The health beliefs and behaviour of older people in relation to the early detection of skin cancer

Abstract

There is an apparent imbalance in the psychological literature towards research with young people. As the proportion of older people in the population increases, and as people live longer, this imbalance will have to be redressed. This thesis consists of three studies which were carried out to look at the early detection of slthi cancer in older people. In Study I semistructured interviews were carried out with ten men and ten women aged 55 to 87 years. Qualitative analysis revealed a number of misconceptions, and a lack of awareness of the increased risk associated with increasing age. In Study II 265 men and women aged 55 to 90 years completed structured questionnaires based on an expanded health belief model (FIBM) which incorporated specific fmdings from Study I. Results show that the expanded FIBM explained a reasonable amount of variance in skin self-examination (SSE), but a negligible amount in treatment-seeking intentions. Path analysis showed that the HBM functioned as a model to some degree, but that the variables were actually working more or less independently rather than together. The future of the HBM is discussed in terms of alternative ways in which it can be tested, and considerations which need to be taken when applying it to particular samples, such as older people. In Study ifi a sample of forty-four GPs were presented with selected items from Study II, and asked to estimate how the sample of older people had responded. The results suggested that the GPs were not sensitive to the beliefs and behaviour of the older people. However, closer inspection of the results showed a strong response bias which limited the degree to which any conclusions could be drawn from the study. Overall, the research has shown that age-related factors need to be considered when looking at preventive health behaviour.
The need to take a broader, less individualistic, approach to health behaviour is also discussed, in terms of both health promotion practice and the development of theoretical models of behaviour.