title: Patient satisfaction with teledermatology is related to perceived quality of life.
abstract: BACKGROUND
  There is a lack of good data about patient satisfaction with teledermatology and about its potential interaction with quality-of-life factors.
  
  
  OBJECTIVE
  To assess the association between perceived skin-related quality of life and patient satisfaction with a nurse-led teledermatology service.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Primary Care, University of Manchester, Rusholme Health Centre, UK.
authors.forename: T L
authors.initials: TL
authors.lastname: Williams
authors.forename: A
authors.initials: A
authors.lastname: Esmail
authors.forename: C R
authors.initials: CR
authors.lastname: May
authors.forename: C E
authors.initials: CE
authors.lastname: Griffiths
authors.forename: N T
authors.initials: NT
authors.lastname: Shaw
authors.forename: D
authors.initials: D
authors.lastname: Fitzgerald
authors.forename: E
authors.initials: E
authors.lastname: Stewart
authors.forename: M
authors.initials: M
authors.lastname: Mould
authors.forename: M
authors.initials: M
authors.lastname: Morgan
authors.forename: L
authors.initials: L
authors.lastname: Pickup
authors.forename: S
authors.initials: S
authors.lastname: Kelly
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000523:psychology / Q000592:standards; D003152:Community Health Nursing / Q000592:standards; D003880:Dermatology / Q000458:organization & administration*; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units / Q000592:standards; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011788:Quality of Life; D019114:Remote Consultation / Q000592:standards*; D012871:Skin Diseases / Q000175:diagnosis* / Q000451:nursing / Q000523:psychology; D019037:Urban Health Services / Q000592:standards