Patient awareness and sun protection behaviour following excision of basal cell carcinoma

Hospital Care for Cancer Patients-Education and Respect for Patient Rights

This study aims to examine cancer patients' opinions of safety, the observance of patient's rights, and the quality of healthcare. Such an analysis will allow for the identification of areas for improvement in quality, safety, and communication between medical staff and patients. Cancer patients are a special kind of patients with chronic and complex diseases, so we need to observe the type of communication they use, which is a critical issue in a hospital ward but also has a significant impact on how the patient follows recommendations at home. Observing a patient's rights impacts the safety and quality of medical care. This information allows for the identification of areas requiring deeper analysis and improvement. This study was based on a survey conducted at an oncology hospital. The survey contained questions divided into seven sections related to the study areas. Our study emphasizes the importance of knowledge and understanding regarding patient rights among medical staff and patients, underscoring their role in ensuring quality and safety in healthcare settings. We found a strong correlation between the politeness of medical receptionists and staff and patient perceptions of the clarity and exhaustiveness of the information provided.

Risk factors and early prevention of skin cancer in rural older outdoor workers: A scoping review

Skin cancer risk increases with age and prolonged exposure to ultraviolet radiation (UVR), particularly in rural geographical locations and for individuals with light skin complexions. However, the impact of UVR-induced skin cancer risk and sun-protective behaviors in rural older populations working outdoors has yet to be explored. A scoping review was conducted to fill this gap, with 12 articles meeting the inclusion criteria of aged 50 years and older among rural outdoor workers. Skin cancer risk factors, prevention strategies, and barriers to sun-protective behaviors were summarized for each study. The scoping review addressed some key differences in age-related effects of UVR among rural older outdoor workers compared to studies among adults in general. Findings have policy and research implications that highlight the need to design feasible preventive strategies to reduce rural disparities in cancer care and enhance access to preventive services for this high-risk population.

Awareness of Disease Status Among Patients With Cancer: An Integrative Review

BACKGROUND

As the quality of cancer care improves, oncology patients face a rapidly increasing number of treatment options. Thus, it is vital that they are full and active partners in the treatment decision-making process. Awareness of disease status has been investigated in the literature; it has been inconsistently conceptualized and operationalized.

OBJECTIVE

The aim of this integrative review was to develop a conceptual definition and model of the awareness of disease status among patients with cancer.

METHODS

Whittemore and Knafl's integrative review methodology guided this article. We obtained data through a systematic search of 8 databases. Key terms utilized were awareness, perception, truth disclosure, diagnosis, prognosis, terminal illness, status, neoplasm, and metastasis. Dates through January 2020 were searched to capture all relevant articles. Sixty-nine articles met inclusion criteria.

RESULTS

The integrative review methodology guided the development of a conceptual definition and model. The concept of "awareness of disease status" was defined as the individual patient's understanding of being diagnosed and treated for cancer based on the multifactorial components of individual patient characteristics and contextually driven communication practices of healthcare providers. This understanding is dynamic and changes throughout the disease trajectory.

CONCLUSION

These findings will inform consistency in the literature. Such consistency may improve person-centered clinical communication, care planning practices, and, ultimately, cancer-related outcomes.

IMPLICATIONS FOR PRACTICE

With a greater understanding of the complexity of patients' awareness of disease status, nurses will be able to guide their patients to make informed decisions throughout their disease trajectory.

Basal cell carcinoma: what new can be learned about the most common human cancer? A cross-sectional prospective study of 180 cases in a single centre

Introduction

Basal cell carcinoma (BCC) is the most common cancer in humans, but the reporting of patients with BCC is still not complete. There are a limited number of analyses in the literature on BCC epidemiology.

Aim

To study the epidemiological as well as clinical aspects of BCC by analysing a single centre’s experience in the Lower Silesia region of Poland.

Material and methods

We investigated 180 patients with BCC treated in the Unit of Dermatosurgery, Department of Dermatology, Venereology, and Allergology of Wroclaw Medical University between September 2017 and December 2019.

