Yu Regina, Miura Kyoko, Chambers Daniel C, Hopkins Peter M, Proby Charlotte M, Bibee Kristin, Plasmeijer Elsemieke I, Green Adele C
Population Health Department, Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
Biomedical Sciences, the University of Queensland, St Lucia, QLD, Australia.
Transplant Direct. 2023 Jun 8;9(7):e1492. doi: 10.1097/TXD.0000000000001492. eCollection 2023 Jul.
We studied the feasibility of transplant-clinic staff routinely providing primary prevention advice to lung transplant recipients at high risk of skin cancer.
Patients enrolled by a transplant-clinic study nurse completed baseline questionnaires and received sun-safety brochures. For the 12-mo intervention, transplant physicians were alerted to provide standard sun-protection advice (use of hat, long sleeves, and sunscreen outdoors) by sun-advice prompt cards attached to participants' medical charts at each clinic visit. Patients indicated receiving advice from their physician and from study personnel via an exit-card postclinic, and at final study clinics, they also reported their sun behaviors by questionnaire. Feasibility of the intervention was measured by patients' and clinic staff's study engagement; effectiveness was assessed by calculating odds ratios (ORs) for improved sun protection, using generalized estimating equations.
Of 151 patients invited, 134 consented (89%), and 106 (79 %) (63% male, median age 56 y, 93% of European descent) completed the study. Odds of receiving sun advice from transplant physicians and study nurses rose after the intervention compared with baseline (ORs, 1.67; 95% confidence interval [CI], 0.96-2.96 and 3.56; 95% CI, 1.38-9.14, respectively). After 12 mo of regular transplant-clinic advice, odds of sunburn decreased (OR, 0.59; 95% CI, 0.13-2.60), and odds of applying sunscreen (OR, 1.93; 95% CI, 1.20-3.09) almost doubled.
Encouragement of primary prevention of skin cancer among organ transplant recipients by physicians and nurses during routine transplant-clinic visits is feasible and appears to be effective.
我们研究了移植诊所工作人员定期向皮肤癌高危肺移植受者提供一级预防建议的可行性。
由移植诊所研究护士招募的患者完成基线调查问卷并收到防晒宣传册。在为期12个月的干预期间，通过在每次诊所就诊时贴在参与者病历上的防晒建议提示卡，提醒移植医生提供标准的防晒建议（在户外使用帽子、长袖衣物和防晒霜）。患者通过诊所后的退出卡表明是否从医生和研究人员那里得到了建议，在最终研究诊所，他们还通过问卷调查汇报了自己的防晒行为。通过患者和诊所工作人员对研究的参与度来衡量干预措施的可行性；通过使用广义估计方程计算改善防晒的优势比（OR）来评估有效性。
在邀请的151名患者中，134名同意参与（89%），106名（79%）（63%为男性，中位年龄56岁，93%为欧洲血统）完成了研究。与基线相比，干预后从移植医生和研究护士那里获得防晒建议的几率有所上升（优势比分别为1.67；95%置信区间[CI]，0.96 - 2.96和3.56；95%CI，1.38 - 9.14）。经过12个月的常规移植诊所建议后，晒伤几率降低（优势比，0.59；95%CI，0.13 - 2.60），涂抹防晒霜的几率（优势比，1.93；95%CI，1.20 - 3.09）几乎翻倍。
在常规移植诊所就诊期间，由医生和护士鼓励器官移植受者进行皮肤癌一级预防是可行的，而且似乎是有效的。
