Mikkilineni R, Weinstock M A, Goldstein M G, Dube C E, Rossi J S
Departoepidemiology Unit, VA Medical Center, Providence, RI 02908, USA.
J Gen Intern Med. 2001 May;16(5):302-7. doi: 10.1046/j.1525-1497.2001.00626.x.
To evaluate the effect of a 2-hour, multicomponent educational intervention on provider skin cancer control practices.
Nonrandomized intervention study. The intervention was a 2-hour curriculum designed to augment provider skin cancer control practices through instruction in basic skin cancer triage (BSCT) and a brief summary of skin cancer epidemiology, prevention, and counseling.
Five staff-model health maintenance organizations in southeastern New England.
Convenience sample of primary care providers. Providers older than age 75, individuals in practice for less than 1 year, or individuals planning to retire in the next 2 years were excluded from the study. Twenty-two of 28 participants completed the study.
Providers completed preintervention and postintervention surveys asking them to rate their attitudes towards skin examination and skin cancer counseling and to rate the frequency of their skin cancer control practices, using 5-point Likert scales. We independently assessed provider behavior through surveys of their patients, eliciting information on provider practices before and after BSCT participation. Following participation in the curriculum, there was significant improvement in provider attitudes towards the total body skin examination but not towards skin cancer prevention counseling. Significant increases in provider self- reported skin cancer control practices during an initial visit with a new patient (2.17 to 3.21, P <.0001) and a routine visit with a patient at high risk for melanoma (2.15 to 3.00, P <.0001) were demonstrated. Analysis of the patient exit interviews independently confirmed these changes in practice patterns.
The study results suggest that the BSCT curriculum may be a useful tool in increasing the practice of skin cancer control measures by primary care providers.
评估一项为期2小时的多组分教育干预对医疗服务提供者皮肤癌防控措施的影响。
非随机干预研究。干预措施为一门2小时的课程,旨在通过基础皮肤癌分诊(BSCT)教学以及皮肤癌流行病学、预防和咨询的简要概述,增强医疗服务提供者的皮肤癌防控措施。
新英格兰东南部的5家员工模式的健康维护组织。
初级保健提供者的便利样本。年龄超过75岁、从业时间少于1年或计划在未来2年内退休的个体被排除在研究之外。28名参与者中有22名完成了研究。
医疗服务提供者完成了干预前和干预后的调查,要求他们使用5点李克特量表对自己对皮肤检查和皮肤癌咨询的态度进行评分,并对其皮肤癌防控措施的频率进行评分。我们通过对他们的患者进行调查,独立评估医疗服务提供者的行为,获取他们参与BSCT前后的行为信息。参与课程后,医疗服务提供者对全身皮肤检查的态度有显著改善,但对皮肤癌预防咨询的态度没有改善。在首次接诊新患者(从2.17提升至3.21,P<.0001)以及对黑色素瘤高危患者进行常规诊疗时(从2.15提升至3.00,P<.0001),医疗服务提供者自我报告的皮肤癌防控措施有显著增加。对患者出院访谈的分析独立证实了这些行为模式的变化。
研究结果表明,BSCT课程可能是增加初级保健提供者实施皮肤癌防控措施的有用工具。