Estudio de Hábitos de Fotoprotección, Conocimientos y Actitudes frente al Sol

Los baños de sol en la playa son actividades asociadas a una exposición solar de riesgo. Los bañistas constituyen uno de los grupos diana más estratégicos en la prevención del cáncer de piel. Conocer sus hábitos, actitudes y conocimientos es imperativo previo al desarrollo de intervenciones educativas dirigidas específicamente a este colectivo de riesgo. OBJETIVOS: Objetivo general: Estudiar los hábitos, actitudes y conocimientos relacionados con la exposición solar en la playa de los bañistas. Objetivos específicos: Analizar diferencias en los hábitos, actitudes y conocimientos de los bañistas según sus características sociodemográficas. Caracterizar a bañistas con mayor riesgo de quemadura solar. Identificar factores predictores de las conductas de fotoexposición y fotoprotección. METODOLOGÍA: Estudio transversal descriptivo basado en cuestionarios de salud, empleándose el "Cuestionario a pie de playa" validado en investigaciones previas en la misma población diana. Se realizó un análisis descriptivo de las variables sociodemográficas, tipo de piel, hábitos de exposición solar (HES), uso de lámparas de bronceado artificial, quemaduras solares (QS), prácticas de protección solar (PPS) (sombrilla, gafas de sol, ropa, sombrero, horario, cremas), actitudes y conocimientos relacionados con la exposición solar. Se evalúan diferencias en la distribución de variables principales (comportamientos, actitudes y conocimientos) en relación a las variables sociodemográficas y fenotípicas (edad, sexo, origen, residencia, nivel de estudios, estado civil, hijos menores y fototipo cutáneo). Se construyeron cuatro modelos de regresión logística multivariante para valorar los factores predictores de riesgo de QS (una o más QS en el último verano), conducta de exposición solar a mediodía (tomar el sol 1 o más horas entre las 12.00 a las 16.00 horas), uso de cremas fotoprotectoras (uso regular de cremas con FPS>15) y uso de medidas de al menos 3 PPS (uso regular de 3 o más PPS). RESULTADOS: Durante el verano de 2012 se reclutaron un total de 1.154 bañistas, de los que 1.079 cumplimentaron el cuestionario en español. De dichas encuestas, se tuvieron en cuenta para su análisis a 1.054 (97,7%), dado que en las 25 restantes no se había registrado la QS en el último verano. Del total de encuestados incluidos en el análisis, la edad media fue de 43,8 (DE: 18,7) años. El 61,2% eran mujeres, 86,1% de origen español. Respecto, al tipo de piel el color de piel más común fue la piel clara (41,3%), y los fototipos más presentes el tipo III (34%) y tipo IV (30,2%). Respecto a los HES, indicaron haber pasado 30 o más días en la playa en el último verano el 19,1%; 3 o más horas al día, el 17,3%; y una o más horas al mediodía, el 47,4%; el 46,9% refirió al menos un episodio de QS, y hasta el 10,4% 3 o más veces en el mismo año. En cuanto a las PPS, la más utilizada fue el uso de crema fotoprotectora, con un 68,1% de los casos que la usaban “habitualmente” o “siempre”, seguido del uso de gafas de sol en un 66,1%. La PPS menos utilizada fue llevar manga larga – pantalón largo (7,6%), seguida de evitar el sol al mediodía (42,2%). El 61,3% de los encuestados reflejo utilizar tres o más PPS de forma habitual. Para las dimensiones de actitudes relacionadas con la exposición solar, valoradas en puntuaciones estandarizadas, la dimensión actitud frente a la protección solar obtuvo la mayor puntuación con una media de 86,1 (DE: 16,2%), seguida de la dimensión actitud frente al bronceado con una media de 63,2 (DE: 18). La que obtuvo menor puntuación fue la dimensión actitud frente a las cremas con 58,4 (DE: 24,4). Respecto a los conocimientos, también valorado con puntuación estandarizada, se obtuvo un valor de 86,4 (DE: 14,2). Mediante el análisis multivariante, se halló un mayor riesgo de quemadura solar para los hombres, niveles de estudios secundarios o superiores, para los colores de piel clara-muy clara, los fototipos más bajos, y para el hábito de estar 1 o más horas en las horas centrales del día, y la actitud frente al bronceado; mientras que se hallaron como protectores, la edad, las PPS (uso habitual o siempre) de gafas de sol, evitar el medio día y fotoprotector (FPS>=15), junto con los conocimientos. CONCLUSIONES: Los resultados de este estudio confirman el riesgo de la exposición solar en la playa revelan necesidades educativas de los bañistas así como claves para modificar sus comportamientos. Estos hallazgos tiene gran interés para el desarrollo de futuras intervenciones de prevención primaria del cáncer de piel en bañistas de playa

