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Keywords:

  • instrument development;
  • nursing;
  • psychological theory;
  • skin cancer;
  • skin self-examination;
  • theoretical domains framework

Abstract

Aim

To develop and psychometrically test the Motivation and Self-Efficacy in Early Detection of Skin Lesions Index.

Background

Skin cancer is the most frequently diagnosed cancer worldwide. The primary strategy used to prevent skin cancer is promotion of sun avoidance and the use of sun protection. However, despite costly and extensive campaigns, cases of skin cancer continue to increase. If found and treated early, skin cancer is curable. Early detection is, therefore, very important. The study was conducted in 2013.

Design

Instrument Development.

Methods

A literature review and a survey identified barriers (factors that hinder) and levers (factors that help) to skin self-examination. These were categorized according to a the Theoretical Domains Framework and this formed the basis of an instrument, which was tested for validity and reliability using confirmatory factor analysis and Cronbach's alpha respectively.

Results

A five-factor 20-item instrument was used that tested well for reliability and construct validity. Test–retest reliability was good for all items and domains. The five factors were: (i) Outcome expectancies; (ii) Intention; (iii) Self-efficacy; (iv) Social influences; (v) Memory.

Conclusions

The Motivation and Self-Efficacy in Early Detection of Skin Lesions Index provides a reliable and valid method of assessing barriers and levers to skin self-examination. The next step is to design a theory-based intervention that can be tailored according to individual determinants to behaviour change identified by this instrument.