DOI QR코드

DOI QR Code

Training Program to Raise Consciousness Among Adolescents for Protection Against Skin Cancer through Performance of Skin Self Examination

  • Balyaci, Ozum Erkin (Department of Public Health Nursing, Faculty of Nursing, Ege University) ;
  • Kostu, Nazan (Department of Public Health Nursing, Denizli Vocational High School of Health, Pamukkale University) ;
  • Temel, Ayla Bayik (Department of Public Health Nursing, Faculty of Nursing, Ege University)
  • Published : 2012.10.31

Abstract

Background: Overexposure to sunlight in childhood and the adolescent period and associsated sunburns significantly increase the risk of skin cancer in adulthood. In Turkey, the incidence of skin cancer in the general population is 0.8%. The incidence is 0.6% and the mortality rate is 0.4% for men, while these rates are 1.0% and 0.7%, respectively, for women. If skin cancer is found early, its treatment is facilitated. Therefore, personal skin examination is important for early diagnosis. Objectives: Our aim was to determine the effects of training for raising consciousness among adolescents to protect against skin cancer by influencing skin self examination behavior. Method: This quasi experimental intervention study was conducted between February and April 2012 in Izmir. The study population consisted of students attending $6^{th}$, $7^{th}$ and $8^{th}$ classes of a primary school (n:302). No sampling was performed. Data were collected with a form developed by the researchers based on the literature. The first part of form is aimed to determine demographic characteristics of adolescents (3 questions) and their risk status of skin cancer (6 questions). The second part was prepared for skin cancer risks of adolescents (8 questions) and indications of skin cancer (12 questions). The last part was intended to determine their knowledge about skin self examination (4 questions) and behavioral stages of skin self examination (1 question). Data collection was achieved with a questionnaire form in three phases. In the 1st phase, data about demographic characteristics of students, risk status of skin cancer, knowledge level of skin cancer and behavior stages were collected. In the $2^{nd}$ phase, skin self examination training based on the transtheoretical model was performed within the same day just after obtaining preliminary data. In the $3^{rd}$ phase, adolescents were followed up three times to establish the efficacy of the training (on the $15^{th}$ day after training program and at end of the $1^{st}$ and $2^{nd}$ months). Follow-up data were evaluated by questioning skin self examination performing behavior stages through electronic mail. Results: Half of the adolescents (50.5%) are male, and 58.4% of them are 13 years old with a mean age of $12{\pm}1.15$ years. About 29.4% of adolescents had brown hair color, 37.9% had brown/hazel eye color, 29.4% had white skin, and 47.2% had fewer than 10 moles in their body. The pretest mean score on knowledge level about risks of skin cancer was found to be $4.19{\pm}1.96$, while the post-test mean score was $6.79{\pm}1.67$ (min:0, max:8).The pretest mean score about indications of skin cancer was $7.45{\pm}3.76$, while the post-test mean score was $10.7{\pm}2.60$ (min:0, max:12). The increases were statistically significant (p<0.05). The behavior "I do not perform skin self examination regularly in every month and I do not think to perform it in the next 6 months" was reduced from 52.8 to 35.5% after training. Conclusion: The training program organized to raise consciousness among adolescents for protection against skin cancer increased the knowledge level about risks and indications of skin cancer and it also improved the behavior of performing skin self examination.

