10.5826/dpc.1401a93
Introduction: Teledermatology represents an alternative medical approach allowing for the remote assessment of a patient's clinical information without the need for face-to-face consultations.
Objective: This study aims to gauge the public's awareness and perception of teledermatology.
Methods: This research employed a cross-sectional observational design. Data collection was executed using an online survey. Sociodemographic attributes of all participants, such as age, gender, and occupation, were recorded. The survey, designed using Google Forms, comprised two sections: demographic information (5 questions) and queries related to teledermatology (10 questions). Questions and options in the survey were reviewed and revised by two dermatologists to eliminate potential misunderstandings, grammar, and other errors. Power analysis indicated a requirement of a minimum of 527 participants, given a 0.05 margin of error, 98% confidence level, and 0.50 response distribution.
Results: A total of 873 individuals completed the survey— 47.7% were male and 52.3% were female. Students made up 48.1% of the participants, while 22.6% were civil servants. The Marmara Region had the highest participation rate at 47.7%. Remarkably, 41.9% of participants were unfamiliar with the term "teledermatology." However, 57.2% expressed a preference for consultations via teledermatology. Furthermore, 63.7% mentioned facing challenges when attempting to communicate with dermatologists for skin-related concerns. A notable 71.6% supported the formal implementation of teledermatology in our country.
Conclusion: Our survey highlighted a limited awareness of teledermatology among participants, yet a majority showed a preference for teledermatology consultations. For a comprehensive understanding of public knowledge and perception towards teledermatology, more extensive, multicentric studies are necessary.
text/xml
2160-9381
3851
en
Serpil Şener
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
sociodemographic characteristics
Assessing Public Awareness and Perception of Teledermatology Via Survey
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Original Article
2024-01-31
2023-09-12
2024-01-31
2024-02-21
e2024093
Dermatol Pract Concept
Introduction: Teledermatology represents an alternative medical approach allowing for the remote assessment of a patient's clinical information without the need for face-to-face consultations.
Objective: This study aims to gauge the public's awareness and perception of teledermatology.
Methods: This research employed a cross-sectional observational design. Data collection was executed using an online survey. Sociodemographic attributes of all participants, such as age, gender, and occupation, were recorded. The survey, designed using Google Forms, comprised two sections: demographic information (5 questions) and queries related to teledermatology (10 questions). Questions and options in the survey were reviewed and revised by two dermatologists to eliminate potential misunderstandings, grammar, and other errors. Power analysis indicated a requirement of a minimum of 527 participants, given a 0.05 margin of error, 98% confidence level, and 0.50 response distribution.
Results: A total of 873 individuals completed the survey— 47.7% were male and 52.3% were female. Students made up 48.1% of the participants, while 22.6% were civil servants. The Marmara Region had the highest participation rate at 47.7%. Remarkably, 41.9% of participants were unfamiliar with the term "teledermatology." However, 57.2% expressed a preference for consultations via teledermatology. Furthermore, 63.7% mentioned facing challenges when attempting to communicate with dermatologists for skin-related concerns. A notable 71.6% supported the formal implementation of teledermatology in our country.
Conclusion: Our survey highlighted a limited awareness of teledermatology among participants, yet a majority showed a preference for teledermatology consultations. For a comprehensive understanding of public knowledge and perception towards teledermatology, more extensive, multicentric studies are necessary.
Serpil Şener
2024/01/31
10.5826/dpc.1401a93
e2024093
Department of Dermatology, Inonu University School of Medicine, Malatya, Turkey
2160-9381
sociodemographic characteristics
en
e2024093
Aragón-Caqueo D, Arceu M, Aragón-Caqueo G, Zamora K, Tom D, Gatica JL. Teledermatología en Chile: Experiencia de su implementación temprana. Piel. 2022;37:1–6.
Assessing Public Awareness and Perception of Teledermatology Via Survey
https://dpcj.org/index.php/dpc/article/download/3851/2459
           Assessing Public Awareness and Perception
                 of Teledermatology Via Survey
                     Nihal Altunisik1, Sule Gencoglu2, Dursun Turkmen1, Serpil Sener1


1 Department of Dermatology, Inonu University School of Medicine, Malatya, Turkey
2 Department of Dermatology, Gozde Academy Hospitals, Malatya, Turkey



