College of Nursing, The University of Arizona, Tucson, Arizona.
College of Nursing, Zuckerman College of Public Health and The Skin Cancer Institute, The University of Arizona, Tucson, Arizona.
J Am Assoc Nurse Pract. 2020 May;32(5):369-379. doi: 10.1097/JXX.0000000000000235.
Skin cancer, the most commonly diagnosed cancer in the United States, is a serious health care concern. Early skin cancer detection improves prognosis; most common early detection approach is a comprehensive clinical skin examination (CSE). A CSE consists of skin cancer risk assessment, head-to-toe skin examination, and skin lesion assessment. Nurse practitioners (NPs) currently lack adequate training and confidence to conduct CSE. The goal of this systematic review was to learn more about published interventions targeting CSE training for primary care NPs and/or other primary care providers. The findings were categorized based on the established procedures for intervention development.
The databases PubMed, Google Scholar, CINAHL, and Web of Science were searched. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 10 articles were selected for data extraction.
There is a paucity of articles that report rigorously developed interventions aimed at educating primary care NPs to conduct CSE. Existing CSE interventions were not tested for efficacy or effectiveness, and the implementation methods were weak or not reported. A synthesis of the review findings revealed inadequately reported sample characteristics, vague intervention goals, unspecified frequency or duration of interventions, and lack of standardized intervention protocols.
This review builds a foundation for more rigorously developed interventions to improve CSE and provides guidance for NPs to select education on CSE and other clinical foci. Future research will guide the development and evaluate the effectiveness of CSE education, which ultimately could improve skin cancer prognosis interventions and lack of standardized intervention protocols.
皮肤癌是美国最常见的癌症,也是一个严重的医疗保健问题。早期皮肤癌的检测可改善预后;最常见的早期检测方法是全面的临床皮肤检查(CSE)。CSE 包括皮肤癌风险评估、从头到脚的皮肤检查和皮肤病变评估。护士从业者(NPs)目前缺乏进行 CSE 的充分培训和信心。本系统评价的目的是更多地了解针对初级保健 NPs 和/或其他初级保健提供者的 CSE 培训的已发表干预措施。根据既定的干预措施开发程序对研究结果进行了分类。
在 PubMed、Google Scholar、CINAHL 和 Web of Science 数据库中进行了搜索。根据系统评价和荟萃分析的首选报告项目指南,选择了 10 篇文章进行数据提取。
几乎没有报道旨在教育初级保健 NPs 进行 CSE 的经过严格开发的干预措施的文章。现有的 CSE 干预措施未经过疗效或有效性测试,实施方法薄弱或未报告。对审查结果的综合分析显示,样本特征报告不充分、干预目标模糊、干预频率或持续时间不明确以及缺乏标准化的干预方案。
该审查为更严格的干预措施奠定了基础,以改善 CSE,并为 NPs 提供了选择 CSE 和其他临床重点教育的指导。未来的研究将指导 CSE 教育的发展和评估其有效性,这最终可以改善皮肤癌预后干预措施和缺乏标准化的干预方案。