Factors associated with older adults’ knowledge, attitude and practice on skin cancer prevention

Serafim, Antonia Imaculada Santos; Maniva, Samia Jardelle Costa de Freitas; Campos, Regina Kelly Guimarães Gomes; Silva, Paulo Goberlânio de Barros; Pinheiro, Patrícia Neyva da Costa; Lopes, Consuelo Helena Aires de Freitas; Morais, Huana Carolina Cândido; Freitas, Aline de Oliveira de

doi:10.1590/0034-7167-2022-0606

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 76 (3) • 2023 • https://doi.org/10.1590/0034-7167-2022-0606 copy

Factors associated with older adults’ knowledge, attitude and practice on skin cancer prevention

Factores asociados al conocimiento, actitud y práctica de los ancianos sobre la prevención del cáncer de piel

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to identify factors associated with older adults’ knowledge, attitude and practice regarding skin cancer prevention.

Methods:

this is a cross-sectional study, carried out with 120 older adults from a Basic Health Unit in Quixadá, Ceará, from September to November 2018.

Results:

individuals aged 60 to 69 years and working were statistically associated with adequate knowledge (p=0.038). Having light skin, eyes and hair was associated with adequate attitude (p=0.030). Having skin problems, such as bleeding wounds, was associated with adequate practice (p=0.016). With regard to inappropriate behavior for skin cancer prevention, there was a statistically significant association between working or having worked under direct exposure to the sun, inadequate knowledge (p=0.036), inadequate attitude (p=0.010) and having incomplete primary education and inadequate practice (p<0.001).

Conclusions:

sociodemographic and clinical factors influence older adults’ knowledge, attitude and practice regarding skin cancer prevention.

Descriptors:
Skin Neoplasms; Aged; Knowledge; Attitude; Nursing

Sociodemographic variables		Adequate knowledge			Adequate attitude			Adequate practice
Sociodemographic variables	Total	No	Yes	p value	No	Yes	p value	No	Yes	p value
Age
60 to 69	69 (57.5%)	21 (45.7%)	48 (64.9%)^* * p<0.05, Fisher’s exact test (n, %).	0.038	16 (48.5%)	53 (60.9%)	0.219	64 (57.1%)	5 (62.5%)	0.767
70+	51 (42.5%)	25 (54.3%)^* * p<0.05, Fisher’s exact test (n, %).	26 (35.1%)		17 (51.5%)	34 (39.1%)		48 (42.9%)	3 (37.5%)
Sex
Male	52 (43.3%)	16 (34.8%)	36 (48.6%)	0.136	12 (36.4%)	40 (46.0%)	0.343	50 (44.6%)	2 (25.0%)	0.279
Female	68 (56.7%)	30 (65.2%)	38 (51.4%)		21 (63.6%)	47 (54.0%)		62 (55.4%)	6 (75.0%)
Education
Illiterate	16 (13.3%)	9 (19.6%)	7 (9.5%)	0.149	7 (21.2%)	9 (10.3%)	0.116	16 (14.3%)	0 (0.0%)	<0.001
Elementary	19 (15.8%)	4 (8.7%)	15 (20.3%)		6 (18.2%)	13 (14.9%)		17 (15.2%)	2 (25.0%)
Incomplete elementary school	65 (54.2%)	29 (63.0%)	36 (48.6%)		20 (60.6%)	45 (51.7%)		64 (57.1%)^* * p<0.05, Fisher’s exact test (n, %).	1 (12.5%)
Complete high school	13 (10.8%)	3 (6.5%)	10 (13.5%)		0 (0.0%)	13 (14.9%)		11 (9.8%)	2 (25.0%)^* * p<0.05, Fisher’s exact test (n, %).
Incomplete high school	3 (2.5%)	1 (2.2%)	2 (2.7%)		0 (0.0%)	3 (3.4%)		3 (2.7%)	0 (0.0%)
Complete higher education	3 (2.5%)	0 (0.0%)	3 (4.1%)		0 (0.0%)	3 (3.4%)		1 (0.9%)	2 (25.0%)^* * p<0.05, Fisher’s exact test (n, %).
Incomplete higher education	1 (0.8%)	0 (0.0%)	1 (1.4%)		0 (0.0%)	1 (1.1%)		0 (0.0%)	1 (12.5%)
Occupation
Working	54 (45.0%)	14 (30.4%)	40 (54.1%)^* * p<0.05, Fisher’s exact test (n, %).	0.011	12 (36.4%)	42 (48.3%)	0.242	53 (47.3%)	1 (12.5%)	0.056
Not working	66 (55.0%)	32 (69.6%)^* * p<0.05, Fisher’s exact test (n, %).	34 (45.9%)		21 (63.6%)	45 (51.7%)		59 (52.7%)	7 (87.5%)
Marital status
Married	84 (70.0%)	33 (71.7%)	51 (68.9%)	0.797	25 (75.8%)	59 (67.8%)	0.313	78 (69.6%)	6(75.0%)	0.452
Single	12 (10.0%)	3 (6.5%)	9 (12.2%)		2 (6.1%)	10 (11.5%)		10 (8.9%)	2 (25.0%)
Stable union	4 (3.3%)	1 (2.2%)	3 (4.1%)		0 (0.0%)	4 (4.6%)		4 (3.6%)	0 (0.0%)
Divorced	4 (3.3%)	2 (4.3%)	2 (2.7%)		0 (0.0%)	4 (4.6%)		4 (3.6%)	0 (0.0%)
Widower	16 (13.3%)	7 (15.2%)	9 (12.2%)		6 (18.2%)	10 (11.5%)		16 (14.3%)	0 (0.0%)

