A cross-sectional study among Chinese melanoma patients was conducted between 4 Apr, 2020 and 11 Apr, 2020. The online survey link to facilitate the collection of questionnaires was distributed on social media (WeChat groups and teledermatology platforms). Every single IP address was allowed only one entry and submission in order to avoid repeated submissions by individual patients. The final submission required the patients to complete all the questions. The study was reviewed and approved by the institutional research ethics boards of Xiangya Hospital, Central South University (approval number: 202002024). Electronic informed consent was collected from all participants before the survey.
The exposure variables (employment status, income change and outdoor activity restriction) and covariates (gender, age, educational level, annual income, marital status, clinical stage of melanoma, course of melanoma, site of melanoma, current status of disease, comorbidities, adherence to treatment, and healthcare utilization) were collected. Functional Assessment of Cancer Therapy-Melanoma (FACT-M), an outcome measurement system, was use to evaluate the quality of life in melanoma patients (www.facit.org). FACT-M is composed of a core questionnaire, the FACT-General (FACT-G), and a disease-specific module including melanoma subscale (MS), and melanoma surgery scale (MSS) . In our study, the primary outcome was the FACT-G score (the sum of physical well-being (PWB), social/family well-being (SWB), emotional well-being (EWB) and functional well-being (FWB)), and the secondary outcome was the MS score. The possible score ranges of the FACT-G and MS were 0–108 and 0–64, respectively, and higher scores indicate better HRQoL. The MSS was not analyzed since not all patients received surgery. The use of the FACT-M was authorized, and the Chinese version was obtained from the copyright holder before the survey.
There was no missing data in the questionnaire survey. The data were exported from the online survey system and analyzed with R version 3.5.2. Continuous variables with normal distribution were expressed as mean ± standard deviation (SD) and compared with analysis of variance (ANOVA). Hotelling’s T2 test was used for the multivariate comparison of multiple subscale scores. Continuous data with skewed distribution were presented as median (interquartile range, IQR) and compared with Wilcoxon rank sum test. Categorical variables were summarized as counts (percentages) and compared using the chi-square test or Fisher’s exact test. Stepwise linear regression with the corrected Akaike information criteria was used to identify variables that were associated with the outcomes. The effect size of the association was presented as regression coefficient and 95% confidence interval. P-value less than 0.05 was considered statistically significant. Reporting of the results followed the STROBE guideline.