0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Original Investigation |

Influence of Quality of Relationship Between Patient With Melanoma and Partner on Partner-Assisted Skin Examination Education A Randomized Clinical Trial

Brittney A. Hultgren, MS1; Rob Turrisi, PhD1; Kimberly A. Mallett, PhD2; Sarah Ackerman, MS2; June K. Robinson, MD3,4
[+] Author Affiliations
1Biobehavioral Health and Prevention Research Center, The Pennsylvania State University, University Park
2Prevention Research Center, The Pennsylvania State University, University Park
3Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
4Editor, JAMA Dermatology
JAMA Dermatol. 2016;152(2):184-190. doi:10.1001/jamadermatol.2015.2819.
Text Size: A A A
Published online

Importance  Melanoma has a high survival rate if it is detected early. Training patients with early-stage melanoma who are at risk of developing new melanomas to perform skin self-examination (SSE) may improve survival.

Objective  To examine for whom the intervention works best in a sample composed of dyads of patients with melanoma and skin-check partners who received an SSE intervention vs customary care.

Design, Setting, and Participants  For 494 patients with stage 0 to IIB melanoma (mean age, 55 years; 253 [51.2%] females) and their skin-check partners (mean age, 55 years; 280 [56.7%] females), a randomized clinical trial was conducted in ambulatory care dermatologic offices from June 6, 2011, to April 14, 2014. Follow-up assessments were performed at 12 months. Analysis was performed between March 23 and June 25, 2015.

Methods  Dyads of 494 patients and their partners were randomly assigned to receive the intervention (395 patients) or customary care (control) (99 patients). The main outcome was patient SSE self-efficacy. Partner motivation to assist with SSE and relationship quality (eg, agreeability, activities with partner, and happiness) were assessed for moderation of the influence of the intervention’s effect on SSE self-efficacy.

Results  Relationship quality, defined by activities with the partner (β = –0.892, SE = 0.432, t = –2.066; P = .001) and happiness (β = –4.586, SE = 2.044, t = –2.24; P = .001), significantly moderated the intervention effects on patients’ SSE self-efficacy. In contrast, patient-partner agreeability (β = –0.262, SE = 0.148, t = –1.773; P = .09) and partner motivation (β = –0.328, SE = 1.024, t = –0.320; P = .10) did not significantly moderate the intervention effects on patients’ SSE self-efficacy. Differences between the conditions were highest when activities performed with the partner were below average (mean difference, 6.652; P = .001) and when happiness was below average (mean difference, 7.000; P = .001). Although everyone receiving the intervention experienced some benefit, the findings indicate the greatest increases in self-efficacy were observed for those with below-average activities performed with the partner and happiness.

Conclusions and Relevance  The training of patients with melanoma and their partners in early-detection SSE benefited some more than others. Pairs who have low relationship quality, as determined by activities performed with the partner and happiness, may have received the greatest benefits from the training intervention because they were given an activity to perform together.

Trial Registration  clinicaltrials.gov Identifier: NCT01432860

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Figures

Place holder to copy figure label and caption
Figure 1.
Activities Spent With Partner as a Moderator of Skin Self-Examination (SSE) Self-Efficacy

Pairs with above average activities performed together have greater SSE self-efficacy.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.
Relationship Happiness as a Moderator of Skin Self-Examination (SSE) Self-Efficacy

All pairs, even those who reported less happy relationships, benefited from the SSE intervention.

Graphic Jump Location

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

756 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

Care at the Close of Life: Evidence and Experience
Symptom Education and Support

Care at the Close of Life: Evidence and Experience
Self-Care Education

brightcove.createExperiences();