Factors to consider in surveillance of high risk individuals

October 12, 2017

Strengths and limitations of this study

  • Participation in this questionnaire survey was higher than 70%.
  • Our findings are based on actual adherence after several months of follow-up (and not on intention to participate).
  • We used validated tools to assess anxiety and locus of control.
  • We also used Likert scales that were created for our study but were not validated.

Abstract

Objective 
The aim of the study was to assess whether adherence to annual clinical skin monitoring is dependent on patient sociodemographic characteristics or personality traits.

Design 
The study was a questionnaire survey.

Setting and participants 
Data were collected between February and April 2013 in a sample of 1000 patients at high risk of melanoma who participated in a pilot-targeted screening programme in western France.

Outcome measures 
Sociodemographic data, overall anxiety level (State-Trait Anxiety Inventory questionnaire), locus of control (Multidimensional Health Locus of Control scale) and levels of anxiety specifically associated with screening and melanoma were collected. Actual participation in the skin monitoring examination was reported by 78 general practitioner investigators.  Statistical analysis Statistical analysis was performed using R statistical software. Factors associated with non-adherence were identified by multivariate analysis.

Results 
Our analysis included 687 responses (526 adherent patients and 161 non-adherent patients). Non-adherence was higher in younger patients and in men (OR=0.63 (0.41–0.99)). Viewing health status as dependent on external persons (OR=0.90, 95% CI 0.83 to 0.97) or determined by chance (OR=0.89, 95% CI 0.80 to 0.98) and overall anxiety (OR=0.98, 95% CI 0.97 to 0.99) were also factors associated with non-adherence. In contrast, there was no link between anxiety specifically associated with the screening performed or melanoma and patient adherence to monitoring. Adherence was higher in married patients (OR=1.68 95% CI 1.08 to 2.60).

Conclusions  
The results of this study suggest that sociodemographic and psychological characteristics should be considered when including patients at elevated risk of melanoma in a targeted screening programme.

Source:

Rat, C, et al.  Anxiety, locus of control and sociodemographic factors associated with adherence to an annual clinical skin monitoring: a cross-sectional survey among 1000 high-risk French patients involved in a pilot-targeted screening programme for melanoma.BMJ Open, 2017
http://bmjopen.bmj.com/content...


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