Emotional Experiences of Skin Markings Among Patients Undergoing Radiotherapy and Related Factors: A Questionnaire-Based Cross-Sectional Study

Hiromi Asada,1 Yoshimitsu Takahashi,1 Yuka Ono,2 Noriko Kishi,2 Yukinori Matsuo,2 Takashi Mizowaki,2 Takeo Nakayama1 1Department of Health Informatics, Kyoto University School of Public Health, Kyoto, 606-8501, Japan; 2Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, JapanCorrespondence: Hiromi Asada, Department of Health Informatics, Kyoto University School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan, Tel/Fax +81-75-753-9479, Email asada.hiromi.62a@st.kyoto-u.ac.jpPurpose: Patients undergoing radiotherapy often have their skin marked. Previous studies on skin markings examined the durability and physical effects of the markings, but no study has focused on patients’ emotional experiences toward the markings. This study aimed to clarify how patients undergoing radiotherapy feel about skin markings, as well as factors that affect patients’ emotional experiences.Patients and Methods: We conducted a cross-sectional study using a self-administered questionnaire and medical records. Participants were patients aged ≥ 20 years undergoing cancer radiotherapy at a designated cancer care hospital. The primary outcome was the level of uncomfortable emotions toward skin markings, and the secondary outcome was the level of favorable ratings on skin markings. To examine factors related to uncomfortable emotions, ordinal logistic regression analysis was performed.Results: Questionnaire forms were distributed to 153 patients, and responses were collected from 132 (86%). Among 108 patients included in the analysis, 56% (59/105, excluding 3 who did not answer this question) responded that they were uncomfortable with skin markings. The proportion of patients who favorably rated skin markings was 63% (59/93, excluding 15 who did not answer this question). No factors were significantly associated with the primary outcome.Conclusion: Many patients accepted skin markings with resignation, as they understood the necessity of the markings in their treatment. Medical staff should understand the emotional experiences of patients toward skin markings and take sufficient care to ensure that they are provided with explanations, including the impact of skin markings on their daily lives, as well as a sense of security that treatment is being performed in a precise manner.Keywords: radiotherapy, marking, emotional experiences, questionnaire survey