Skin cancer: how portuguese “sunbathers” perceive risk

- 37 - Departamento de Personalidad, Evaluación y Tratamiento Psicológicos Anuario de Psicología Clínica y de la Salud Annuary of Clinical and Health Psychology Year 2013 • Volume 09 • Pages 37 to 39 Skin cancer: how portuguese “sunbathers” perceive risk Rita Silvestre Costa and Ana Rosa Tapadinhas Instituto Superior de Psicologia Aplicada, Instituto Universitário, ISPA-IU Abstract: Skin cancer has been on the rise among the Caucasian population and scientific literature suggests that the incidence of this type of cancer could be prevented if individuals adopted precautionary behaviours. Effectively, rates decrease if citizens avoid prolonged exposure to the sun and protect themselves when exposed. The current research paper aims to understand how a sample of Portuguese citizens perceive the risk of skin cancer during bathing season. Method: A sample of 318 participants, between 18 and 74 years of age, was gathered and both the Risk perception of Skin Cancer and the Socio-Demographic Questionnaire were employed. Results: It was found that the risk perception in the sample could be considered median, and is significantly higher than the average risk awareness in general. Conclusions: The study provides a boost towards identifying priorities in intervention programs in cancer and preventive behaviors. As recommendations for future research, we suggested comparative data, validations of the scale and qualitative methodology. Future research should examine the relations between risk perception in concomitance with other psychological concepts. Keywords: Risk perception, Skin cancer, Sun exposure, Health Psychology. Received:26/06/2013 Accepted: 05/09/2013 Introduction In Portugal, it is estimated that each year there are approximately 10,000 new diagnoses of non-melanoma skin cancer and about 1000 cases of melanoma (www.apcancrocutaneo.pt), the most serious form of skin cancer (Pollock, 2006). Numbers are high not only for our overall population, but also for the European rates (Parente, Gomes, Viana, & Valley, 2012). The aforementioned research solidly establishes that, with regards to the various types of skin cancer, the foremost external cause is exposure to ultraviolet rays (Kasparian, McLoone, & Meiser, 2009). It is estimated that 4 in 5cases of skin cancercould be prevented by reducing solar exposure, particularly avoiding sunburns and using sunscreen(Hawkes, Hamilton, White, & Young, 2012; Myers & Horswill, 2006).In this context, risk perception plays an important role in most cognitive models for predicting health-related behaviour (Brewer, Chapman, Gerrard, Mc- Caul, & Weinstein, 2007; Camilo & Lima, 2010; Hay et al., 2011) and it appears that risk is a underlying component in exposure to sunlight (Craciun, Schüz, Lippke, & Schwarzer, 2010; Sjöberg, Holm, Ullén, & Brandberg, 2004). According to Janssen, Osch, Vries and Lechner (2011), risk perception can be measured along the dimensions of Perceived Likelihood and Perceived Severity. Objective Having established these facts, and taking into account the few existing studies on this subject, the following research problem suggests itself: What is the risk perception of skin cancer among a sample of Portuguese sunbathers during the bathing season? Methods Participants. The participants were 318 sunbathers from different districts of Portugal; of these 64.2% were female and 35.8 % male. All were aged between 18 and 74 years (M=35.61; SD=12.412). Instruments. Two instruments were employed, the “Risk Perception of Skin Cancer (Janssen et al., 2011), translated by ourselves and the “Sociodemographic Questionnaire”. The “Risk Perception of Skin Cancer”(Janssen et al., 2011), consists of two main operationalizations, one for Perceived Likelihood and the other for Perceived Severity. Procedure.A trial run was carried out. We proceeded to collect the sample, which is restricted to subjects with minimum age of 18 years, of Portuguese nationality, Caucasians, with the additional criterion of being sunbathers. Treatment and statistical analysis of data was made using the Statistical Package for the Social Sciences(version 20.0 for Windows). The present study is one of a correlational and descriptive quantitative nature. It also has an exploratory nature (D’Oliveira, 2007). Results In order to answer the point of research, we performed a Student t-test for paired samples. The results (Table 1) indicate that the risk perception in skin cancer was median in this sample compared with the values of a population answer average of 3.00. Briefly, risk perception, t (317) = 15.040, Contact informaction: Rita Costa Rua Ventura Abrantes, nº7,3ºB (1750-323 Lisboa, Portugal) Tel.: (+351)917855869 [email protected] - 38 - Anuario de Psicología Clínica y de la Salud Annuary of Clinical and Health Psychology Year 2013 Volume 9 p = 0.000, was significantly higher in the sample than average risk perception in an average population. The Perceived Likelihood, t (317) = -2.139, p = 0.033, was significantly lower in the sample than the average Perceived Likelihood. Comparatively the Perceived Severity was significantly higher in the sample, t (317) = 18.5170, p = 0.000, than the average Perceived Severity. References Bränström, R., Kristjansson, S., & Ullén, H. (2005). Risk perception, optimistic bias, and readiness to change sun related