Williams T L, Esmail A, May C R, Griffiths C E, Shaw N T, Fitzgerald D, Stewart E, Mould M, Morgan M, Pickup L, Kelly S
School of Primary Care, University of Manchester, Rusholme Health Centre, UK.
Br J Dermatol. 2001 Dec;145(6):911-7. doi: 10.1046/j.1365-2133.2001.04472.x.
There is a lack of good data about patient satisfaction with teledermatology and about its potential interaction with quality-of-life factors.
To assess the association between perceived skin-related quality of life and patient satisfaction with a nurse-led teledermatology service.
In a mobile nurse-led teledermatology clinic located in four inner city general practices in Manchester, the teledermatology service used digital cameras to capture and store images of skin conditions for remote diagnosis by dermatologists. One hundred and twenty-three adult patients, non-urgent dermatology referrals from primary care, completed the Dermatology Life Quality Index (DLQI) and a 15-item patient satisfaction questionnaire.
In common with other studies of patient satisfaction, subjects reported highly favourable views of 'hotel' aspects of the service (93%) and found it 'convenient' (86%). However, 40% of patients would have preferred to have had a conventional face-to-face consultation with a dermatologist, and 17% felt unable to speak freely about their condition. Patient satisfaction with the service was related to quality of life. Patients reporting lower quality of life as measured by the DLQI were more likely to prefer a face-to-face encounter with a dermatologist (r = 0.216, P < 0.05), and to evince anxiety about being photographed (r = 0.223, P < 0.05).
Patient acceptance and satisfaction with telemedicine services is complicated by patients' subjective health status. Telehealthcare providers need to recognize that patients with poor quality of life may want and benefit from face-to-face interaction with expert clinicians.
关于患者对远程皮肤病学的满意度及其与生活质量因素的潜在相互作用,缺乏可靠的数据。
评估感知到的皮肤相关生活质量与患者对护士主导的远程皮肤病学服务的满意度之间的关联。
在位于曼彻斯特四个市中心全科诊所的移动护士主导的远程皮肤病学诊所中,远程皮肤病学服务使用数码相机拍摄和存储皮肤状况图像,以供皮肤科医生进行远程诊断。123名成年患者,即来自初级保健的非紧急皮肤科转诊患者,完成了皮肤病生活质量指数(DLQI)和一份包含15个项目的患者满意度问卷。
与其他患者满意度研究一样,受试者对服务的“体验”方面给予了高度评价(93%),并认为其“方便”(86%)。然而,40%的患者更希望与皮肤科医生进行传统的面对面咨询,17%的患者觉得无法自由谈论自己的病情。患者对该服务的满意度与生活质量相关。根据DLQI测量,生活质量较低的患者更倾向于与皮肤科医生进行面对面会诊(r = 0.216,P < 0.05),并且对被拍照表现出焦虑(r = 0.223,P < 0.05)。
患者的主观健康状况使患者对远程医疗服务的接受度和满意度变得复杂。远程医疗服务提供者需要认识到,生活质量较差的患者可能希望与专家临床医生进行面对面交流并从中受益。