Research Dissemination and Utilization

New Jersey Nurse, Jul/Aug 2004 by O'Shea, Kevin, O'Connor, Priscilla, Nucero, Margaret

This is the second in a series of research utilization reports provided for nurses in medical centers and in the community. The model was presented by Valente in 2003. The first author has extensive experience in dermatology nursing.

Skin Cancer Prevention: Research Utilization

Abstract

Why does sun protection and skin cancer awareness need to be addressed?

* Skin cancer is the most common form of cancer.

* There has been a steady increase in the incidence of melanoma every year.

* Evidence shows that ultraviolet radiation from sun exposure during early life is associated with an increased risk of skin cancer in later life.

* The majority of skin cancer can be prevented by limiting sun exposure.

* Children and adolescents spend more time exposed to the sun than adults.

What are the obstacles to skin cancer prevention?

* Public perception of tanning needs to be changed.

* The public associates well being with a tan.

* The public is uneducated on skin cancer prevention.

* Skin cancer awareness does not take precedence in our society.

* School health providers are not active in stressing the importance of avoiding sun exposure.

How can nurses promote sun protection?

* Become educated in the identification of atypical lesions.

* Reinforce the benefits of sun protection.

* Recommend sun protection techniques to clients at every office visit.

* Partner with parents in stressing to children the importance of skin protection.

For more information contact

* The American Academy of Dermatology (www.aad.org)

* The American Medical Association

* The Centers for Disease Control and Prevention

Research Problem

Skin cancer is a significant health problem in the United States. Limiting sun exposure can prevent 85% of skin cancer. But, most people still associate a suntan with good health and attractiveness (Coogan, Geller, Adams, Benjes, & Koh, 2001). Because of this way of thinking, changing beliefs about sun exposure and the potential risks that it represents, has been difficult.

Skin cancer is the most common form of cancer and is increasing at a faster rate than any other cancer types, with about 600,000 cases occurring each year (Mickler & Rodrigue, 1997). From 1973 to 1995 the incidence of melanoma, the deadliest form of skin cancer, increased steadily by 4% each year (Tripp, Herrmann, Parcel, Chamberlain, & Gritz, 2000).

Of all age groups, children and adolescents spend the most time outdoors. Increased sun exposure during childhood and adolescence increases the risk of developing melanoma, basal cell carcinoma, and squamous cell carcinoma later in life. Because of an increase in free time during the summer months, children spend more time outdoors than do adults. Being concerned with appearance, adolescents intentionally expose themselves to excessive sunlight in order to get a summer tan. Various forms of media suggest that getting tan is an important part of summer. Changes in social norms are needed to reinforce the importance of sun protection. Because of these increases in sun exposure during our early years and its direct effect on development of skin cancer in the later years of life, childhood and adolescence are considered high-risk periods. It is imperative therefore, that efforts be made to educate children, adolescents, and their caregivers about the importance of sun protection.

Purpose

This research utilization paper addresses the need for sun protection and identifies suggestions for preventative measures that can be implemented to decrease the risk of sun damage. Nurses can educate clients to understand the relationship between sun exposure and potentially life-threatening skin cancers. Awareness of the importance of safe sun practices is necessary. Therefore, information is presented to help clients to understand proper use of sun protection. Suggestions are offered for curriculum development to ensure adherence. Also, factors that influence adherence are identified.

Review of Literature

Davis, Cokkinides, Weinstock, and O'Connell (2002) gathered population-based data on exposure to the sun of children in the US and their use of protection (hat, sun block/lotion, sun protective clothing, and shade). The results showed that 72% reported having at least one sunburn, 30% reported three sunburns, and 12% reported at least five sunburns in their young lives. Before receiving their most serious summer sunburns, 39% of youth reported using sunscreen.

Coogan, Geller, Adams, & Koh (2001) examined the sun protection practices of Connecticut school children. The subjects were 25,000 Caucasian children between the ages of 9 and 18 years.

Children in public and private schools of various socioeconomic status completed a self-administered survey. The results showed that only 20% of the sample reported always using sun protection. This outcome is far below national goals recommended by Healthy People 2000(Coogan, et al.).

Buller, Callister, and Reichert (1995) evaluated parent's knowledge of skin cancer and sun protection practices for themselves and their children. The results showed that parents were more likely to practice skin cancer prevention for their children than themselves. Applying sunscreen was the most common form of protection. Parents did not tell their children to play in the shade, but they did have their children wear protective clothing and had them avoid the midday sun.