Patient drawings of their melanoma: A novel approach to understanding symptom perception and appraisal prior to health care

S.E. Scott, L. Birt, D. Cavers, N. Shah, C. Campbell, F.M. Walter

Objective: This pilot study investigated the use of patient drawings to explore patient experiences of symptoms of melanoma prior to healthcare use. Design: Patients (n=63) with melanoma were interviewed within 10 weeks of diagnosis. Participants were asked to draw what their melanoma had looked like when they first noticed it, and to make additional drawings to depict changes as it developed. Main outcome measure: The size and features of the drawings were compared between participants and with clinical data (thickness of the melanoma; histological diameter; clinical photographs). Results: 84% of participants were able to produce at least one drawing. This facilitated discussion of their lesion and recall of events on the pathway to diagnosis. Common features of the drawings related to the view, presence of shading, inclusion of sections, and the shape and border of the lesion. There was potential for disparity between the details in awareness resources and the perceptions of patients. The drawings resembled the clinical photographs and the size of the drawings was positively associated with the histological diameter, but did not differ according to tumour thickness. Conclusion: Asking patients to make drawings of their melanoma appears to be an acceptable, inclusive, feasible and insightful methodological tool.