Fluhr Joachim W, Gueguen Annie, Legoupil Delphine, Brenaut Emilie, Abasq Claire, Araújo Helena, Misery Laurent
Univ Brest, LIEN, Brest, France,
Department of Dermatology, CHRU Brest, Brest, France,
Dermatology. 2021 Feb 10;237(2):1-6. doi: 10.1159/000514029.
The French government imposed the first COVID-19 pandemic lockdown from March 17 until May 11, 2020. Only emergency cases and teledermatology (TD) were allowed in outpatient settings. A standardized questionnaire was developed to compare the satisfaction level of patients and their treating physicians. Our main question was whether the patients would perceive TD as a valid alternative for direct physical face-to-face consultation. Eighty-two patients and their 4 treating dermatologists from one dermatology department participated in the study (43 females, 39 males) with a mean age of 46.6 years (SD ±23.9). The reason for TD was a chronic disease in the majority (87.8%), and mainly as a follow-up (96.3%). Regarding satisfaction, almost all categories rated around 9 on a 0-10 verbal analogue scale. The same level of global satisfaction could be seen between the patients and the physicians as well as for the quality of the patient-physician relation and whether all questions could be addressed during the TC. Physicians showed significantly higher scores than patients only for the category of "length" of the consultation. Gender, age, as well as distance between the clinic and home of the patient were not influencing factors for satisfaction. Regarding the technical parameters, the evaluation was mostly comparable for patients and physicians, but overall lower than the relational satisfaction parameters, especially for image quality. Patients were significantly more motivated to continue the TD after the lockdown than their treating dermatologists. We see an interest for implementing TD in specialized centers with chronic patients coming from remote places for regular follow-ups. TD cannot replace in-person patient-physician interaction, but was helpful during the lockdown. As a result, TD might become part of dermatology training to prepare for future lockdown situations.
法国政府于2020年3月17日至5月11日实施了首次新冠疫情封锁。门诊环境中仅允许急诊病例和远程皮肤病学（TD）诊疗。我们设计了一份标准化问卷，以比较患者及其主治医生的满意度水平。我们的主要问题是，患者是否会将TD视为直接面对面咨询的有效替代方式。来自一个皮肤科的82名患者及其4名主治皮肤科医生参与了该研究（43名女性，39名男性），平均年龄为46.6岁（标准差±23.9）。进行TD诊疗的原因大多是慢性病（87.8%），主要是作为随访（96.3%）。关于满意度，在0至10的语言模拟量表上，几乎所有类别得分都在9分左右。患者和医生之间的总体满意度水平相同，患者与医生关系的质量以及在TD诊疗期间是否能解决所有问题方面也是如此。仅在咨询“时长”类别中，医生的得分显著高于患者。患者的性别、年龄以及诊所与患者家的距离都不是影响满意度的因素。关于技术参数，患者和医生的评价大多相当，但总体低于关系满意度参数，尤其是图像质量方面。封锁解除后，患者比其主治医生更有动力继续接受TD诊疗。我们发现，对于来自偏远地区的慢性病患者定期随访的专科中心而言，实施TD诊疗很有意义。TD无法取代医患面对面互动，但在封锁期间很有帮助。因此，TD可能会成为皮肤科培训的一部分，为未来的封锁情况做好准备。
