Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
J Pediatr. 2013 Feb;162(2):381-6. doi: 10.1016/j.jpeds.2012.07.045. Epub 2012 Sep 3.
To compare counseling concerning sun protection and outdoor exercise with the parent's report of the behavior of a child aged 9-16 years old.
Structured interviews of medical personnel in 3 Chicago area practices elicited information about counseling methods and recommendations. In each practice, a convenience sample of parents completed a self-reported survey of their and their child's behavior.
Sun protection counseling occurred more frequently than exercise counseling in all practices (P = .014). Sun protection counseling was associated with parental prompting (P = .004), performing a summer camp physical (P = .002), and the child having a sunburn (P = .003). After controlling for the child's age, sex, and skin tone, sun protection counseling was not associated with the child's use of sun protection. In multivariate analysis of the child's sun protection behavior, parental sunburns, indoor tanning in the last 12 months, perception of skin cancer risk, and sun protection self-efficacy were significant (P = .02). Children who pursued outdoor sports were twice as likely to use inadequate sun protection and sustain sunburns (CI 1.3-1.7).
The child's sun protection behavior was influenced by parental sun protection, parental perception of skin cancer risk, and parental sun protection self-efficacy; therefore, sun protection for children needs to be aimed at parents as well as children. Communication with parents in a way that incorporates the principles of motivational interviewing may be more effective in promoting behavioral change than admonitions to use sunscreen.
比较防晒和户外运动方面的咨询指导与 9-16 岁儿童家长报告的儿童行为。
在芝加哥地区的 3 家诊所中,医务人员接受了结构化访谈,以了解咨询方法和建议。在每家诊所中,都采用方便抽样法选择家长填写关于其自身及其孩子行为的自我报告调查问卷。
在所有诊所中,防晒咨询的频率均高于运动咨询(P =.014)。防晒咨询与父母的提示(P =.004)、进行夏令营体检(P =.002)和孩子晒伤(P =.003)有关。在控制孩子的年龄、性别和肤色后,防晒咨询与孩子使用防晒措施无关。在对孩子的防晒行为进行多变量分析时,父母的晒伤情况、过去 12 个月内的室内晒黑、对皮肤癌风险的认识以及防晒自我效能感均有显著影响(P =.02)。从事户外运动的孩子更有可能使用不足量的防晒措施并晒伤(CI 1.3-1.7)。
儿童的防晒行为受到父母的防晒措施、父母对皮肤癌风险的认识和父母的防晒自我效能感的影响;因此,儿童的防晒需要针对父母和儿童双方。以包含动机性访谈原则的方式与父母沟通,可能比告诫使用防晒霜更能有效地促进行为改变。