Robinson JK, Turrisi R, Stapleton J, Journal of the American Academy of Dermatology- 2007 03 (Vol. 56, Issue 3) Published online 12 December 2006.
Robinson and colleagues, who had previously demonstrated that patients at risk for melanomas who were trained together with their significant others to perform a skin self-examination (SSE) were more likely to perform the exams as scheduled than those who were trained alone, undertook this study to discover the reasons for that differentiation.
130 participants drawn from a melanoma hospital registry were randomly assigned to a solo-learning control group (n = 65) or a partner-learning group (n = 65). The intervention was a 10-minute educational presentation and skills training session based on the ABCDE rule of early melanoma detection. The main outcome measure was SSE performance as measured by use of a body map.
The mediators measured included
- Attitudes toward SSE
- Self-efficacy/confidence in the ability to effectively perform SSE
- Comfort with having a partner help with SSE
- Perceived melanoma/skin cancer risk
- Concern about developing skin cancer/skin damage
- Melanoma/skin cancer knowledge
Of these, the most significant mediators were found to be
- Attitudes toward SSE
- Self-efficacy
- Comfort with having a partner help with SSE
- Concern about developing sun-damaged skin
The conclusions, as excerpted from the abstract, follow:
Commentary
That training in medical self-examination is enhanced by partner-oriented rather than solo instruction is intuitively appealing and has far-reaching implications.
Nonetheless, a more rigorous evaluation of the consequences of this improvement would seem to be in order; i.e., do these patients who are trained as couples actually find a higher percentage of potential lesions over time than those trained individually? The clinical trials thus far appear to be a good start, not a finished product.
