Patient satisfaction with receiving skin cancer diagnosis by letter: comparison with face-to-face consultation

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 62; no. 8; pp. 1059 - 1062
• Main Authors: Karri, V, Bragg, T.W.H, Jones, A, Soldin, M, Misch, K
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.08.2009; Elsevier
• Subjects: Adult; Attitude to Health; Biological and medical sciences; Communication; Correspondence as Topic; Dermatology; Female; Humans; Letter; Male; Medical sciences; Melanoma - diagnosis; Melanoma - psychology; Middle Aged; Patient Satisfaction; Physician-Patient Relations; Plastic Surgery; Retrospective Studies; Skin cancer; Skin Neoplasms - diagnosis; Skin Neoplasms - psychology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surveys and Questionnaires; Tumors of the skin and soft tissue. Premalignant lesions; Letter; Patient satisfaction; Skin cancer; Communication; Human; Skin disease; Satisfaction; Malignant tumor; Treatment; Surgery; Consultation; Diagnosis; Face; Comparative study; Cancer
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2007.11.068

Summary Providing patients with clear and concise information is central to modern medical practice. Patients diagnosed with skin cancer are traditionally told their result by face-to-face consultation in the outpatient clinic. Previous studies have shown poor patient satisfaction with the traditional outpatient consultation. The skin oncology service at Kingston Hospital uses two different methods to inform selected patients of their skin cancer diagnosis. Those diagnosed with thin melanoma (MM) or squamous cell carcinoma (<2 cm) (SCC) are informed by letter (with an accompanying information leaflet), or seen in outpatient clinic for a face-to-face consultation. However, it is unclear which of these methods patients prefer. We performed a retrospective postal questionnaire survey to elicit the views of patients that had been informed of their skin cancer by these two methods. Patients had been diagnosed with either MM or SCC between February 2005 and March 2006. Demographic details and patient satisfaction using five-point Likert scales were determined. Of the eligible 118 patients, 90 (76%) completed the questionnaire. Questionnaires from five respondents were incorrectly completed and excluded from further analysis. Of the final 85 patients, 41 (48%) were told their diagnosis via face-to-face consultation (clinic) and 44 (52%) by letter. The demographic profile of both groups was similar ( P > 0.05). Patients of both groups had a similar expectation of being told a skin cancer diagnosis ( P > 0.05). A high level of satisfaction was expressed for both methods of communication, with no difference between the groups ( P > 0.05). In the letter group, patients placed more value on convenience than preference to seeing a doctor ( P < 0.001). The option of contacting a support nurse was also cited as a reassuring feature. The findings of this study suggest disclosure of skin cancer diagnosis by letter has high satisfaction, for selected patients. Using this method of communication may ultimately lessen the burden on outpatient service.