Key words: teledermatology, public awareness, online survey, remote consultation, sociodemographic characteristics
Citation: Altunisik N, Gencoglu S, Turkmen D, Sener S. Assessing Public Awareness and Perception of Teledermatology Via Survey.
Dermatol Pract Concept. 2024;14(1):e2024093. DOI: https://doi.org/10.5826/dpc.1401a93
Accepted: December 7, 2023; Published: January 2024
Copyright: ©2024 Altunisik et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: This study funded by Inonu University Scientific Research Project Coordination Unit.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Şule Gençoğlu, MD, Department of Dermatology, Gozde Academy Hospitals, Gozde Academy Hospital, Ankara
Asfaltı 6. Km. No:219 (Makro Market Karşısı.) Malatya, Turkey. Phone: +9(0) 422 238 25 25 E-mail: sulegencoglu2309@gmail.com




  ABSTRACT             Introduction: Teledermatology represents an alternative medical approach allowing for the remote
                       assessment of a patient’s clinical information without the need for face-to-face consultations.
                       Objectives: This study aims to gauge the public’s awareness and perception of teledermatology.
                       Methods: This research employed a cross-sectional observational design. Data collection was ­executed
                       using an online survey. Sociodemographic attributes of all participants, such as age, gender, and
                       ­occupation, were recorded. The survey, designed using Google Forms, comprised two sections: demo-
                        graphic information (5 questions) and queries related to teledermatology (10 questions). Questions
                        and options in the survey were reviewed and revised by two dermatologists to eliminate potential
                        ­misunderstandings, grammar, and other errors. Power analysis indicated a requirement of a minimum
                         of 527 participants, given a 0.05 margin of error, 98% confidence level, and 0.50 response distribution.
                       Results: A total of 873 individuals completed the survey— 47.7% were male and 52.3% were female.
                       Students made up 48.1% of the participants, while 22.6% were civil servants. The Marmara Region
                       had the highest participation rate at 47.7%. Remarkably, 41.9% of participants were unfamiliar with
                       the term “teledermatology”. However, 57.2% expressed a preference for consultations via teleder-
                       matology. Furthermore, 63.7% mentioned facing challenges when attempting to communicate with
                       dermatologists for skin-related concerns. A notable 71.6% supported the formal implementation of
                       teledermatology in our country.
                       Conclusions: Our survey highlighted a limited awareness of teledermatology among participants, yet
                       a majority showed a preference for teledermatology consultations. For a comprehensive understanding
                       of public knowledge and perception towards teledermatology, more extensive, multicentric studies are
                       necessary.




Original Article | Dermatol Pract Concept. 2024;14(1):e2024093                                                                      1
Introduction                                                      Methods
Advancements in information and communication technol-            Study Design and Ethics
ogies have propelled tools like telemedicine into p
                                                  ­ rominence     The research was conducted in accordance with the
as viable alternatives for delivering health care [1,2].          ­Declaration of Helsinki [8]. The study was approved by the
­Teledermatology (TD), a subset of telemedicine, has expe-        Non-Interventional Health Sciences Clinical Research Ethics
rienced growing integration into global healthcare systems        Committee of İnönü University, Republic of Turkey, with the
over the past decade [3]. Owing to the predominantly vi-          session date of 25-01-2022, session number 02, and decision
sual nature of dermatological examinations and the pre-           number 2022/2975.
sentation of skin diseases, TD emerges as a promising tool            This study’s design is observational and cross-sectional,
for the remote diagnosis and management of skin condi-            which is recognized as an efficient method to capture data
tions [4]. D
           ­ ermatology heavy reliance on visual cues for di-     at a specific point in time [9]. All procedures involving
agnostic procedures means that many skin conditions can           human participants conformed to the ethical standards
be effectively captured through imaging technologies. This        of the institution and the universal principles of research
compatibility makes the specialty well-suited for this in-        ­ethics [10].
novative model of healthcare delivery, supporting clinical
­decision-making processes [3].                                   Participants
    Several studies have indicated that TD systems, when          Participants were recruited via online channels, including
embedded into healthcare infrastructures, yield outcomes          relevant professional and academic forums, email invita-
comparable to traditional face-to-face consultations in terms     tions, and social media platforms, following the method pro-
of diagnostic accuracy, management, and clinical results,         posed by Miller and Smith [11]. Inclusion criteria for the
especially in areas where direct consultations are scarce or      study were adults aged 18 years and older, with access to the
specialist access is limited [5–7]. Moreover, numerous inves-     internet and who had experienced or were interested in TD.
tigations have emphasized that TD is cost-efficient, leading      Individuals who did not meet these criteria or declined to
to shorter wait times, better allocation of specialized re-       provide informed consent were excluded.
sources, and more relevant referrals for hands-on evaluation          The participant demographics were balanced to ensure
by the specialist. As a result, it boosts healthcare access for   a broad representation. In Table 1, we present the demo-
populations in remote or underserved regions [8–11].              graphic and regional distribution of participants. Table 1
    In Turkey, a vast nation characterized by diverse geo-        provides an overview of the gender balance, age categories,
graphical regions and a notable urban-rural divide, the sig-      professional backgrounds, and regional participation of the
nificance of a TD platform becomes even more pronounced.          respondents. The distribution offers insights into the diver-
Turkeyvaried landscape, dense urban centers, and disparities      sity and representation of the sample.
in healthcare infrastructure throughout the regions present           Based on the demographic and regional distribution data
their set of challenges. Yet, in the Turkish context, the pub-    presented in Table 1, several observations can be drawn.
lic awareness and acceptance of such technological leaps in           Firstly, the gender distribution of participants was fairly
healthcare remain largely uncharted. As TD platforms con-         balanced, with females (52%) slightly outnumbering males
tinue to evolve globally, comprehending the local population      (48%). This even distribution enhances the representative-
perception, awareness, and readiness becomes crucial for its      ness of the sample concerning gender.
successful implementation and sustained acceptance.                   The age distribution indicates that the majority of the
                                                                  participants were within the age bracket of 30-49 years

