title: Predictors of patient satisfaction with initial diagnosis and management of malignant melanoma.
abstract: BACKGROUND
  Malignant melanoma (MM), accounts for around 10% of skin cancers. To date, there have been few data on patient satisfaction with initial management of MM.
  
  
  OBJECTIVE
  To identify the predictors of patient satisfaction with initial diagnosis and management of MM.
  
  
  METHODS
  Data on 214 patients were collected using a questionnaire filled in by a clinician during a face-to-face interview when the patient attended an appointment at a tertiary melanoma centre. Age, gender, ethnic origin, date of diagnosis, site of lesion, and overall stage at diagnosis and at interview were obtained from the hospital notes. Patients were asked about their satisfaction level at the end.
  
  
  RESULTS
  In total, 64 (29.9%) patients were dissatisfied with the time they had to wait to receive a diagnosis. Patients whose initial biopsy was taken by a dermatologist were more satisfied than those whose biopsy was taken by a general practitioner (GP) (P < 0.003) and women were more dissatisfied than men (P = 0.04). Delay in diagnosis (P < 0.001) and number of visits (P < 0.001) were found to be predictors for dissatisfaction in univariate analysis, but in multivariate analysis, only the number of visits (P < 0.001) was a significant predictor of patient satisfaction. For each additional visit made by the patient, the odds of dissatisfaction increased by 3.5 times, irrespective of who did the initial biopsy, any delay in diagnosis, and the age and gender of the patient.
  
  
  CONCLUSIONS
  Patients whose initial biopsy was taken by dermatologist were more satisfied than those with a biopsy taken by a GP. The number of visits was an important predictor of patient satisfaction.
authors.affiliation: Melanoma Group, Skin Tumour Unit, St John's Institute of Dermatology, St Thomas' Hospital, London, UK. nisithsheth@yahoo.co.uk
authors.forename: N
authors.initials: N
authors.lastname: Sheth
authors.forename: S J
authors.initials: SJ
authors.lastname: Sarker
authors.forename: M
authors.initials: M
authors.lastname: Harries
authors.forename: C
authors.initials: C
authors.lastname: Healy
authors.forename: R
authors.initials: R
authors.lastname: Russell-Jones
authors.forename: K
authors.initials: K
authors.lastname: Acland
mesh_terms: D001706:Biopsy; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology* / Q000523:psychology / Q000628:therapy; D011795:Surveys and Questionnaires; D013997:Time Factors