Effects of Creating Awareness Through Photographs and Posters on Skin Self-Examination in Nursing Students

An application of a series of theory-based educational intervention based on the health belief model on skin cancer prevention behaviors in female high school students

Background

Cancer is a leading cause of death globally and the second cause of death in developed countries. Having a rising incidence, skin cancer is the most prevalent cancer in Iran. Long-term UV radiations, particularly during childhood and adolescence, is a major cause of skin cancers. The Theory of Planned Behavior as the most precise indicator of behavior, contains motivational factors affecting behavior. This theory has been successful in predicting factors related to chronic diseases, especially cancer. As this model was successful in assessing sun-protective behaviors in previous studies, this study was designed to figure out how a theory-based educational intervention can affect the skin cancer prevention practices of Iranian female high school students.

Methods

This experimental investigation was carried out 2019-2020 using multistage cluster sampling method on 400 female high school students in Fasa, Fars, Iran. A questionnaire consisting of demographic data and a questionnaire including the components of the Theory of Planned Behavior was used to assess skin cancer preventative behaviors of both the trial and control groups of the study. An educational program based on the Theory of Planned Behavior was held for the experimental group for eight weeks regarding skin cancer preventive behaviors. The two groups completed questionnaires three months following the intervention for a second time.

Results

The study's findings revealed that prior to the intervention, there was no considerable distinction between the two study groups with regard to knowledge, attitude, subjective norms, perceived behavioral control, behavioral intentions, and skin cancer prevention behaviors; yet, three months later, the experimental group demonstrated increases in each of the mentioned variables with a significant difference. In contrast, the control group showed no discernible difference.

Conclusions

The findings of this investigation highlighted the success of the Theory of Planned Behavior for designing educational interventions aimed at encouraging skin cancer prevention in a population of female high school students.

Systematic Review of Interventions to Increase Awareness of Ultraviolet Radiation-Induced Harm and Protective Behaviors in Post-Secondary School Adults

College and university students are a group known for excessive sun exposure and indoor tanning. Health education campaigns for avoidance of ultraviolet (UV) radiation have been relatively unsuccessful in this population. This systematic review examines interventions aimed at post-secondary school young adults on college and university campuses for skin cancer awareness, photoprotection, and change in UV-exposure-related behavior. Fifty-nine studies were identified for inclusion according to predetermined criteria. Study heterogeneity was high; methods of intervention were individual or group-based, and were mostly visually delivered and/or passive learning. Most interventions occurred at a single time point. Intervention success was assessed by evaluating subject behavior, intention, attitudes, knowledge, and emotion. Multicomponent interventions, generally consisting of UV photography and a passively delivered educational component, may be more effective than a single component alone. Overall, study quality was poor. Sample size of the majority of studies was <150 subjects. Most studies used self-report of behavior and had a short follow-up time. Generalizability of findings may be impacted as women, particularly white/Caucasian women, were overrepresented in the studies identified by this systematic review. For this specific target population, themes arising from the review include the importance of self-relevance and message framing. Self-affirmation was identified as a potential challenge in designing interventions for this target group, which can lead to defensiveness and a negative reaction to the health message. The findings of this systematic review may inform future research in this field, as well as guide planning of effective interventions in this target population.

Educational methods used in cancer training for health sciences students: An integrative review

OBJECTIVE

To explore the educational methods used in the cancer training of undergraduate students in health sciences.

DESIGN

Integrative review with a systematic methodology was performed to obtain a comprehensive picture of the variety of educational methods used in cancer training.

DATA SOURCES

A search was performed in the PubMed, CINAHL, PsycINFO and Cochrane databases for the period 2008-2020.

REVIEW METHODS

The Critical Appraisal Skills Program (CASP) was used to assess the quality of included studies. Three reviewers extracted data and did quality appraisal.

RESULTS

A total of 40 articles referring to cancer training in medicine and nursing were included in the review; no articles referring to other health disciplines were found. The main educational methods used were expository methods, case studies, exercises and problems, problem-based learning, learning contracts and project-oriented learning.

CONCLUSION

This review shows the need to combine educational methods so that health sciences students acquire competency (knowledge, skill, attitude) for comprehensive cancer care. There is a gap in the training of undergraduate nursing students to provide person/family centered care in oncology. To improve the training and professional practice of future health professionals, interprofessional education and the involvement of people with cancer in simulation education are recommended.

Effects of an Education Intervention on Nursing Students' Knowledge and Attitudes Regarding Skin Self-Examination and Skin Cancer Risks

BACKGROUND

The incidence of skin cancers is increasing in Turkey as well as worldwide. Nurses have a potentially influential role to play in educating the public about skin cancer prevention.

PURPOSE

The purpose of this study was to teach nursing students the risks of skin cancer and the steps involved in conducting related skin self-examinations to encourage positive attitudes toward skin cancer protection and early detection.