Sun Exposure during Water Sports: Do Elite Athletes Adequately Protect Their Skin against Skin Cancer?

Excessive sun exposure is the main avoidable cause of skin cancer. Outdoor sports performed without adequate photoprotection are risky practices in this respect. This study examines whether elite athletes in water sports (specifically surfing, windsurfing, and sailing) take appropriate measures to protect their skin from the sun, and whether there are differences in this respect according to age, gender, or sports discipline. This study is based on a questionnaire-based health survey. World championship competitors completed a self-administered questionnaire on their sun protection and exposure habits, as well as sunburns during the last sports season. In total, 246 participants, with an age range of 16-30 years, completed the questionnaire. Of these, 49.6% used inadequate sun protection. Those who protected their skin appropriately tended to be older than those who did not (average age = 23.28 and 20.69 years, respectively; p = 0.000). There were no significant differences in sun protection habits between male and female athletes. The rate of sunburn was very high (76.7%). A high proportion (22.5%) of participants never used sunscreen. Elite athletes in water sports are at real risk of skin lesions from overexposure to the sun, associated with inadequate photoprotection practices. Campaigns to raise awareness and to promote the early detection of skin cancer should target these risk groups

Assessment of Quality of Life Following Diagnosis in Patients with Cervicofacial Non-melanoma Skin Cancer

Non-melanoma skin cancer (NMSC) is the most common neoplasm. The characteristics of this disease (location in aesthetically sensitive areas, the appearance of successive tumors during follow-up, and high rates of survival) are such that the concept of health-related quality of life (HRQoL) is of particular importance. The aim of the present study was to describe and analyses patient quality of life following diagnosis with cervicofacial NMSC. A descriptive cross-sectional study was conducted on patients with cervicofacial NMSC, confirmed by skin biopsy. In each case, when the definitive diagnosis of NMSC was established, the patient completed the Skin Cancer Index questionnaire and demographic data, health status, and sun exposure habits were recorded. The study population was composed of 220 patients with histologically confirmed cervicofacial NMSC. The mean score obtained for the Skin Cancer Index questionnaire was 54.1 (SD 21.9), in which the social-aesthetic component had a mean score of 76.7 (SD 26.2), while the emotional component had a mean score of 23 (SD 25.1). Male patients, those with secondary or higher education, and those who had no history of anxiety or depression had significantly higher mean scores for HRQoL. This study demonstrated that the diagnosis of cervicofacial NMSC significantly impacts HRQoL and that certain population groups (women, persons with only primary or no education qualifications, and those a history of anxiety or depression) are more susceptible. The questionnaire scores obtained were lower than those reported in previous studies on this topic and reflect a particularly strong impact on emotional aspects of patient quality of life

Assessment of Quality of Life Following Diagnosis in Patients with Cervicofacial Non-melanoma Skin Cancer

