Teledermatology for chronic disease management: coherence and normalization.
OBJECTIVE
To explore the importance of ;coherence' in the normalization of treatment interventions by examining teledermatology for skin disease management from the perspectives of patients and their advocates.


METHODS
Twelve teledermatology services were studied using semi-structured interviews. Participants were patients (n = 20) and health professionals, managers and patient advocates (n = 68).


RESULTS
Teledermatology lacked coherence for patients and advocates. It was seen to be different from standard dermatology care, but the objectives of it -- what it is for -- were neither clear nor understandable to participants. Teledermatology 'fitting in' with the patient's own lifeworld appeared to be unlikely for patients suffering a range of skin diseases, as features of teledermatology (e.g. absence of talk with consultant, and diagnostic uncertainty) were incongruent with the wide-ranging needs of patients and limited their participation in management.


CONCLUSIONS
Healthcare technology may facilitate greater self-management of chronic disease. However, successful normalization of technology for this purpose will require greater understanding of what it means to patients in the context of their experiences of disease and the parameters of their lives.
Finch
Tracy
T
Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK. Tracy.Finch@ncl.ac.uk
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002908:Chronic Disease; D003880:Dermatology / Q000379:methods*; D019468:Disease Management; D006801:Humans; D007407:Interviews as Topic; D008962:Models, Theoretical; D010342:Patient Acceptance of Health Care; D011369:Professional-Patient Relations; D011788:Quality of Life; D019114:Remote Consultation / Q000379:methods; D012871:Skin Diseases; D017216:Telemedicine / Q000379:methods*