Robinson June K, Turrisi Rob
Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Arch Dermatol. 2006 Apr;142(4):447-52. doi: 10.1001/archderm.142.4.447.
To develop skin self-examination skills by improving the use of the ABCDE criteria by those at risk of developing melanoma.
Ten single-sex groups of 10 unrelated adults received a knowledge-based intervention followed by skills training.
Classroom in the ambulatory care area of a hospital. Patients One hundred unrelated adults with either a personal or family history of melanoma and no previous skin self-examination counseling. Interventions A dermatologist presented information, and each subject read a brochure and reviewed a bookmark. The facilitator led the group discussions about scoring each feature and the decision to seek medical care. Measurement of moles with a ruler and a pencil eraser and the use of an illuminated magnifying lens were demonstrated. Preintervention and postintervention assessments were performed for each intervention.
Recognition of A, B, C, D, and E traits.
The subjects preferred the bookmark (87% of subjects), opaque ruler (94% of subjects), and lighted magnifying lens (81% of subjects) to reading the brochure, which was felt to take too long. Recognition of border irregularity, color variation, and diameter improved significantly after the intervention. Women recognized color variation more often than men (94% vs 62%; odds ratio [OR], 23.7; 95% confidence interval [CI], 16.1-50.5). Men identified irregular borders more often than women (91% vs 75%; OR, 16.8; 95% CI, 4.5-22.6). Women appropriately decided to see a physician more often than men (81% vs 57%; OR, 13.5; 95% CI, 7.1-28.4).
Determining the presence of the A, B, C, and E criteria is challenging for the novice. Skills training aided performance of skin self-examination. Differences in proclivities according to sex suggest that if men and women form partnerships for skin checks, they may learn from each other, and their combined strengths will promote detection of early melanomas.
通过提高黑素瘤高危人群对ABCDE标准的运用能力，来培养皮肤自我检查技能。
十个由10名互不相关的成年人组成的单性别小组接受了基于知识的干预，随后进行技能培训。
医院门诊护理区的教室。患者为100名互不相关的成年人，他们有黑素瘤个人病史或家族病史，且之前未接受过皮肤自我检查咨询。干预措施：一名皮肤科医生进行讲解，每位受试者阅读一本宣传册并查看一张书签。主持人引导小组讨论对每个特征进行评分以及寻求医疗护理的决定。演示了用尺子和铅笔橡皮擦测量痣以及使用带照明的放大镜。对每次干预进行干预前和干预后评估。
对A、B、C、D和E特征的识别。
与阅读宣传册相比，受试者更喜欢书签（87%的受试者）、不透明尺子（94%的受试者）和带照明的放大镜（81%的受试者），因为他们觉得阅读宣传册耗时过长。干预后，对边界不规则、颜色变化和直径的识别有显著改善。女性比男性更常识别出颜色变化（94%对62%；优势比[OR]，23.7；95%置信区间[CI]，16.1 - 50.5）。男性比女性更常识别出不规则边界（91%对75%；OR，16.8；95% CI，4.5 - 22.6）。女性比男性更常适当地决定去看医生（81%对57%；OR，13.5；95% CI，7.1 - 28.4）。
对于新手来说，确定A、B、C和E标准是否存在具有挑战性。技能培训有助于皮肤自我检查的实施。根据性别不同的倾向表明，如果男性和女性结成皮肤检查伙伴关系，他们可能会相互学习，并且他们的综合优势将促进早期黑素瘤的检测。