behaviour. European Journal of Public Health, 16(5), 492-497. Brewer, N. T., Chapman, G. B., Gerrard, M., McCaul, K. D., & Weinstein, N. D. (2007). Meta-analysis of the relationship between risk perception and health behaviour: The example of vaccination. Health Psychology, 26(2), 136-145. Camilo, C., & Lima, M. L. (2010). No que se pensa quando se pensa em doenças?: estudo psicométrico dos riscos de sáude. Revista portuguesa de sáude pública, 28 (2), 140-154. Cestari, M. E., & Zago, M. M. (2005). A prevenção do câncer e a promoção de sáude: um desafio para o século XXI. Revista Brasileira de Enfermagem, 58(2), 218-221. Craciun, C., Schüz, N., Lippke, S., & Schwarzer, R. (2010). Risk perception moderates how intentions are translated into sunscreen use. Journal of Behavioral Medicine, 33, 392- 398. D’Oliveira, T. (2007). Teses e Dissertações: Recomendações para a elaboração e estruturação de trabalhos científicos. Lisboa: Editora RH. Hawkes, A. L., Hamilton, K., White, K. M., & Young, R. M. (2012). A randomised controlled trial of a theory-based intervention to improve sun protective behaviour in adolescents (“you can still be HOT in the shade”): study protocol. BioMedCentral Cancer, 12(1), 1-8. Hay, J., DiBonaventura, M., Baser, R., Press, N., Shoveller, J., & Bowen, D. (2011). Personal attributions for melanoma risk in melanoma-affected patients and family members. Journal of Behavioral Medicine, 34, 53-63. Henriques, A. M., & Lima, M. L. (2003). Estados afetivos, perceção do risco e do suporte social: A familiaridade e a relevância como moderadores nas respostas de congruência com o estado de espírito . Análise Psicológica , 3 (XXI), 375-392. Janssen, E., Osch, L. V., Vries, H. D., & Lechner, L. (2011). Measuring risk perceptions of skin cancer: Reliability and validity of different operationalizations. British Journal of Health Psychology, 16, 92-112. Kasparian, N. A., McLoone, J. K., & Meiser, B. (2009). Skin cancer-related prevention and screening behaviours: a review of the literature. Journal of Behavioral Medicine, 32, 406-428. Table 1 –Student t test for Risk Perception Medium SD TSig. Risk perception 3,36 0,42 15,040 0,000*** Perceived likelihood 2,92 0,58 -2,139 0,033** Perceived severity 3,48 0,46 18,517 0,000*** * * p ≤ 0,05 *** p ≤ 0,001 Discussion and conclusions The risk perception in the sample of Portuguese citizens could be considered median, and is significantly higher than the average risk awareness in general. However, when comparing the two operationalizations of risk perception, we found that the participants reportedbeing aware of the severity of skin cancer, butconsidered that they had a lower Perceived Likelihood of suffering from this disease.This could be supported by the research ofBränström, Kristjansson, andUllen (2005). Taking into account these values, we may be before a case of “unrealistic optimism” (Radcliffe & Klein, 2002; Henriques & Lima, 2003). We should also consider the possibilty of a denial mechanism as a strategy of minimizing risk perception (Thielen, Hartmann, & Soares, 2008). Focusing on generalist Health psychology, the data could be approached in light of the biomedical model (Ogden, 2004). Given the relevance of thetopicand itsexploratory nature, one can view this study as a stepping stone in the understandingof risk perception in individuals who attend the beach and that are facing the most important risk factor: sun exposure - a factor that is in turn conditioned by awareness and responsible behaviour of each individual (Cestari & Zago, 2005). In terms of implications, the study could provide aboosttowards identifying priorities in intervention programs. It should be noted that there were some limitations, as the impact of social desirability, random responses and the absence of comparative data should be noted. As recommendations for future research, we suggested further validation of the scale for the population and gather/analyzingthe datathrough a qualitative methodology (Pais-Ribei- ro, 2008). Finally, it is suggestedstudying risk perception in concomitance with other psychological aspects. - 39 - Costa and Tapadinhas Skin cancer: how portuguese “sunbathers” perceive risk Myers, L. B., & Horswill, M. S. (2006). Social cognitive predictors of sun protection intention and behaviour. Behavioral Medicine, 32, 57-63. Ogden, J. (2004). Psicologia da Saúde (2ª ed. Rev.). Lisboa: Climepsi Editores. Pais- Ribeiro, J. (2008). Metodologia de Investigação em Psicologia e Saúde. Porto: Legis Editora. Parente, J., Gomes, J., Viana, I., & Vale, E. (2012). Variantes raras de Melanoma Maligno – Um desafio clínico e histopatológico. Revista Sociedade Portuguesa de Dermatologia e Venereologia, 70 (2). Recuperado a 10 setembro, 2012, de http://spdv.com.pt/pt/?id=61&mid=7 Pollock, R. E. (2006). Manual de Oncologia Clinica da UICC. Sao Paulo : 8º Edição. Radcliffe, N. M., & Klein, M. P. (2002). Dispositional, unrealistic, and comparative optimism: Differential relations with knowledge and processing of risk information and beliefs about personal risk. Personality and Social Psychology Bulletin, 28, 836-846. Sjöberg, L., Holm, L.-E., Ullén, H., & Brandberg, Y. (2004). Tanning and risk perception in adolescents. Health, Risk & Society, 6(1), 81-94. Thielen, I. P., Hartmann, R. C., & Soares, D. P. (2008). Perceção de risco e excesso de velocidade. Cad. Saúde Pública, Rio de Janeiro, 24 (1), 131-139.