Non-melanoma skin cancer (NMSC) is the most common neoplasm. The characteristics of this disease (location in aesthetically sensitive areas, the appearance of successive tumors during follow-up, and high rates of survival) are such that the concept of health-related quality of life (HRQoL) is of particular importance. The aim of the present study was to describe and analyses patient quality of life following diagnosis with cervicofacial NMSC. A descriptive cross-sectional study was conducted on patients with cervicofacial NMSC, confirmed by skin biopsy. In each case, when the definitive diagnosis of NMSC was established, the patient completed the Skin Cancer Index questionnaire and demographic data, health status, and sun exposure habits were recorded. The study population was composed of 220 patients with histologically confirmed cervicofacial NMSC. The mean score obtained for the Skin Cancer Index questionnaire was 54.1 (SD 21.9), in which the social-aesthetic component had a mean score of 76.7 (SD 26.2), while the emotional component had a mean score of 23 (SD 25.1). Male patients, those with secondary or higher education, and those who had no history of anxiety or depression had significantly higher mean scores for HRQoL. This study demonstrated that the diagnosis of cervicofacial NMSC significantly impacts HRQoL and that certain population groups (women, persons with only primary or no education qualifications, and those a history of anxiety or depression) are more susceptible. The questionnaire scores obtained were lower than those reported in previous studies on this topic and reflect a particularly strong impact on emotional aspects of patient quality of life

A Pilot of Brief Mindfulness-Based Intervention to manage emotions in patients with psoriasis

La psoriasis es una dermatosis de alta incidencia relacionada con el estrés, constituyendo las personas que lo padecen, un grupo objetivo adecuado para llevar a cabo intervenciones basadas en mindfulness, destinadas a ayudar a la regulación de las emociones. El objetivo del presente estudio es evaluar los efectos de la Técnica de Acompañamiento Emocional Compasivo (CEAT), como una intervención breve basada en mindfulness, sobre el afrontamiento emocional en pacientes con psoriasis grave, para determinar la eficacia del afrontamiento emocional tras la inducción de un estado emocional negativo. Cuarenta y cuatro adultos (el 59,1% mujeres) con edades comprendidas entre los 22 y los 71 años (M = 51,95, DT = 11,87), con psoriasis grave, fueron asignados aleatoriamente a un grupo de intervención con CEAT o a un grupo control de intervención de Revelación Emocional. Se evaluaron malestar subjetivo, capacidad cognitiva, afecto y frecuencia cardíaca, antes y después de las intervenciones, con dos seguimientos a las 48 horas y a los siete días. Los resultados muestran diferencias estadísticamente significativas a favor de la intervención CEAT frente al grupo de Revelación Emocional, siendo más eficaz en el manejo emocional tras la inducción y el seguimiento. Estos resultados podrían favorecer la intervención en entornos clínicos con pacientes con psoriasis grave, y futuras investigaciones podrían considerar el uso de esta, para mejorar la gestión emocional en este tipo de poblaciónAbstract: Psoriasis is a high incidence dermatosis related to stress, and its sufferers provide an appropriate target group to carry out interventions such as those based on mindfulness, aimed at helping emotion regulation. To assess the Compassionate Emotional Accompaniment Technique (CEAT) effects within a brief mindfulness-based intervention on emotional coping in patients with severe psoriasis to determine the efficacy of emotional coping after the induction of a negative emotional state. Fortyfour adults (59.1% were women) aged 22 - 71 years (M = 51.95, SD = 11.87) with severe psoriasis were assigned randomly to the CEAT group or the Emotional Disclosure control group. Subjective discomfort, cognitive ability, affect, and heart rate were assessed before and after the interventions, with two follow-ups at 48 hours and seven days. The results show significant statistical differences in favour of the CEAT intervention versus the Emotional Disclosure group, being more effective in the emotional management after induction and follow-up. These results encourage interventions in a clinical setting with patients with severe psoriasis, so future research should consider using this intervention type to improve emotional management with this population grou

What Sun Protection Practices Should Be Adopted by Trainee Teachers to Reduce the Risk of Skin Cancer and Other Adverse Outcomes?

