RESUMO
BACKGROUND AND OBJECTIVES: This study aimed to fill the gap of evidence-based data by examining the impact of health-related digital media use's impact on the patient-physician relationship and patient journey, with the goal of driving positive changes in office-based dermatological practice. PATIENTS AND METHODS: German individuals with skin conditions completed a questionnaire assessing health-related digital media use, eHealth literacy, impact of digital media use on the patient-physician relationship and patient journey, and sociodemographic and health characteristics from June to November 2022, followed by descriptive analysis and linear regressions. RESULTS: Overall, 919 participants were analyzed (median age: 47.00, interquartile range [28.00; 61.00] years, female: 53.6%, health-related digital media users: 56.8%). Google and online encyclopedias were commonly used before and after dermatological consultations. Online self-help groups were used by 75% of non-treated participants. Digital media use had no impact on the patient-physician relationship and a positive impact on the patient journey. Positive impacts were associated with higher eHealth literacy, satisfaction with digital media quality, importance of digital media, rural residence, high education, and trust in dermatologists. CONCLUSIONS: The potential of health-related digital media in office-based dermatological care necessitates the drive of an evidence-based digital health platform to improve eHealth literacy and satisfaction with the quality of digital media among affected individuals.
Assuntos
Dermatologia , Letramento em Saúde , Humanos , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Internet , Inquéritos e Questionários , Alemanha/epidemiologiaRESUMO
BACKGROUND: Digital media are easily accessible without time restrictions and are widely used for health- or disease-related purposes. However, their influence on the patient journey and the patient-physician relationship has not yet been sufficiently investigated. OBJECTIVE: This qualitative interview study was designed to explore dermatologists' and patients' experiences with digital media for medical purposes in the context of patient journeys and patient-physician relationships. METHODS: Twenty-eight semistructured video conference-based interviews were conducted and audiorecorded by experienced interviewers between November 2021 and June 2022 in Germany. Eligible patients were those who were aged ≥18 years, were affected by at least one physician-confirmed skin disease, and were fluent in the German language. The eligibility criterion for dermatologists was that they were currently practicing dermatology in an outpatient setting or in a hospital. Randomly selected dermatologists from the listing of the German National Association of Statutory Health Insurance Physicians and dermatologists from personal academic and professional networks were invited for participation via postal mail and asked to identify potential patient volunteers from their patient bases. All recorded data were pseudonymized, fully transcribed verbatim, and subsequently analyzed according to Mayring's qualitative content analysis by 2 researchers, allowing for both a qualitative interview text analysis and a quantitative assessment of category assignments. RESULTS: In total, 28 participants were interviewed: 16 adult patients and 12 dermatologists. Eight main categories emerged as key areas of interest: (1) the search for diagnosis and symptom triggers, (2) preconsultation digital media use, (3) in-depth information and exchange with other patients, (4) self-treatment, (5) patient-physician interaction, (6) roles of dermatologists and patients, (7) patient eHealth literacy, and (8) opportunities and risks. Categories 1 and 2 were only coded for patients; the other categories were coded for both patients and dermatologists. Patients reported searches for diagnosis or treatment options were most frequently (8/16) caused by a mismatch of symptoms and diagnosis or dissatisfaction with current therapies. Concerns regarding a potentially severe diagnosis prompted searches for initial or in-depth information before or after dermatological consultations. However, the large volume of information of varying quality often confused patients, leading dermatologists to assume the role of evaluating information from preinformed patients. Dermatologists generally encouraged the use of digital media, considered teledermatology advantageous, and viewed big data and artificial intelligence as being potentially beneficial, particularly when searching for rare diagnoses. A single, easily accessible, and free-of-charge platform with high quality information in lay language was recommended by the dermatologists and desired by patients. CONCLUSIONS: Digital media are widely accepted by both patients and dermatologists and can positively influence both the dermatological patient journey and patient-physician relationship. Digital media may therefore have great potential to improve specialized health care if patients and dermatologists embrace their new roles.