Sun protection in Iranian kidney transplant recipients: knowledge, attitude and practice

Background Kidney transplant recipients (KTR) are at increased risk of developing skin cancer. The purpose of this study was to evaluate the knowledge, attitude, and practices of KTRs regarding skin cancer after transplantation and to identify the role of education in motivating these patients to practice sun-protective behaviours. Methods Two hundred and fifty KTRs in a referral hospital were interviewed using a questionnaire. All patients received a skin cancer information booklet after completion of the questionnaire. Six months later, these patients were invited and interviewed again about their skin cancer-prevention practices. Results The patients consisted of 153 men and 97 women patients with a mean age of 35.9 +/- 14.2 years and mean of 49.7 +/- 53.1 months after their transplantation. A total of 102 patients (40.8%) mentioned receiving skin care advice after transplantation. Nonetheless, the majority of patients did not have appropriate skin cancer-prevention practices. Patients who had received advice on skin care after transplantation were significantly more likely to do skin self-examination (chi-squared test; P < 0.001) and have less sun exposure daily (Mann-Whitney test; P = 0.019) than those who did not. Half of the patients (125 patients) participated in the second part of the study 6 months after the first interview and providing skin care instruction booklet. Although regular skin self-examination and sunscreen use was significantly increased (P = 0.006 and P = 0.001, respectively), but daily sun exposure was not changed significantly (P = 0.64). Conclusions Post-transplantation education does not necessarily lead to patients' awareness about their increased risk of skin cancer, and subsequent motivation to practice effective sun protection. Health professionals and dermatologists in particular need to establish better methods of dissemination of information, repeatedly and at the proper time.