Results

The mean age of patients with BCC was 70.5 ±11.9 years. The most frequently diagnosed type of BCC was nodular type, at 72% of all patients. BCC occurred most commonly on the face and neck area, at 132 (73.3%), without a statistical difference between males and females. The vast majority of cancers were located on the nose. There was a personal history of skin cancer in 29% of our patients. In 127 (70.6%) subjects, the diameter of the BCC on the day of excision was less than 2 cm.

Conclusions

The clinical characteristics of our cohort of BCC patients has some similarities with that reported from central Poland and other European countries. However, we found an increase in the incidence of BCC among females.

Comparison of the Skin Cancer Quality of Life Impact Tool and the Skin Cancer Index Questionnaire in Measurement of Health-Related Quality of Life and the Effect of Patient Education Brochures in Patients with Actinic Keratosis, Non-melanoma Skin Cancer, and Cutaneous Melanoma

Introduction

Few studies have evaluated patient-reported outcome measures and the effect of patient educational materials in German patients with skin cancer. We conducted a prospective study to measure the impact of treatment on health-related quality of life in German patients with skin cancer, identify variables that may contribute to changes in health-related quality of life, and evaluate the effect of providing additional information through a patient education brochure.

Methods

A total of 461 patients diagnosed with actinic keratosis, nonmetastatic nonmelanoma skin cancer, melanoma in situ, or nonmetastatic cutaneous melanoma treated between August 2018 and July 2020 were included. Ninety-seven patients were randomly selected to receive an additional patient education brochure (“Hautkrebs”). The patients completed a Skin Cancer Quality of Life Index Tool (n = 324) or a Skin Cancer Index Questionnaire (n = 137) 1 week after surgical treatment.

Results

Ninety-seven patients were provided an additional patient education brochure. We found statistical correlation between sociodemographic factors (young age and female gender) and the location of the skin cancer (head and face) and impairment of health-related quality of life in patients with skin cancer (p < 0.05). Moreover, we found that patients who were presented a brochure showed significantly higher awareness concerning direct sun exposure (p < 0.05).

Conclusion

Impaired health-related quality of life is correlated with a patient with skin cancer’s age, gender, and the location of the lesion. Physicians should consider these factors in clinical practice and advocate the use of patient education brochures as effective assets in preventing the reoccurrence of skin cancer.

Comparison of skin cancer awareness and sun protection behaviours between renal transplant recipients and patients with glomerular disease treated with immunosuppressants

BACKGROUND

There is no previous study that compare skin cancer awareness and photoprotective behaviours between renal transplant recipients (RTR) and patients with glomerular disease (GD).

OBJECTIVES/METHODS

Sixty-one RTR and 51 patients with GD were given a self-reported questionnaire to evaluate skin cancer awareness and photoprotective behaviours in this cross-sectional study. The former group received a formal education on skin cancer and the latter an informal session prior to immunosuppressant use.

RESULTS

Ninety-three percent (n = 57) of RTRs and 88% (n = 45) of patients with GD responded to the survey. Majority of participants from both groups were aware that ultraviolet radiation could play a role in the occurrence of skin cancers and the awareness increased in participants with higher education (odds ratio [OR] = 1.50, 95% confidence interval [CI] = 1.15-1.95, P = .003). Ninety-eight percent vs 71% were aware that immunosuppressants can increase the risk of developing cancer (P < .001) and higher awareness was noted in younger participants (OR = 0.92, 95% CI = 0.87-0.97, P = .003). Suboptimal photoprotective behaviours (sun avoidance, sunscreen usage and sun-protective clothing) were noted in both cohorts and slightly lower sun protection rates were reported in RTR when compared with patients having GD. The level of sun protective measures in RTR based on high, moderate and minimal use of photoprotective measures were 21%, 46% and 33%, respectively. In terms of patients with GD, the latter practices were 13%, 50% and 37%, respectively (P = .560). Higher educational status was significantly associated with better sunscreen usage in RTR (P = .017) whereas this finding was not observed in patients with GD.