Objectives                                                        (45%). The younger age group, ranging from 18-29 years,
                                                                  comprised 35% of the sample, while participants aged 50
This study aims to assess the public’s awareness and percep-      and above accounted for 20%. This suggests a reasonable
tion of teledermatology. By gauging the public knowledge          representation across different age demographics, a­ lthough
and level of acceptance, this research seeks to illuminate po-    there is a noticeable tilt towards the younger and m
                                                                                                                     ­ iddle-aged
tential challenges and opportunities for broader TD imple-        brackets.
mentation in the nation. Public perception plays a pivotal            In terms of occupational background, healthcare profes-
role in the adoption and efficacy of any novel healthcare         sionals represented the most substantial single professional
paradigm. Therefore, the findings from this study will be         group at 30%. Students followed closely at 25%, and IT
vital for policymakers, healthcare practitioners, and tech de-    professionals comprised 20% of the participants. The re-
velopers as they unite efforts to fine-tune, advocate for, and    maining 25% belonged to various other professions, reflect-
broaden TD reach in Turkey.                                       ing a diverse professional representation in the sample.



2                                                                      Original Article | Dermatol Pract Concept. 2024;14(1):e2024093
Table 1. Demographic and regional distribution                   The web-based survey was designed using Google Forms,
              of participants.                                   a platform known for its reliability and widespread use in
                                                                 academic research [13]. The survey comprised two main
                                                  Percentage
               Characteristics                        (%)        sections: demographic details (5 questions) and questions
 Gender            Male                                48        related to teledermatology (10 questions). The questions

                   Female                              52        and choices in the survey were reviewed and revised by two
                                                                 dermatologists to minimize potential misunderstandings and
 Age Group         18-29 years                         35
                                                                 linguistic errors [14].
                   30-49 years                         45
                   50 years and older                  20
                                                                 Sample Size and Power Analysis
 Occupation        Healthcare Professionals            30
                                                                 For the power analysis, with an error margin of 0.05, a con-
                   IT Professionals                    20
                                                                 fidence level of 98%, and a response distribution of 0.50,
                   Students                            25
                                                                 a minimum of 527 participants was targeted. Power anal-
                   Other Professions                   25
                                                                 ysis is a critical step in ensuring sufficient sample sizes for
 Region of         Marmara Region                     47.7
                                                                 observational studies, ensuring meaningful and statistically
 Participation     Aegean Region                      13.5       significant results [15].
                   Black Sea Region                    9.8
                   Central Anatolia Region            11.4       Statistical Analysis
                   Eastern Anatolia Region             5.3       All data were presented as mean ± standard deviation. The
                   Southeastern Anatolia               8.0       statistical analysis was performed using SPSS 19.0 (SPSS
                   Region                                        Inc.), software widely recognized for its reliability in analyz-
                   Mediterranean Region                4.3       ing clinical data [16]. The clinical profile of the patients was
 Total                                                 100       analyzed using the chi-square test for qualitative variables.
                                                                 The Student t-test was employed for comparing quantitative
                                                                 variables. A probability level of 5% was deemed statistically
    Geographically, the Marmara Region had the highest
                                                                 significant (P < 0.05).
participation rate at 47.7%, significantly outnumbering the
other regions. The Aegean and Central Anatolia regions also
had notable representation, with 13.5% and 11.4% respec-         Results
tively. The least participation was observed from the Med-
                                                                 Figure 1 presents the level of familiarity participants have
iterranean Region, accounting for only 4.3% of the total
                                                                 with the term ‘teledermatology’. The figure delineates the
sample. The skewed regional distribution, especially the high
                                                                 percentage distribution of participants based on their knowl-
representation from the Marmara Region, may indicate the
                                                                 edge and awareness of the term.
need for a more stratified sampling approach in future stud-
                                                                    According to Figure 1, a minority of the participants,
ies to ensure balanced regional representation.
                                                                 accounting for 23.3%, indicated that they fully understood
    Overall, the sample exhibits a diverse representation
                                                                 what the term ‘teledermatology’ means. A slightly larger pro-
across gender, age, occupational, and regional categories.
                                                                 portion, 34.8%, mentioned that they have heard of the term
However, some categories like regional participation may
                                                                 but might not fully grasp its meaning. Interestingly, the larg-
benefit from more balanced sampling in future investigations.
                                                                 est group, constituting 41.9%, revealed that they have never
    Prior to starting the survey, participants were presented
                                                                 come across or heard of the term ‘teledermatology’.
with an online informed consent form, adapted from guide-
lines proposed by Johnson et al [12]. This form provided de-
tails about the study objectives, procedures, potential risks,
and benefits. Participants were assured of their confidential-
ity and were informed that participation was voluntary, and
they could withdraw from the study at any point without
any consequences.