Excessive sun exposure and insufficient protection are the main risk factors for the onset of melanoma and non-melanoma skin cancer (the most common types of cancer suffered by fair-skinned populations) and other adverse effects on the skin and eyes. Epidemiological data highlight the scant awareness of this risk among young people and the high rates of sunburn often recorded among this population. The main aim of the present study is to examine sun exposure and protection behavior by university students. A cross-sectional questionnaire-based study was undertaken to investigate sun exposure and protection practices among students of education sciences at a university in southern Spain. The data obtained were used to perform a descriptive, comparative analysis, by groups and by gender, of photoprotection and skin self-examination practices. The reliability and validity of the questionnaire were both tested. Of the 315 students who completed the questionnaire, 74.6% had suffered at least one sunburn during the previous year. Few made frequent use of sunscreen or protective clothing and 89.5% did not self-examine their skin. The metric properties of the questionnaire revealed its excellent reliability and validity. Among the Spanish university students considered, there was little awareness of the risk of excessive sun exposure, self-protection was insufficient, the potential exposure to dangerous levels of ultraviolet radiation was high, and most had suffered one or more sunburns in the last year. Intervention strategies should be implemented to highlight the risks involved and the need for more appropriate sun protection practices. Information campaigns should be conducted in this respect so that, when these students become teachers, they will have adequate knowledge of the risks involved and of the benefits of addressing this problem effectively, and will ultimately transfer these health education competences to their own students

Sun exposure habits, sun protection practices, knowledge and attitudes of andalusian teenagers

La historia de quemaduras solares y la exposición solar acumulativa durante la infancia y la adolescencia son los factores de riesgo más importantes para el desarrollo de cáncer de piel. Se conoce que el 85% de esta neoplasia podría evitarse reduciendo la exposición solar, especialmente durante la adolescencia. En este grupo de edad se han intensificado las prácticas de riesgo relacionadas con la exposición solar, motivadas por el deseo del bronceado, el tiempo que pasan al aire libre, la baja percepción del riesgo a desarrollar cáncer de piel y la falta de control paterno. Las campañas de prevención de cáncer de piel tienen como objetivo mejorar los hábitos de exposición solar, reducir las quemaduras solares y la incidencia de cáncer de piel. Los adolescentes son un grupo prioritario al que debe ir dirigidas estas campañas. En el presente trabajo se realiza un recorrido por los hallazgos más significativos sobre los hábitos de exposición solar, las prácticas de protección solar, las actitudes y comportamientos de riesgo de los adolescentes, de las intervenciones educativas que se han llevado a cabo en Andalucía y las perspectivas futuras.A history of sunburn and cumulative sun exposure during childhood and adolescence are the most important risk factors for the development of skin cancer. Nevertheless, 85% of the cases of skin cancer could be prevented by reducing sun exposure, particularly during adolescence. In fact, persons in this age group have now increased their sun exposure practices, motivated by the desire for a suntan, and the fact that they spend more time outdoors, have a poor perception of the risk of developing skin cancer, and the lack of parental control. Skin cancer prevention campaigns aim to improve sun protection habits, and reduce sunburns and incidence of skin cancer. In this work, we do a summary about the most significant findings on the sun exposure habits, sun protection practices, attitudes and risk behaviors of adolescents, as well as, educational interventions that have been carried out in Andalusia and the future prospects.Los autores agradecen el apoyo del equipo de investigación del Hospital Costa del Sol y al Programa del Doctorado de Medicina Clínica y Salud Pública de la Universidad de Granad

Sun exposure and protection habits in transplant athletes: an international survey

