Centre for Health Services Research, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
Dermatology. 2020;236(2):97-104. doi: 10.1159/000505620. Epub 2020 Mar 3.
Mobile teledermoscopy is a rapidly advancing technology that promotes early detection and management of skin cancers. Whilst the use of teledermoscopy has proven to be effective and has a role in the detection of skin cancers, patients' attitudes towards the multiple ways in which this technology can be utilised has not been explored.
Data were obtained from a large randomised controlled trial comparing mobile teledermoscopy-enhanced skin self-examinations (SSEs) with naked-eye SSE. A semi-structured interview guide was developed by the investigators with questions focusing on people's previous skin screening behaviours and 2 of the major pathways which can be utilised in mobile teledermoscopy: (i) direct-to-consumer and (ii) doctor-to-doctor. All interviews were tape-recorded and transcribed verbatim. Thematic analysis was undertaken by 2 independent researchers.
Twenty-eight participants were interviewed. Eighty-six percent of participants (n = 24/28) had previously had a clinical skin examination. Only 18% of participants (n = 5/28) visited the same doctor for each clinical skin examination. Five main themes were identified in the interviews that affected how people felt about the integration of mobile teledermoscopy into skin screening pathways: history of clinical skin examinations, continuity of the doctor-patient relationship, convenience of the direct-to-consumer teledermoscopy, expedited review enhancing the doctor-to-doctor setting and mobile teledermoscopy as a partner-assisted task.
Overall mobile teledermoscopy was viewed positively for both direct-to-consumer and doctor-to-doctor interaction. Continuity of care in the doctor-patient relationship was not found to be a priority for clinical skin examination with most participants visiting several doctors throughout their clinical skin examination history.
移动远程皮肤镜检查是一种快速发展的技术，可促进皮肤癌的早期发现和管理。虽然远程皮肤镜检查的使用已被证明是有效的，并且在皮肤癌的检测中具有作用，但尚未探讨患者对该技术可以使用的多种方式的态度。
数据来自一项比较移动远程皮肤镜增强皮肤自我检查（SSE）与裸眼 SSE 的大型随机对照试验。调查人员制定了一份半结构化访谈指南，问题重点是人们以前的皮肤筛查行为以及移动远程皮肤镜检查可以利用的两种主要途径：（i）直接面向消费者和（ii）医生对医生。所有访谈均进行录音，并逐字转录。两位独立的研究人员进行了主题分析。
对 28 名参与者进行了访谈。86%的参与者（n=24/28）之前曾进行过临床皮肤检查。只有 18%的参与者（n=5/28）每次临床皮肤检查都去看同一位医生。访谈中确定了五个主要主题，这些主题影响了人们对将移动远程皮肤镜检查整合到皮肤筛查途径中的看法：临床皮肤检查的历史，医患关系的连续性，直接面向消费者的远程皮肤镜检查的便利性，加快审查增强医生对医生的环境以及移动远程皮肤镜检查作为合作伙伴辅助任务。
总体而言，移动远程皮肤镜检查无论是直接面向消费者还是医生对医生的互动都受到了积极评价。在医患关系中，护理的连续性并不是临床皮肤检查的优先事项，大多数参与者在整个临床皮肤检查历史中都看了几位医生。