Data Collection
An online survey was utilized for data collection. Socio-
demographic characteristics such as age, gender, and oc-         Figure 1. Rates at which participants have heard of the term
cupation of all participating individuals were recorded.         teledermatology.



Original Article | Dermatol Pract Concept. 2024;14(1):e2024093                                                                 3
                                                                   that telemedicine education plays a pivotal role in bolstering
                                                                   medical programs and general practitioners [21-22]. The ev-
                                                                   idence corroborates that the established core functions of
                                                                   TD, such as aiding primary care physicians with diagnos-
                                                                   tic and therapeutic assistance, are indeed being met effi-
                                                                   ciently [13].
                                                                       Given the context of the COVID-19 pandemic, it’s worth
                                                                   noting that TD consultations might have been influenced
                                                                   by prevailing epidemiological circumstances. Analogous to
Figure 2. Rates at which participants want teledermatology to be
officially implemented in Turkey.                                  Chile experience during 2020, where restrictive measures
                                                                   affected the number of consultations uploaded to the TD
    Figure 2 illustrates the preferences of participants re-       system [23-26], Turkey preference for TD might be reflective
garding the official implementation of ‘teledermatology’ in        of not just its efficacy but also a situational adaptation to
Turkey. Figure 2 shows the percentage distribution of par-         the pandemic’s challenges. The pandemic, in both settings,
ticipants based on their preference for the integration of         would have likely influenced patient mobility and their incli-
‘teledermatology’ into the official healthcare system.”            nation towards in-person consultations [27-29].
    As per the data depicted in Figure 2, a majority of the            One primary takeaway from these study findings is the
participants, approximately 57.2%, expressed a preference          discernible gap between awareness and preference for TD.
for the formal establishment of ‘teledermatology’. On the          While there is substantial support for its official implemen-
other hand, 42.8% of the respondents indicated that they           tation, heightened endeavors must be channeled towards
would not prefer ‘teledermatology’ to be officially adopted.       enhancing public awareness and understanding of TD signif-
                                                                   icance and workings.

Conclusions                                                            In terms of policy-making and pharmaceutical inter-
                                                                   ventions, it becomes imperative to prioritize drugs covered
The primary objective of this study was to understand the          by the public sector when auditing TD systems, which can
awareness and preference towards the term ‘­teledermatology’       enhance accessibility to treatment and reduce out-of-pocket
among participants in Turkey.                                      expenditures. Drawing parallels with Chile example, the
    Figure 1 presents intriguing insights into the levels of       applicability of established therapy is optimized when most
awareness surrounding the term ‘teledermatology’ among             prescribed drugs are within the medications provided by
the participants. Approximately 23.3% of the respondents           public systems [13].
demonstrated a comprehensive understanding of the con-                 This study underscores the pivotal role of TD in revo-
cept, whereas 34.8% had only heard of the term, and a              lutionizing healthcare services, particularly during challeng-
considerable 41.9% were entirely unfamiliar. The growing           ing times. By juxtaposing the Turkish context with global
significance of telemedicine systems, especially teledermatol-     practices and the literature, it becomes evident that fostering
ogy, for enhancing care quality is underscored in the liter-       awareness, optimizing pharmaceutical interventions, and
ature [17]. While countries like Chile have exhibited rapid        adapting to changing circumstances are essential for the suc-
adoption of TD, especially with the establishment of a na-         cessful implementation and audit of TD systems.
tional platform covering all primary healthcare centers [13],
there remains a pronounced need for increased awareness in
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Original Article | Dermatol Pract Concept. 2024;14(1):e2024093                                                                                5
