Hansen Sara Mølgaard, Johansen Christoffer, Kasparian Nadine A, Grand Mia Klinten, Bidstrup Pernille Envold, Hölmich Lisbet Rosenkrantz
Department of Plastic Surgery, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark.
Department of Oncology, Cancer Survivorship and Late Effects Research Center (CASTLE), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
J Cancer Surviv. 2025 Jun 12. doi: 10.1007/s11764-025-01841-1.
The MELACARE intervention aimed to evaluate a nurse-led follow-up program incorporating skin self-examination (SSE) education and psychosocial support to address fear of cancer recurrence (FCR) in early-stage melanoma survivors. This study assessed the MELACARE intervention's impact on FCR, psychological well-being, SSE performance, and healthcare usage compared to standard physician-led follow-up.
A two-group randomised controlled trial was conducted at Herlev and Gentofte Hospital, Denmark. Participants included 153 patients with surgically treated melanoma (stages IA-IIA). Patients were randomised to either the MELACARE intervention (n = 78) or a control group provided treatment as usual (n = 75). The intervention involved nurse-led sessions focusing on SSE techniques and metacognitive strategies. Outcomes included FCR (primary), distress, anxiety, depression, health-related quality of life (HRQoL), patient activation, and SSE frequency and confidence (secondary) at 6 months.
ClinicalTrials.gov (NCT05253872).
At 6 months, the mean of the primary outcome FCR was lower in the intervention compared to the control groups, but the difference was not statistically significant (- 0.86 [- 3.34;1.62]). Intervention patients reported higher HRQoL (18% [3;32]) and patient activation (0.43 [0.15;0.71]) as the only significant secondary outcomes. Confidence in SSE was higher in the intervention group, with most performing SSE at recommended intervals.
The MELACARE intervention may improve HRQoL and patient activation but did not reduce FCR. High fidelity of delivery and patient adherence highlight its potential utility.
The MELACARE approach empowers melanoma survivors through structured SSE education and psychosocial support. Future analyses will investigate long-term safety and efficacy.
MELACARE干预旨在评估一项由护士主导的随访项目，该项目纳入皮肤自我检查（SSE）教育和心理社会支持，以解决早期黑色素瘤幸存者对癌症复发的恐惧（FCR）。本研究评估了MELACARE干预与标准的医生主导随访相比，对FCR、心理健康、SSE表现和医疗保健使用的影响。
在丹麦的Herlev和Gentofte医院进行了一项两组随机对照试验。参与者包括153例接受手术治疗的黑色素瘤患者（IA-IIA期）。患者被随机分为MELACARE干预组（n = 78）或接受常规治疗的对照组（n = 75）。干预包括由护士主导的课程，重点是SSE技术和元认知策略。结局包括6个月时的FCR（主要结局）、痛苦、焦虑、抑郁、健康相关生活质量（HRQoL）、患者参与度，以及SSE频率和信心（次要结局）。
ClinicalTrials.gov（NCT05253872）。
在6个月时，干预组的主要结局FCR平均值低于对照组，但差异无统计学意义（-0.86 [-3.34；1.62]）。干预组患者报告的HRQoL更高（18% [3；32]），患者参与度更高（0.43 [0.15；0.71]），这是仅有的显著次要结局。干预组对SSE的信心更高，大多数患者按推荐间隔进行SSE。
MELACARE干预可能改善HRQoL和患者参与度，但并未降低FCR。高保真的实施和患者依从性突出了其潜在效用。
MELACARE方法通过结构化的SSE教育和心理社会支持增强黑色素瘤幸存者的能力。未来的分析将调查长期安全性和疗效。
