title: Skin self-examination in patients at high risk for melanoma: a pilot study.
abstract: OBJECTIVE
  To compare the effect of providing high-risk patients with standard brochures versus personalized photo books as part of a comprehensive nursing intervention on knowledge, awareness, and confidence with skin self-examination (SSE) performance, as well as compliance in performing SSE.
  
  
  METHODS
  Randomized intervention design.
  
  
  METHODS
  The Lawrence E. Rockefeller Ambulatory Outpatient Cancer Center at Memorial Sloan-Kettering Cancer Center in New York, NY.
  
  
  METHODS
  100 patients at high risk for melanoma.
  
  
  METHODS
  Patients completed a baseline questionnaire before their initial photographs were taken and at the end of a nurse-teaching intervention at the clinic.
  
  
  METHODS
  Skin cancer knowledge, awareness, and self-confidence in SSE.
  
  
  RESULTS
  A two-way analysis of variance with repeated measures was performed to examine differences within and among groups in relation to knowledge, awareness, and confidence. The group-time interaction was not significant. In group A (nursing intervention with photo book), 10% of the patients at baseline reported performing SSE three or more times during the prior four months. Mean knowledge scores, awareness, and confidence scores all increased. In group B (nurse-teaching intervention using brochures only, without a photo book), 20% reported practicing SSE three or more times during the prior four months. Mean knowledge, awareness, and confidence scores increased.
  
  
  CONCLUSIONS
  The main difficulty that patients experience with self-detection of melanoma is their limited recall of skin appearance; therefore, photographic records may be the most effective aid for detecting changes at longer intervals. The use of a photo book may help to diminish that difficulty.
  
  
  CONCLUSIONS
  This study supports the fact that education can increase knowledge, awareness, and confidence regarding SSE, which is consistent with the findings of other investigators. Therefore, nurses should incorporate teaching patients how to perform SSE into their practice and recognize that personal involvement in health care has become a dominant theme in the cancer education literature in recent years. With this new emphasis, important self-care activities, such as testicular self-examination, breast self-examination, and now SSE, are being stressed because early detection has shown favorable effects in improving the prognosis of cancer.
authors: Department of Dermatology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. dlp415@aol.com
authors: Deborah L
authors: DL
authors: Phelan
authors: Susan A
authors: SA
authors: Oliveria
authors: Paul J
authors: PJ
authors: Christos
authors: Stephen W
authors: SW
authors: Dusza
authors: Allan C
authors: AC
authors: Halpern
mesh_terms: D000704:Analysis of Variance; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008545:Melanoma / Q000175:diagnosis* / Q000451:nursing; D010353:Patient Education as Topic; D010865:Pilot Projects; D012307:Risk Factors; D016353:Self-Examination; D012867:Skin; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000451:nursing