Background: Transplant recipients are particularly prone to the development of skin cancer, and overexposure to UV radiation during outdoor activities increases the risk of carcinogenesis. Objective: The aim of this study was to analyze sun-related behaviors and knowledge in transplant athletes, examine the equency of sunburns, and explore associations with a history of skin cancer. Materials and methods: Cross-sectional descriptive study. Participants (n = 170) in the XXI World Transplant Games from >50 countries completed a questionnaire on sun protection habits and knowledge, type of transplant, immunosuppressive therapy, and personal history of skin cancer. Results: The most common transplanted organs were the kidney (n = 79), the liver (n = 33), and the heart (n = 31). Overall, 61.3% of athletes had been doing sport for >15 years and 79.5% spent >1–2 h a day outdoors. Fifteen % of athletes had a history of skin cancer. The prevalence of sunburn in the previous year was 28.9%, higher in athletes aged <50 years (37.2%); without a primary school education (58.3%), not taking cyclosporin (32.6%), and athletes who played basketball (75%). The main sun protection measures used were sunscreen (68.9%) and sunglasses (67.3%). Use of a hat or cap was the only measure significantly associated with a reduced prevalence of sunburn. Conclusions: Despite high awareness that sun exposure increases the risk of skin cancer, sunburn was common in transplant athletes. Efforts should be made to strengthen multidisciplinary sun protection education strategies and ensure periodic dermatologic follow-up to prevent sun-induced skin cancer in this population.This work has been supported by the project no. PID2020-117224RB-100 of State Programs of Generation of Knowledge and Scientific and Technological Strengthening of the System from the Spanish Ministry of Science and Innovation. This is part of the research of the Institute of Biomedicine of Málaga (IBIMA) and the Junta de Andalucía working group CTS-162. Funding for open access charge: Universidad de Málaga/CBUA

Ultraviolet exposure of competitors during a Tokyo Olympic Sailing Regatta Test Event

Background Overexposure to sunlight is the main cause of skin cancer. Photoprotection practices and sunburn play a crucial role in skin cancer prevention. Objectives This study aimed to quantify the risk of sun exposure and to evaluate photoprotection practices in Spanish sailors during Olympic competitions. Methods Solar daily ultraviolet (UV) radiation cycle, personal UV dosimetry, photoprotection practices and sunburn checking were followed during three consecutive days of competition among sailors from the Spanish Olympic Sailing Team during a Tokyo Olympic Regatta Test Event. Results A total of 13 sailors (7 women), with mean age of 27.6 +/- 4.7 years and sports experience of 17.7 +/- 5.4 years, were studied. The most common phototypes were type III (53.8%) and type II (38.5%). The rate of sunburn checked was high (46.2%). The mean daily personal UV exposure received was 761.0 +/- 263.6 J/m(2), 3.0 +/- 1.1 minimal erythemal dose and 7.6 +/- 2.6 standard erythemal dose, seven times greater than the maximum permissible UV light exposure values for an 8 h working day. The use of a T-shirt was the most common practice (94.2%), followed by the use of shade (50.2%), hat/cap (44.0%), sunglasses (26.1%) and sunscreen (11.8%). Conclusions Olympic sailor's studies presented high levels of UV radiation received, high rate of sunburn and insufficient adherence to sun-protective behaviours (especially, to use of sunscreen) to prevent sunburn, the main cause of skin cancer. Sport Federations should develop educational campaigns addressing sun-related exposure habits and photoprotection behaviours to reduce the risk of skin cancer among these athletes

Impact of a Community Intervention for Early Skin Cancer Diagnosis Implementing Teledermatology

The principal cause of skin cancer is sun exposure. In areas with high sun exposure levels, early diagnosis and sun protection education strategies must be developed. Aim of the study was to evaluate the impact of an early skin cancer diagnosis intervention implementing teledermatology. Transversal descriptive study on a population in the Western Costa del Sol. Primary care physicians were instructed on skin cancer diagnosis. They recruited consecutive at-risk patients and held four workshops for early skin cancer diagnosis and education on sun protection. The resulting variables on participants’ satisfaction and intention to change were collected. 393 patients were recruited. The mean age was 52.9 years, and 65.4% were women. Suspicious lesions were detected in 24.1% of participants, and 11.7% were attended to via teledermatology. Of these, 65.2% were evaluated in person at the Dermatology Department. Fourteen basal cell carcinomas, 5 squamous cell carcinomas, and 2 melanomas were diagnosed. Regarding patient satisfaction, 67.7% found all aspects of the workshops of interest, 41.7% found the skin check-up of interest, and 26.4% found sun and skin cancer prevention information of interest. Of the patients attended to via teledermatology, 100% stated it was good or very good and 100% would consult again via this method. The intervention was successful in terms of participation, skin cancer diagnosis, and satisfaction, especially compared with other international campaigns. Therefore, although the data cannot be extrapolated to all environments, this initiative may be used as the basis for the development of future interventions