Variables		Adequate knowledge			Adequate attitude			Adequate practice
Variables	Total	No	Yes	p value	No	Yes	p value	No	Yes	p value
Self-reported chronic diseases
No chronic disease	15 (12.5%)	5 (10.9%)	10 (13.5%)	0.257	5 (15.2%)	10 (11.5%)	0.421	14 (12.5%)	1 (12.5%)	0.907
Hypertension	54 (45.0%)	17 (37.0%)	37 (50.0%)		16 (48.5%)	38 (43.7%)		49 (43.8%)	5 (62.5%)
Diabetes	20 (16.7%)	8 (17.4%)	12 (16.2%)		4 (12.1%)	16 (18.4%)		19 (17.0%)	1 (12.5%)
Skin cancer	4 (3.3%)	3 (6.5%)	1 (1.4%)		2 (6.1%)	2 (2.3%)		4 (3.6%)	0 (0.0%)
Family history of cancer	8 (6.7%)	2 (4.3%)	6 (8.1%)		0 (0.0%)	8 (9.2%)		7 (6.3%)	1 (12.5%)
Arthritis/rheumatism	9 (7.5%)	5 (10.9%)	4 (5.4%)		4 (12.1%)	5 (5.7%)		9 (8.0%)	0 (0.0%)
Chronic pain in the spine	8 (6.7%)	4 (8.7%)	4 (5.4%)		2 (6.1%)	6 (6.9%)		8 (7.1%)	0 (0.0%)
Heart disease	2 (1.7%)	2 (4.3%)	0 (0.0%)		0 (0.0%)	2 (2.3%)		2 (1.8%)	0 (0.0%)
Continuous use medication
Yes	94 (78.3%)	35 (76.1%)	59 (79.7%)	0.430	27 (81.8%)	67 (77.0%)	0.740	88 (78.6%)	6 (75.0%)	0.925
No	25 (20.8%)	10 (21.7%)	15 (20.3%)		6 (18.2%)	19 (21.8%)		23 (20.5%)	2 (25.0%)
Types of medications
No	25 (20.8%)	10 (21.7%)	15 (20.3%)	0.305	6 (18.2%)	19 (21.8%)	0.898	23 (20.5%)	2 (25.0%)	0.693
Antihypertensive	59 (49.2%)	21 (45.7%)	38 (51.4%)		16 (48.5%)	43 (49.4%)		54 (48.2%)	5 (62.5%)
Antidiabetic	25 (20.8%)	8 (17.4%)	17 (23.0%)		7 (21.2%)	18 (20.7%)		24 (21.4%)	1 (12.5%)
Analgesics/anti-inflammatories	11 (9.2%)	7 (15.2%)	4 (5.4%)		4 (12.1%)	7 (8.0%)		11 (9.8%)	0 (0.0%)

Variables		Adequate knowledge			Adequate attitude			Adequate practice
Variables	Total	No	Yes	p value	No	Yes	p value	No	Yes	p value
Self-reported skin problems
Yes	25 (20.8%)	13 (28.3%)	12 (16.2%)	0.114	10 (30.3%)	15 (17.2%)	0.116	23 (20.5%)	2 (25.0%)	0.764
No	95 (79.2%)	33 (71.7%)	62 (83.8%)		23 (69.7%)	72 (82.8%)		89 (79.5%)	6 (75.0%)
Which skin problems
No	96 (80.0%)	33 (71.7%)	63 (85.1%)	0.289	23 (69.7%)	73 (83.9%)	0.205	90 (80.4%)	6 (75.0%)	0.016
Skin peeling	9 (7.5%)	4 (8.7%)	5 (6.8%)		4 (12.1%)	5 (5.7%)		9 (8.0%)^* * p<0.05, Fisher’s exact test.	0 (0.0%)
Pigmented patches/plaques with crusts	11 (8.3%)	7 (13.0%)	4 (5.4%)		6 (15.2%)	5 (5.7%)		11 (8.9%)^* * p<0.05, Fisher’s exact test.	0 (0.0%)
Bleeding wound	5 (4.2%)	3 (6.5%)	2 (2.7%)		1 (3.0%)	4 (4.6%)		3 (2.7%)	2 (25.0%)^* * p<0.05, Fisher’s exact test.
Works or has worked under direct sun exposure
Yes	89 (74.2%)	39 (84.8%)^* * p<0.05, Fisher’s exact test.	50 (67.6%)	0.036	30 (90.9%)^* * p<0.05, Fisher’s exact test.	59 (67.8%)	0.010	85 (75.9%)	4 (50.0%)	0.106
No	31 (25.8%)	7 (15.2%)	24 (32.4%)^* * p<0.05, Fisher’s exact test.		3 (9.1%)	28 (32.2%)^* * p<0.05, Fisher’s exact test.		27 (24.1%)	4 (50.0%)
Has light skin, eyes, hair
Yes	44 (36.7%)	16 (34.8%)	28 (37.8%)	0.736	7 (21.2%)	37 (42.5%)^* * p<0.05, Fisher’s exact test.	0.030	39 (34.8%)	5 (62.5%)	0.117
No	76 (63.3%)	30 (65.2%)	46 (62.2%)		26 (78.8%)^* * p<0.05, Fisher’s exact test.	50 (57.5%)		73 (65.2%)	3 (37.5%)

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[1] Corresponding author: Samia Jardelle Costa de Freitas Maniva, E-mail: samia.jardelle@gmail.com