Cancer Society Social & Behavioural Research Unit, Department of Preventive & Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin 9058, New Zealand.
BMC Fam Pract. 2012 Aug 17;13:85. doi: 10.1186/1471-2296-13-85.
The health effects of ultraviolet radiation vary according to wavelength, timing and pattern of exposure, personal characteristics and practices. Negative effects include skin cancers, eye diseases and immune suppression; positive effects primarily relate to endogenous vitamin D production which protects against bone disease. Drafting comprehensive guidelines regarding appropriate sun protective behaviours and vitamin D sufficiency is challenging. Advice given by general practitioners is potentially influential because they are widely respected.
A survey instrument was developed, pre-tested and provided to practising GP's, either by on-line link or mailed, reply paid hard-copy. Odds ratios, differences in means, or ratios of geometric means from regression models are reported for potential predictor variables with 95% confidence intervals.
Data (demographic, training, practicing, information accessing, confidence in vitamin D knowledge) suitable for analysis were obtained from 1,089 GPs (32% participation). Many (43%) were 'not at all confident' about their vitamin D knowledge. Recent information led 29% to recommend less sun protection during winter months and 10% less all year. Confidence was positively associated with non-'Western' medical training, information sources read and practising in a metropolitan centre with a medical school. Reading the Melanoma Clinical Practice Guidelines was associated with lower estimates of the amount of summer sun exposure required to obtain adequate vitamin D. Increasing years in practice was negatively associated with provision of recommended advice about summer and winter sun protection. Greater concern about vitamin D than skin cancer was expressed by females and those in practice longer.
Concern about the potentially negative impact of skin cancer prevention on vitamin D status may undermine appropriate sun protective recommendations. Reading some educational resources was associated with confidence about vitamin D knowledge and a perception that significantly less summer sun exposure was required for those with high sun sensitivity to achieve adequate vitamin D, suggesting a potentially positive impact of such resources. Education could be targeted towards groups least likely to promote existing recommendations. Authoritative guidelines about vitamin D and sun protection would be a valued resource among GPs. Study findings are potentially valuable to help guide public policy and target interventions.
紫外线的健康影响因波长、暴露时间和模式、个人特征和行为而异。负面影响包括皮肤癌、眼病和免疫抑制；积极影响主要与内源性维生素 D 产生有关，可预防骨病。制定关于适当的防晒行为和维生素 D 充足的综合指南具有挑战性。由于全科医生受到广泛尊重，他们提供的建议可能具有影响力。
开发了一个调查工具，经过预测试后，通过在线链接或邮寄回复付费的硬拷贝提供给执业全科医生。使用回归模型报告潜在预测变量的优势比、均值差异或几何均数比，并带有 95%置信区间。
从 1089 名全科医生（参与率为 32%）中获得了适合分析的数据（人口统计学、培训、执业、信息获取、对维生素 D 知识的信心）。许多人（43%）对自己的维生素 D 知识“一点也不自信”。最近的信息导致 29%的人建议在冬季减少冬季的防晒措施，10%的人全年减少防晒措施。信心与非“西方”医学培训、阅读的信息来源以及在有医学院的大都市中心执业呈正相关。阅读黑色素瘤临床实践指南与夏季获得足够维生素 D 所需的阳光暴露量估计值较低有关。执业年限越长，提供有关夏季和冬季防晒建议的可能性就越小。与男性相比，女性和执业时间较长的人对维生素 D 的关注度更高，对皮肤癌的关注度更低。
对预防皮肤癌对维生素 D 状态的潜在负面影响的担忧可能会破坏适当的防晒建议。阅读某些教育资源与对维生素 D 知识的信心以及对高阳光敏感性的人获得足够维生素 D 所需的夏季阳光暴露量明显减少的看法有关，这表明此类资源可能具有积极影响。教育可以针对最不可能促进现有建议的群体。全科医生将非常重视关于维生素 D 和防晒的权威指南。研究结果对于帮助指导公共政策和确定干预目标可能具有重要价值。
