Ramcharan Michael, Evans Marion Willard, Ndetan Harrison, Beddard Jennifer
Assistant Professor, Department of Research/Clinic, Cleveland Chiropractic College, Overland Park, KS 66210.
J Chiropr Med. 2011 Jun;10(2):77-85. doi: 10.1016/j.jcm.2010.09.004. Epub 2011 Apr 5.
Skin cancer is a major public health concern in the United States. Chiropractic physicians and interns need to recognize and refer patients with atypical moles and skin cancer. The purpose of this study was to test chiropractic interns about their current knowledge, practices, and perceptions of atypical moles and skin cancer.
This study was a cross-sectional study using chiropractic interns at 2 chiropractic colleges who received a 26-item survey that used a 5-point Likert scale involving close-ended questions regarding demographics, importance, knowledge, and clinical images regarding atypical moles and skin cancer. Frequencies and odds ratios (ORs) were generated using multiple regression models.
A total of 217 surveys were collected in the study. The importance of skin cancer recognition as a predictor of practice patterns was examined. Interns who stated it was "important/very important" to recognize skin cancer were slightly more likely to state they "frequently/always" scanned patient's skin on the initial visit, were more likely to state they "frequently/always" scanned on a treatment visit (OR = 3.30; 95% confidence interval [CI], 1.6-6.9), and stated they had noticed a mole that needed follow-up (OR = 3.04; 95% CI, 1.52-6.10). However, interns were no more likely to state they documented moles in the soap notes (OR = 1.38; 95% CI, 0.77-2.47) or to know the warning signs of melanoma (OR = 0.76; 95% CI, 0.40-1.46).
As skin cancer continues to increase in prevalence, chiropractic interns can serve in the primary screening process of patients with atypical moles; and chiropractic education should emphasize the opportunity to detect and assess atypical moles as a routine part of primary prevention in clinical education.
皮肤癌是美国主要的公共卫生问题。整脊医师和实习生需要识别并转诊患有非典型痣和皮肤癌的患者。本研究的目的是测试整脊实习生对非典型痣和皮肤癌的现有知识、实践和认知。
本研究是一项横断面研究，对两所整脊学院的整脊实习生进行了一项包含26个项目的调查，该调查采用5点李克特量表，涉及有关人口统计学、重要性、知识以及非典型痣和皮肤癌的临床图像的封闭式问题。使用多元回归模型生成频率和比值比（OR）。
本研究共收集到217份调查问卷。研究了将皮肤癌识别作为实践模式预测指标的重要性。表示识别皮肤癌“重要/非常重要”的实习生更有可能表示他们在初次就诊时“经常/总是”检查患者的皮肤，更有可能表示他们在治疗就诊时“经常/总是”检查（OR = 3.30；95%置信区间[CI]，1.6 - 6.9），并表示他们注意到有痣需要随访（OR = 3.04；95% CI，1.52 - 6.10）。然而，实习生不太可能表示他们在病历中记录了痣（OR = 1.38；95% CI，0.77 - 2.47），也不太可能知道黑色素瘤的警示信号（OR = 0.76；95% CI，0.40 - 1.46）。
随着皮肤癌患病率持续上升，整脊实习生可参与非典型痣患者的初级筛查过程；整脊教育应强调在临床教育中将检测和评估非典型痣作为初级预防常规部分该机会。