CONCLUSION

Patients with GD and RTR should have formal education on the risks of skin cancers before starting immunosuppressants. Follow-up education and surveillance is required to improve skin protective practices in these patients.

Histopathological and patient-related characteristics of basal cell carcinomas of the head and neck influencing therapeutic management

The authors hypothesize that histopathological characteristics of basal cell carcinomas of the head and neck (BCCHN) have changed over time and the correlation of BCCHN localization and histological tumour type can help improving the number and quality of necessary therapeutic interventions. Information of 222 patients with 344 BCCHN was gained. Descriptive measures were compared to prior studies to prove whether or not characteristics of basal cell carcinomas or patients have changed over time. Afterwards descriptive measures were correlated with number of conducted operations to evaluate if tumour localization, histological tumour type and number of operations depend on one another. Aggravating factors which lead to a higher number of operations were older age, greater size of BCCHN, adjacent elastosis, the localizations eye, ear and nose and histological tumour types morpheaform and nodularulcerated. In comparison to earlier studies characteristics of BCCHN and patients showed positive developments because of grown awareness of BCCHN. Furthermore, our correlations demonstrate that therapeutic results of BCCHN treatment are continuously improving. Nevertheless, treatment of aggressive morpheaform BCCHN in combination with distinctive patient characteristics still needs improvement.

UV imaging reveals facial areas that are prone to skin cancer are disproportionately missed during sunscreen application

Application of sunscreen is a widely used mechanism for protecting skin from the harmful effects of UV light. However, protection can only be achieved through effective application, and areas that are routinely missed are likely at increased risk of UV damage. Here we sought to determine if specific areas of the face are missed during routine sunscreen application, and whether provision of public health information is sufficient to improve coverage. To investigate this, 57 participants were imaged with a UV sensitive camera before and after sunscreen application: first visit; minimal pre-instruction, second visit; provided with a public health information statement. Images were scored using a custom automated image analysis process designed to identify areas of high UV reflectance, i.e. missed during sunscreen application, and analysed for 5% significance. Analyses revealed eyelid and periorbital regions to be disproportionately missed during routine sunscreen application (median 14% missed in eyelid region vs 7% in rest of face, p<0.01). Provision of health information caused a significant improvement in coverage to eyelid areas in general however, the medial canthal area was still frequently missed. These data reveal that a public health announcement-type intervention could be effective at improving coverage of high risk areas of the face, however high risk areas are likely to remain unprotected therefore other mechanisms of sun protection should be widely promoted such as UV blocking sunglasses.

Predictors of sun protection behaviours and sunburn among Australian adolescents

BACKGROUND

Excessive sun exposure and sunburn increase individuals' risk of skin cancer. It is especially important to prevent sunburn in childhood due to the higher relative risk of skin cancer across the life span compared to risk associated with sunburn episodes experienced later in life. This study examined demographic and attitudinal factors associated with engagement in a range of sun protection behaviours (wearing a hat, wearing protective clothing, staying in the shade, and staying indoors during the middle of the day) and the frequency of sunburn among Western Australian adolescents to provide insights of relevance for future sun protection campaigns.

METHODS

Cross-sectional telephone surveys were conducted annually with Western Australians between 2005/06 and 2014/15. The results from 4150 adolescents aged 14-17 years were used to conduct a path analysis of factors predicting various sun protection behaviours and sunburn.

RESULTS

Significant primary predictors of the sun protection behaviours included in the study were skin type (sun sensitivity), gender, tanning-related attitudes and behaviours, and perceived relevance of public service advertisements that advocate sun protection. Of the four sun protection behaviours investigated, staying in the shade and staying indoors during the middle of the day were associated with a lower frequency of sunburn.

CONCLUSION

There is a particular need to target sun protection messages at adolescent males who are less likely to engage in the most effective sun protection behaviours and demonstrate an increased propensity to experience sunburn. The results suggest that such future sun protection messages should include a focus on the importance of staying in the shade or indoors during periods of high UV radiation to increase awareness of the efficacy of these methods of avoiding skin cancer.