METHODS

This research used a quasi-experimental, single-group, pretest-posttest design. The study population was composed of all the nursing students who were currently enrolled in a university in Muğla, a city in southern Turkey (n = 900). The study analysis included the 332 nursing students who had completed both the pretest and posttest assessments. An intervention to raise awareness about skin cancer risks and skin self-examination was carried out using educational materials that included posters/pictures, brochures, a PowerPoint slideshow, and a video. The posttest assessment was done 6 weeks after the pretest.

RESULTS

The participants were 18-23 years old, and 67.5% were female. Furthermore, 3.6% had undergone a routine (external) screening for skin cancer, and 14.5% believed that they were at risk for skin cancer. The mean score for knowledge of skin cancer risks for those participants who had completed the program was 5.75 ± 1.20 in the pretest and 6.84 ± 1.17 in the posttest (minimum: 0, maximum: 8). The mean posttest score was higher than the pretest score in this group, F(1, 329) = 6.49, p = .011, and a significant difference was found between the mean pretest and posttest score for knowledge of the ABCDE rule (p < .05).

CONCLUSIONS

Educating nursing students about skin self-examination increased their level of knowledge about both skin cancer risks and the ABCDE rule. We believe that this and similar educational programs are an effective way to increase the knowledge and awareness of nurses regarding skin cancer and to improve their attitudes toward performing skin self-examination.

Randomised controlled trial to evaluate the influence of mHealth and eHealth skin cancer prevention education among young organ transplant recipients: the HIPPOlino intervention study

OBJECTIVES

To determine whether a multicomponent sun protection intervention programme (mHealth) for young organ transplant recipients (OTR) leads to a higher increase of preventive knowledge and behavioural change than an e-learning education programme (eHealth).

DESIGN

Randomised controlled trial with one preintervention baseline survey and three follow-up surveys after 6 weeks, 6 and 12 months. Comparison of two different intervention schedules with a control group (CG).

SETTING

Multicomponent sun protection trainings in Germany, the Netherlands and Austria between June 2013 and September 2015.

PARTICIPANTS

137 OTRs (5-22 years of age, 61 females/76 males) participated in the study.

INTERVENTIONS

(A) Intervention group 1 (IG1): personal training with subsequent forwarding of individual ultraviolet index-dependent sun protection recommendations via short message service (SMS); (B) intervention group 2 (IG2): e-learning training without SMS; (C) CG: regular information letters, online training after 1 year.

OUTCOME MEASURES

Key questions were used to form a knowledge and a behavioural score. Behavioural strategies and knowledge were quantified through self-administered questionnaires.

RESULTS

Analyses 6 weeks after the intervention showed a higher knowledge increase in both IG compared with the CG (IG1 to CG: OR 12.64, 95% CI 4.20 to 38.20; IG2 to CG: OR 2.59, 95% CI 0.95 to 7.04). Sun protection behaviour improved slightly but not significantly in both IG (IG1 to CG: OR 2.56, 95% CI 0.93 to 7.00; IG2 to CG: OR 1.22, 95% CI 0.45 to 3.32). One year after the intervention, no behavioural changes were observed in either IG compared with the CG. IG1 but not IG2 still scored significantly higher in sun protection knowledge than the CG 1 year after intervention (IG1 to CG: OR 4.46, 95% CI 1.48 to 13.43; IG2 to CG: OR 1.41, 95% CI 0.51 to 3.93).

CONCLUSIONS

This multicomponent sun protection programme provides a promising strategy to increase sun protection knowledge and possibly also protective behaviour in young OTR.

TRIAL REGISTRATION NUMBER

DRKS00011393.

Knowledge and practices of primary care providers on skin cancer and skin self-examination

OBJECTIVE

To determine the knowledge and practices related to skin cancer and skin self-examination of primary care providers.

METHOD

This cross-sectional descriptive study was conducted in Turkey. The study was carried out in primary health centers such as family health centers, community health centers, early cancer detection centers and family planning centers in 2016-2017. Participants' socio-demographic characteristics, their knowledge and practices related to skin cancer, skin cancer risk factors and skin self-examination were determined.

RESULTS

The study population included 94 primary care providers. The symptoms of which the participants were most aware were changes in the color of moles or skin spots (95.71%), and of which participants were the least aware was the itching of a mole (71.43%). Among participants, the most recognized risk factor was having fair skin (97.14%), whereas the least known was the presence of birthmarks (24.29%). The mean scores the participants obtained from the questionnaire were as follows: 5.39±1.61 for skin cancer risk factors and 10.47±2.73 for skin cancer symptoms. Of the participants, 14.29% received training on skin self-examination, 38.57% knew how to perform skin self-examination, and 67.14% did not perform skin self-examination. Of the participants, 61.7% did not perform skin self-examination because they did not know what to look for. Of the participants, 85.71% did not have continuing education/workshop about skin self-examination after graduation.

CONCLUSION

Although the primary care providers' knowledge of skin cancer symptoms was adequate, their knowledge of skin cancer risk factors was not sufficient. Primary care providers' knowledge of skin self-examination was good, but they did not perform skin self-examination adequately.