Keywords

References

  1. Balk SJ (2011). Technical Report-Ultraviolet Radiation: A hazard to children and adolescents. Pediatrics, 127, 791-817. https://doi.org/10.1542/peds.2010-3502
  2. Baum A, Cohen L (1998). Successful behavioral interventions to prevent cancer: The example of skin cancer. Annual Review of Public Hlth, 19, 318-333.
  3. Baz K, Kokturk A, Ikizoglu G, et al (2003). Adults' consciousness and habits of protecting their children from the sun. Turkiye Klinikleri Dermatoloji Dergisi, 13, 101-7.
  4. Boyett T, Leigh D, Wearhers L, et al (2002). Sun protection of children at the beach. J Am Board Fam Pract, 15, 112-7.
  5. Cassel KD (2010) "Sun Safe Kids," Implementing a low cost, school-based public policy to protect Hawaii's children from skin cancer risks. Hawaii Medical J, 69, 274-7.
  6. Cokkinides VE, Weinstock MA, O'Connell MC, Thun MJ (2002). Use of indoor tanning sunlamps by US youth, age 11-18 years, and by their parent or guardian caregivers: prevalence and correlates. Pediatrics, 109, 1124-30. https://doi.org/10.1542/peds.109.6.1124
  7. Cokkinides VE, Davis KJ, Weinstock M, et al (2001). Sun Exposure and Sun Protection Behaviors and Attitudes Among U.S Youth, 11 to 18 Years of Age. Preventive Medicine, 33, 141-51. https://doi.org/10.1006/pmed.2001.0877
  8. David Cornfield Melanoma Fund (2012). Dear 16 Year Old Me film. Retrieved: 07.01.2012, from www.dcmf.ca
  9. Davis KJ, Cokkinides VE, Weinstock MA, O'Connell MC, Wingo PA (2002). Summer sunburn and sun exposure among US youths ages 11 to 18: National prevalence and associated factors. Pediatrics, 110, 27-35. https://doi.org/10.1542/peds.110.1.27
  10. Dietrich AJ, Olson AL, Sox CH, et al (1998). A Communitybased randomized trial encouraging sun protection for children. Pediatrics, 102, 64-71. https://doi.org/10.1542/peds.102.6.e64
  11. Emmons KM, Geller AC, Viswanath V, et al (2008). The SunWise policy intervention for school-based sun protection: A Pilot Study. JOSN, 24, 215-21.
  12. Ergul S, Ozeren E (2011). Sun protection behavior and individual risk factors of Turkish primary school students associated with skin cancer: A Questionnaire-Based Study. Asian Pac J Cancer Prev, 12, 765-70.
  13. Feher K, Cercato MC, Prantner I, et al (2010). Skin cancer risk factors among primary school children: Investigations in Western Hungary. Prev Med, 51, 320-24. https://doi.org/10.1016/j.ypmed.2010.07.002
  14. Glanz K, Saraiya M, Wechsler H (2002). Centers for Disease Control and Prevention. Guidelines for school programs to prevent skin cancer. MMWR Recomm Rep, 51, 1-18.
  15. Globocan (2008). Cancer Incidence, Mortality and Prevalence Worldwide in 2008. Retrieved: 05.02.2012, from http://globocan.iarc.fr/factsheet.asp
  16. Gokalp A, Ozgoztası O (2005). Deri ve deri altı dokusu. 'Temel Cerrahi ve Sistemik Cerrahi' (Skin and subcutaneous tissue. In the 'Basic Surgical and Systemic Surgery)Eds: Gulay H. 1. Baski, Guven Kitapevi, İzmir, pp: 887-926 (in Turkish).
  17. Heckman CJ, Coups EJ (2011). Correlates of sunscreen use among high school students: a cross-sectional survey. BMC Public Hlth, 11, 1471-2458
  18. Hossfeld DK, Sherman CD, Love RR, Bosch FX (1992). Uluslararasi Kanserle Savaa Birligi Klinik Onkoloji. Eds: Firat D, Sarioglu F, Kars A, 5. Baski, Ankara, pp: 163-178.
  19. James AS, Tripp MK, Parcel GS, Sweeney A, Gritz ER (2002). Psychosocial correlates of sun-protective practices of preschool staff toward their students. Hlth Education Research, 17, 305-314. https://doi.org/10.1093/her/17.3.305
  20. Kostu N, Erkin Balyacı O, Bayık Temel A (2012). Turkish adaptation of skin self examination (SSE) form), 15. Ulusal Halk Sagligı Kongre Kitabi (15th Congress of the National Public Health, Congress Book), Bursa (in Turkish).
