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Research Letter
April 1, 2008

Family Communication After Melanoma Diagnosis

Arch Dermatol. 2008;144(4):553-554. doi:10.1001/archderm.144.4.553

Physicians often recommend that melanoma survivors discuss family-wide physician skin screening and sun protection.1 Family discussions about melanoma are prevalent2 and can potentiate screening and sun protection.3,4 The goals of the current study are to examine processes that enhance or discourage communication about melanoma in affected families.

We recruited patients with melanoma at surgical follow-up 3 to 18 months after diagnosis of the disease. Eligible patients (English proficient; ≥ age 18 years; non–stage IV; with at least 1 child ≥ age 18 years) were approached by their surgeon and a research study assistant. Interested patients attended the study interview with one of their adult children. Nineteen family pairs (adult child and patient with melanoma) were accrued from 74 eligible families approached (Table). Patients reported choosing the child they did because the child lived locally, was seen as being at risk, or followed a health-oriented lifestyle. The qualitative study procedure involved 4 steps. Step 1 was a 5-minute, unstructured conversation to examine family health communication processes. This was followed by a semistructured interview to determine family melanoma communication processes with both the patient (step 2) and adult child (step 3), and an interview including both family members (step 4) to assess consensus on family communication about melanoma (exact questions available from J. H.). Interviews lasted 2 hours and were videotaped and audiotaped and transcribed. Guided by Grounded Theory, a common approach to developing novel social science theory from narrative data,5 we analyzed 4 interview transcripts per family (76 transcripts). We first developed a codebook through consensus coding (4 raters) of the first 12 transcripts; individual raters coded subsequent transcripts, and revisions to the codebook were resolved by team consensus.

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