How Do Melanoma Survivors and Their Partners Feel About Skin Self-Examination?

The impact of partner support and comfort level in assisting melanoma survivors with skin self-examination may be perceived differently by melanoma survivors and their partners, according to results of a study published in the Clinical Journal of Oncology Nursing.

Previous research has shown that the risk of a new primary melanoma lesion is increased in survivors of the disease compared with the general population. In addition, melanoma survivors are at risk of disease recurrence. Hence, increased vigilance to facilitate early identification of potential melanoma lesions through regular skin self-examination is particularly important in this patient group.

Evidence shows that prognosis is worse for patients with melanomas on parts of the body that are difficult to assess on skin self-examination, such as the scalp, back, the dorsal side of the thighs, and genitals. However, prior studies demonstrated that involving melanoma survivors’ partners in education about skin self-examination had a positive impact on the likelihood that survivors will perform the procedure, as well as their perception that they were able to appropriately do so.

This study added to the body of knowledge on this topic by also evaluating the attitudes of the romantic partners of melanoma survivors with respect to skin self-examination.

“Including the partner perspective is important because of the sensitive nature of completing com­prehensive skin self-examination, the intimacy involved in helping one’s partner with a whole-body examination, and the requirement of patient and partner collaboration for this health behavior,” the study authors commented.

More specifically, the primary objective of this study was to assess the partners’ comfort level regarding skin examinations. The researchers sought to assess the partners’ perception of their support with respect to encouraging skin self-examination and/or their ability to assist with the procedure (self-efficacy). Other objectives included assessing the survivors’ perceptions regarding the impact of perceived partner support and comfort level with performing skin self-examination.

The cross-sectional study used data from a previously conducted longitudinal study where eligibility criteria for enrollment included age 18 years or older, a primary diagnosis of melanoma, or being the partner of a patient enrolled in the study. Following study enrollment, all patients were invited to attend an educational session on skin self-examination, and were encouraged to bring their partners.  

Patients and partners were asked to complete baseline questionnaires on sociodemographic and disease-related characteristics when relevant, and only those patients with a romantic partner who also completed the questionnaire were included in this analysis. Study participants completed versions of the Skin Self-Examination Support Scale, the Skin Self-Examination Efficacy Scale, and the Skin Self-Examination Comfort Scale that were specifically designed for patients or their partners at 3 and 12 months after attending the educational session.

Of the 100 couples included in the study, the patient was a man in 56 couples and a woman in 44 couples; among the romantic partners, 42 were men and 58 were women. Baseline characteristics of patients enrolled in the study included a mean age of 57.81 years and a mean time since diagnosis of 26.53 months. Sixty-nine patients had stage I or stage II melanoma. The mean age of the romantic partners was 57.39 years, and the mean length of their relationship with the patient was 27.42 years.

A key finding of this study was that male patients reported significantly higher levels of skin self-examination support from their romantic partners than did female patients (P <.05).  In addition, the male patients reported having significantly higher comfort levels with having their romantic partners assist them with skin self-examination compared with the female patients (P <.05).

Level of comfort with the skin self-examination and level of support provided by partners during the skin self-examination as reported by the partners were associated with the partners’ perceptions of self-efficacy in assisting with this procedure. However, patients’ perceptions of partner support and patients’ level of comfort with being assisted during the skin self-examination were not predictive of patient-reported self-efficacy in the performance of this examination.

The study authors concluded that “targeted education on skin self-examination, including resources for support and guidance, can address the discrepancies in patient and partner perceptions.”

Reference

DiMillo J, Hall N, Khanna M, et al. Skin self-examination: partner comfort and support during examinations as predictors of self-efficacy in patients at risk for melanoma recurrence. Clin J Oncol Nurs. 2019;23(4):397-404.