Development and validation of a sunlight exposure questionnaire for urban adult Filipinos.

OBJECTIVES: To develop and validate a self-reported sunlight exposure questionnaire (SEQ) for urban adult Filipinos. METHODS: The study included adults (19-76 years old) in Metro Manila, Philippines, well-versed in the Filipino (Tagalog) language and had resided in Metro Manila for at least 1 year. Exclusion criteria included pregnancy, active skin disorders, and immunocompromised states. An expert panel created a questionnaire in Likert-scale format based on a conceptual framework and 4 existing instruments. The study proceeded in 4 phases: questionnaire item development, translation and back-translation, pretesting, and construct validity and reliability testing using factor analysis, the Cronbach alpha coefficient, and the paired t-test. RESULTS: A 25-item, self-administered, Filipino (Tagalog) SEQ answerable using a 4-point Likert scale was created. The questionnaire was administered to 260 adult participants twice at a 2-week interval, with all participants completing both the first and second rounds of testing. All questionnaire items possessed adequate content validity indices of at least 0.86. After factor analysis, 3 questionnaire domains were identified: intensity of sunlight exposure, factors affecting sunlight exposure, and sun protection practices. Internal consistency was satisfactory for both the overall questionnaire (Cronbach alpha, 0.80) and for each of the domains (Cronbach alpha, 0.74, 0.71, and 0.72, respectively). No statistically significant differences were observed in the responses between the first and second rounds of testing, indicating good test-retest reliability. CONCLUSIONS: We developed a culturally-appropriate SEQ with sufficient content validity, construct validity, and reliability to assess sunlight exposure among urban adult Filipinos in Metro Manila, Philippines.

Attitudes, Behaviors and Beliefs of Urban Adult Filipinos on Sunlight Exposure: A Qualitative Study.

OBJECTIVE: To explore the attitudes, behaviors, and beliefs of urban adult Filipinos on sunlight exposure as an initial step in the development and validation of a culturally-appropriate questionnaire. METHODOLOGY: Focus groups were conducted among urban Filipinos 19 years old and above (n=38). The transcribed results underwent qualitative content and thematic analyses and were used to develop a conceptual framework. RESULTS: Qualitative analysis revealed four main themes of sunlight exposure: internal influences, external influences, perceived benefits, and perceived risks. Both internal and external influences lead to perceived risks and benefits. Consequently, the perceived benefits (or lack) of sunlight exposure influence an individual's attitude towards vitamin D supplementation; whereas the perceived risks of sunlight exposure influence an individual's attitude towards the need for sun protection. CONCLUSION: The attitudes, behaviors and beliefs of urban adult Filipinos on sunlight exposure are influenced by both internal and external factors, that in turn lead to perceived risks and benefits. An increased awareness of these factors is necessary to establish future recommendations on proper sunlight exposure in this population. The study results will be used to develop and validate a culturally-appropriate sunlight exposure questionnaire.

Clinical and histopathological profile of melanoma patients seen at the Philippine General Hospital: A six-year retrospective study from 2004 to 2009

BACKGROUND: Melanoma is a malignant tumor ranked as the top cause of skin cancer death and is increasing in incidence in most races. Rarity and atypical presentation in Non-Caucasians lead to delayed diagnosis and poor survival rates in these populations. This is the first study in the Philippines to document and describe both clinical and histopathologic profile of melanoma in Filipinos. Data gathered and analyzed may be used as basis for future research on prevention and treatment of this deadly disease among Filipinos.OBJECTIVE: To determine the epidemiology, clinical and histopathologic characteristics of melanoma patients in the Philippine General Hospital.METHODS: Melanoma patient records and biopsies from the Department of Laboratories-Pathology Services and Section of Dermatology- Dermatopathology Unit of the Philippine General Hospital from 2004 to 2009 were reviewed. RESULTS: Fifty-eight melanoma cases were identified. Based on the medical records retrieved, 35% were males and 23% females, while 42% had missing information. Most were in the fifth decade with a mean age of 52.8 years. The most common sites were the feet and trunk. Seven patients had recorded metastasis. The most common histopathologic characteristics noted was presence of angiolymphoid spread (70%), followed by presence of tumor-infiltrating lymphocytes (42%), ulceration (37%), high mitotic rate (35%), neurotropism (14%) and co-existing nevus (2%). Vertical growth phase was seen in 49% while 16% had a radial growth phase.CONCLUSION: Melanoma has a lower prevalence rate in the population studied, but most presented with clinical and histopathologic features consistent with advanced stages.