Employing skin self-examination and fear of cancer recurrence management in early-stage melanoma follow-up: evaluation of the MELACARE intervention in a randomised controlled trial.

IF 3.1 2区医学 Q2 ONCOLOGY

Journal of Cancer Survivorship Pub Date : 2025-06-12 DOI:10.1007/s11764-025-01841-1

Sara Mølgaard Hansen, Christoffer Johansen, Nadine A Kasparian, Mia Klinten Grand, Pernille Envold Bidstrup, Lisbet Rosenkrantz Hölmich

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引用次数: 0

Abstract

Purpose: 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.

Methods: 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.

Trial registration: ClinicalTrials.gov (NCT05253872).

Results: 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.

Conclusions: 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.

Implications for cancer survivors: The MELACARE approach empowers melanoma survivors through structured SSE education and psychosocial support. Future analyses will investigate long-term safety and efficacy.

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在早期黑色素瘤随访中采用皮肤自检和对癌症复发的恐惧管理：MELACARE干预的随机对照试验评价

目的：MELACARE干预旨在评估护士主导的随访计划，该计划包括皮肤自检（SSE）教育和社会心理支持，以解决早期黑色素瘤幸存者对癌症复发（FCR）的恐惧。与标准的医生主导的随访相比，本研究评估了MELACARE干预对FCR、心理健康、SSE表现和医疗保健使用的影响。方法：在丹麦Herlev和Gentofte医院进行两组随机对照试验。参与者包括153例手术治疗的黑色素瘤患者（IA-IIA期）。患者被随机分配到MELACARE干预组（n = 78）或照常提供治疗的对照组（n = 75）。干预包括护士主导的会议，重点是SSE技术和元认知策略。结果包括6个月时FCR（主要）、苦恼、焦虑、抑郁、健康相关生活质量（HRQoL）、患者激活、SSE频率和信心（次要）。试验注册：ClinicalTrials.gov （NCT05253872）。结果：6个月时，干预组主要结局FCR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（18%[3;32]）和患者激活（0.43[0.15;0.71]）是唯一显著的次要结局。干预组对SSE的信心更高，大多数人在推荐的时间间隔内执行SSE。结论：MELACARE干预可以改善HRQoL和患者激活，但没有降低FCR。交付的高保真度和患者依从性突出了其潜在的实用性。对癌症幸存者的影响：MELACARE方法通过结构化SSE教育和社会心理支持赋予黑色素瘤幸存者权力。未来的分析将调查长期的安全性和有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cancer Survivorship ONCOLOGY-

CiteScore

7.00

自引率

10.80%

发文量

149

审稿时长

>12 weeks

期刊介绍： Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.