Training Increased Patient, Partner Confidence in Performing Skin Exams

Participation in a training program increased levels of self-confidence for both patients and their partners in performing skin self-examinations (SSEs) to detect melanoma, without increasing levels of embarrassment or discomfort, according to the results of a study published in JAMA Dermatology.

“Research suggests that patients with melanoma may benefit from partner-assisted SSEs to increase early detection of new melanoma,” wrote researcher June K. Robinson, MD, of Northwestern University Feinberg School of Medicine in Chicago, and colleagues. “Despite the potential positive aspects of including partners in SSEs, it is plausible that some individuals may be embarrassed or feel uncomfortable having a nonprofessional or intimate partner routinely check their bodies.”

Robinson and colleagues assessed patient-reported and partner-reported levels of embarrassment, comfort, and self-confidence in performing these exams during a 2-year period. The study included 395 participants between ages 21 and 80 years who had been diagnosed with stage 0 to IIb melanoma, with surgical removal of melanoma at least 6 weeks prior. Participants and their partners participated in an SSE education training program and completed surveys every 4 months. Levels of embarrassment and comfort were measured using questions rated on a 5-point scale.

After the training program, there was no significant change in participant or partner levels of embarrassment or comfort in performing SSEs.

“This finding provides substantive evidence that asking dyads to regularly perform SSEs does not increase emotional barriers (ie, feelings of discomfort or embarrassment),” the researchers wrote.

However, participants and partners did report a significant increase in self-confidence from baseline to 24 months (P < .001 for both). When the researchers compared confidence levels of patients and their partners, patients reported significantly higher levels of self-confidence at all assessments except 16 months and 24 months.

Finally, there was no difference in changes in comfort, embarrassment, or self-confidence between male and female participants or partners.

“Our pilot work showed that, of 181 individuals who declined to participate in the study, only 9 indicated that they were uncomfortable having partners help with SSE,” the researchers wrote. “This finding indicates that potential embarrassment prevented a relatively small portion of patients (5.0%) from participating. Therefore, dyads indicating some level of embarrassment still will benefit from SSE training and physicians suggest frequent partner-assisted SSEs.”