Improving outcomes for people with skin tumours including melanoma

Improving Outcomes for
People with Skin Tumours
including Melanoma
Patient-centred care
One systematic review found that the majority of patients with cancer
considered audiotape recordings or summaries of their consultations
valuable. Recordings or summaries were associated with better recall
of information and greater patient satisfaction with the information.
No studies detected any statistically significant effect on anxiety or
depression.
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One systematic review of studies of communication in general
healthcare settings found significant associations between
communication interventions and patient health outcomes. Patient
education was found to influence both emotional and physiological
status, while physician education was found to influence emotional
status.
Disfigurement
One RCT found that the factors related to a negative cosmetic impact
were severity of scar and the extent to which patients were
unprepared for the actual size of their scars. Provision of photographs
as a means of preparing patients for cosmetic impact of surgery did
not increase the accuracy of patients’ expectations of their
postoperative appearance and had no effect on levels of preoperative
or postoperative distress.
One non-randomised intervention study found that a social interaction
skills workshop for people with disfigurement was associated with
reduced scores on scales of anxiety and social avoidance at both 6
weeks and 6 months follow-up.
One non-randomised intervention study found that nurses working in
specialist units were less prepared to assist in social rehabilitation for
patients with disfigurement than in physical rehabilitation. Selfperceived
social rehabilitation skills improved significantly following a
training programme.
Service guidelines produced by the British Association of Plastic
Surgeons and the NHS Modernisation Agency (2005) are supportive of
a patient-focused, rather than specialty-focused, model of care for
patients treated with plastic surgery. The guidelines recommend that
patients should be partners in their own management and also that
carers should receive support.
Effectiveness of psychological interventions
One RCT found that a cognitive-behavioural intervention was not
associated with significantly lower distress in patients with melanoma
at the 2 months and 6 months follow-up points, although effects were
noted on anxiety and health-related quality of life.
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National Institute for Health and Clinical Excellence