  21. Kristja'nsson S, Helgason A'R, Mansson-Brahme E, Widlund-Ivarson B, Ulle'n H (2003). You and your skin: a shortduration presentation of skin cancer prevention for teenagers. Hlth Education Res Theory & Practice, 18, 88-97. https://doi.org/10.1093/her/18.1.88
  22. Lowe JB, McDermott LJ, Stanton WR, et al (2002). Behavior of caregivers to protect their infants from exposure to the sun in Queesland, Australia. Hlth Education Res, 17, 405-14. https://doi.org/10.1093/her/17.4.405
  23. Maguire-Eisen M, Rothman K, Demierre MF (2005) The ABCs of sun protection for children. Dermatology Nursing, 17, 419-33.
  24. McWhirter JM, Collins M, Bryant I, Wetton NM, Bishop JN (2000). Evaluting 'Safe in the Sun', a curriculum programme for primary schools. Hlth Education Res, 15, 203-217. https://doi.org/10.1093/her/15.2.203
  25. Ministry of Health of Turkey (2008). School Health in Health Services Book) T.C. Saglik Bakanligi Refik Saydam Hıfzıssıhha Merkezi Baskanligi, Hifzissihha Mektebi Mudurlugu, Saglik Bakanligi Yayin Numarası:719, Ankara (in Turkish).
  26. Ministry of Health of Turkey, Department of Cancer Control (2009). National cancer program from 2009 to 2015). Eds: Tuncer M., Yayın no:760, Ankara (in Turkish).
  27. Prochaska OJ, Velicer FW (1997). The transtheoretical model of health behavior change. Am J Hlth Promotion, 12, 38-48. https://doi.org/10.4278/0890-1171-12.1.38
  28. Reinau D, Meier C, Gerber N, Hofbauer GFL, Surber C (2012). Sun protective behaviour of primary and secondary school students in North-Western Switzerland. Swiss Med Wkly, 142, 2012-13520.
  29. Saraiya M, Glanz K, Briss PA, et al (2004). Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review. Am J Prev Med, 27, 422-66.
  30. Saridi M, Pappa V, Kyriazis I, et al (2009). Knowledge and attitudes to sun exposure among adolescents in Korinthos, Greece. Rural Remote Hlth, 9, 1162.
  31. Suppa M, Cazzaniga S, Fargnoli MC, Naldi L, Peris K (2012). Knowledge, perceptions and behaviours about skin cancer and sun protection among secondary school students from Central Italy. J Eur Acad Dermatol Venereology, 10, 1468-3083.
  32. The Skin Cancer Foundation (2012). Step by step self examination. Retrieved: 02.01.2012, from http://www.skincancer.org/skin-cancer-information/early-detection/step-by-step-self-examination
  33. Uslu M, Karaman G, Sendur N (2006). The evaluation of level of knowledge and sun protection behaviors of Adnan Menderes University physicians about the skin cancer and effects of the sun. ADU Tip Fakultesi Dergisi, 7, 5-10 (in Turkish).
  34. Uysal A, Altug Ozsoy S, Ergul S (2004). Evaluation of students' sun protection behaviors. Ege Tip Dergisi, 43, 95-9 (in Turkish).
  35. Ulkur E, Karagoz H, Acikel C, Yuksel F, Celikoz B (2005). .Recurrence rates of non-melanoma skin cancer: a retrospective analysis of 11 years. Cerrahpasa J. Med, 36, 189-93 (in Turkish).
  36. Walker DK (2012) Skin protection for (SPF) kids program. J Pediatric Nur, 27, 233-42. https://doi.org/10.1016/j.pedn.2011.01.031
  37. Xiao JJ, O'Neil B, Prochaska MJ, Kerbel CM (2004). A consumer education programme based on the transtheoretical model of change. Int J Consumer Studies, 28, 55-65. https://doi.org/10.1111/j.1470-6431.2004.00334.x

Cited by

  1. Effect of Skin Cancer Training Provided to Maritime High School Students on Their Knowledge and Behaviour vol.16, pp.17, 2015, https://doi.org/10.7314/APJCP.2015.16.17.7769
  2. Effects of Creating Awareness Through Photographs and Posters on Skin Self-Examination in Nursing Students pp.1543-0154, 2016, https://doi.org/10.1007/s13187-016-1037-y
  3. Mouth examination performance by children's parents and by adolescents in Fanconi anemia vol.64, pp.11, 2017, https://doi.org/10.1002/pbc.26622
  4. Knowledge and practices of primary care providers on skin cancer and skin self-examination vol.52, pp.0, 2018, https://doi.org/10.1590/s1980-220x2017039703359