.
Barker J, Kumar A, Stanton W, Bath-Hextall F: The needs and experiences of people with a diagnosis of skin cancer: a systematic review. The JBI Library of Systematic Reviews 2011,9(4):104–121.
Walter F, Humphrys E, Tso S, Johnson M, Cohn S: Patient understanding of moles and skin cancer, and factors influencing presentation in primary care: a qualitative study. BMC Fam Pract 2010, 11: 62. 10.1186/1471-2296-11-62
Alam M, Goldberg L, Silapunt S, Gardner E, Strom S, Rademaker A, Margolis D: Delayed treatment and continued growth of nonmelanoma skin cancer. J Am Acad Dermatol 2011, 64: 839–848. 10.1016/j.jaad.2010.06.028
Winterbottom A, Harcourt D: Patients experiences of the diagnosis and treatment of skin cancer. J Adv Nurs 2004,48(3):226–233. 10.1111/j.1365-2648.2004.03191.x
Cassileth B, Lusk E, Tenaglia A: Patients' perceptions of the cosmetic impact of melanom resection. Plastic Reconstructive Surgery 1983,71(1):73–75.
Carr T, Moss T, Harris D: The DAS24: a short form of the Derriford Appearance Scale DAS59 to measure individual responses to living with problems of appearance. Br J Health Psychol 2005,10(2):285–298. 10.1348/135910705X27613
Zigmond A, Snaith R: The hospital anxiety and drpression scale. Acta Psychiatr Scand 1983, 67: 361–370. 10.1111/j.1600-0447.1983.tb09716.x
GLAZEBROOK C, Garrud P, Avery A, Coupland C, Williams H: Impact of multimedia intervention"Skinsafe" on patients' knowledge and protective behaviours. Preventative Medicine 2006,42(6):449–454. 10.1016/j.ypmed.2006.02.007
Rhee JSMB, Neuburg M, Logan BR, Burzynski M, Nattinger AB: Validation of a quality-of-life instrument for patients with Nonmelanoma skin cancer. Arch Facial Plast Surg 2006, 8: 314–318. 10.1001/archfaci.8.5.314
Rhee JSMB, Neuburg M, Logan BR, Burzynski M, Nattinger AB: The skin cancer index: clinical responsiveness and predictors of quality of life. Laryngoscope 2007,117(3):399–405. 10.1097/MLG.0b013e31802e2d88
Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol 2006,3(2):77–101. 10.1191/1478088706qp063oa
Roberts N, Czajkowska Z, Radiotis G, Korner A: Distress and coping strategies among patients with skin cancer. J Clin Psychol Med Settings 2013,20(2):209–214. doi: 10.1007/s10880–012–9319-y 10.1007/s10880-012-9319-y
Kasparian N, McLoone J, Butow P: Psychological responses and coping stategies among patients with malignant melanoma. Arch Dermatol 2009,145(12):1415–1426. 10.1001/archdermatol.2009.308
Renzi C, Mastroeni S, Mannooranparampil T, Passarelli F, Caggiati A, Potenza C, Pasquini P: Delay in diagnosis and treatment of squamous cell carcinoma of the skin. Acta Derm Venereol 2010, 90: 595–601. 10.2340/00015555-0966
De Nooijer J, Lechner L, De Vries H: A qualitative study on detecting cancer symptoms and seeking medical help: an application of Andersen's model of total patient delay. Patient Educ Couns 2001, 42: 145–157. 10.1016/S0738-3991(00)00104-X
Bailey E, Marghoob A, Orengo I, Testa M, White V, Geller A: Skin cancer knowledge, attitudes, and behaviours in the salon. Arch Dermatol 2011,147(10):1159–1165. 10.1001/archdermatol.2011.184
Schofield P, Freeman J, Dixon H, Borland R, Hill D: Trends in sun protection ehaviour among Australian young adults. Health Promot 2001,25(1):62–65.
Roosta N, Wong M, Woodley D: Utilizing hairdressers for early detection of head and neck melanoma: an untapped resource. J Am Acad Dermatol 2012, 66: 687–688. 10.1016/j.jaad.2011.09.010
Mostow E: Practice gaps. Skin cancer detection in hair salons: opportunity knocking:comment on "skin cancer knowledge, attitudes, and behaviours in the salon'. Arch Dermatol 2011,147(10):1159–1165. 10.1001/archdermatol.2011.184
Oliveria S, Christos P: Patient knowledge, awareness, and delay in seeking medical attention for malignant melanoma. J Clin Epidemiol 1999,52(11):1111–1116. 10.1016/S0895-4356(99)00083-9
Marcil I, Stern R: Risk of developing a subsequent nonmelanoma skin cancer in patients with a history of nonmelanoma skin cancer. Arch Dermatol 2000, 136: 1524–1530. 10.1001/archderm.136.12.1524
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