SKIN-CANCER RISK AND SUN PROTECTION LEARNING BY HELPERS OF PATIENTS WITH NONMELANOMA SKIN-CANCER

Background. Knowledge-based skin cancer risk and prevention educationa l interventions by physicians and nurses were directed to subjects who had a nonmelanoma skin cancer. These high-risk patients asked relativ es or friends to assist with postoperative care rendered after surgica l removal of the skin cancer. The patient's experience with the nonmel anoma skin cancer was expected to raise the awareness of the helper. T he study examined whether the patient became a source of information, risk assessment, and skills training for his or her helper. Methods. S equential patients between 30 and 60 years of age and their designated helpers completed a self-report questionnaire prior to the interventi on and 1 year after the intervention. The questionnaire examined: (a) knowledge of skin cancer and sun protection; (b) individual susceptibi lity as determined by ease of sunburning or tanning; (c) attitudes abo ut self-esteem, sun exposure, and health locus of control; (d) intenti ons to use sun protection; and (e) behaviors of sun protection used. R esults. Over the course of 1 year, 200 pairs were entered into the stu dy. Both patients and helpers demonstrated an increase in knowledge af ter the educational intervention with the patients. There was a change in the self-reported intention to use sun protection and the behavior s of sun protection used in both patients and helpers after the interv ention; however, there was no attitudinal change demonstrated in pre- and post-tests for either patients or helpers. Among both patients and helpers, gender-specific differences in attitudes, intentions, and be haviors existed. Women expressed a greater likelihood of taking precau tions, including the use of sunblock; however, men reported the protec tive strategy of wearing a hat more than women did. Men valued a tan m ore than women and had greater outdoor exposure, which they restricted after the intervention. Women helpers ceased using indoor tanning dev ices after the intervention. Behavioral change in use of sun protectio n measures, including protective clothing or sunblock use and decrease in hours of outdoor sun exposure or use of indoor tanning devices, wa s dependent upon the patient or helper's own reported susceptibility a s determined by his or her history of poor tanning and ease of sunburn ing. Conclusion. Patients transferred knowledge to their helpers. inte ntion to change behavior and behavioral change were strongly correlate d with the individual's reported susceptibility to easy sunburning and poor tanning. Despite a lack of change in attitudes, changes in both intention to change behavior and behavior itself occurred in those who perceived themselves to be at risk. While the attitudes of participan ts in this study reflected popular beliefs, targeted education of high -risk adults with a nonmelanoma skin cancer caused changes in sun prot ection behaviors in both the patients and their helpers. (C) 1995 Acad emic Press, Inc.