Elysha Kolitz|Juliana Pineider|Melissa Mauskar|Audrey Rutherford
The impact of an encounter with a gynaecologic dermatologist on quality of life, health literacy and education satisfaction for patients with vulvar lichen sclerosus: A survey study
The University of Texas Southwestern Medical Center|The University of Texas Southwestern Medical Center|The University of Texas Southwestern Medical Center|The University of Texas Southwestern Medical Center
dear editor vulvar lichen sclerosus vls chronic inflammatory dermatosis severely impact quality life qol14 women vls express disappointment medical care view social justice issue2 3 reasons unsatisfactory care multifactorial societal health system conditionspecific factors implicated2 3 5 ultimately patients eager learn vls associate quality care communication treatment education2 3 however decreased health literacy negatively impacts patients healthcare experience may diminish compliance5 purpose study investigate qol health literacy education satisfaction vls patients initial encounter gynaecologic dermatologist specialist crosssectional pilot survey emailed consenting adult women referred specialist vls specialist blinded participants history physical completed including taking patient photographs appendix s1 diagnosis confirmation specialist educated patient patients photograph printed annotated reference specialist demonstrated petrolatum much topical medication use applying correct amount dorsal hand standardized handout research article individualized written directions provided appendix s1 postencounter surveys collected electronically matched preencounter surveys using anonymous identifiers survey qol measured using vulvar quality life index vqli1 health literacy assessed selfrated disease understanding management capabilities6 patients satisfaction providerpatient interactions education queried survey questions adapted health literacy survey study hidradenitis suppurativa6 likert scale satisfied completely satisfied assessed education satisfaction pre postsurveys ordinal continuous data analysed using nonparametric wilcoxon matchedpairs signed rank test graphpad prism version 900 pvalues reported tests statistical significance comparisons twotailed alpha error set 5 total 31 women vls received survey 27 871 completed presurvey 25 806 completed postsurvey matched pre postsurveys complete responses included narrowing sample size 15 485 two women identified hispanic latinx spanish origin 13 women identified whitecaucasian average age 48 encounter vqli decreased significantly indicating improvement qol p 00083 patientreported health literacy significantly improved encounter determined patientrated knowledge p 00004 ability manage p 00002 tools treat p 00005 ability explain vls p 00039 amount education provided p 00012 survey responses prior patient encounter indicated patients less satisfied previous education healthcare providers 67 patients reported satisfied 27 somewhat satisfied figure 1a encounter data showed statistically significant improvement patients satisfaction rating regarding explanation disease complications treatment goals treatment duration 53 individuals reported completely satisfied 33 satisfied figure 1b results indicated education helpful trustworthy delivered suitably overall participants acknowledged positive experience specialist compared previous medical encounters patients indicated using patients photograph education 93 demonstrating apply medication 93 demonstrating amount use 87 listening patient experiences 87 differentiating factors satisfactory specialist encounter figure 1cd distinguishing factors impacting patient education satisfaction reported patients vulvar lichen sclerosus initial gynaecologic dermatology specialist encounter factors led dissatisfaction education patients answered satisfied red n 10 somewhat satisfied yellow n 4 one patient respond b factors led satisfaction education patients answered completely satisfied green n 8 satisfied blue n 5 two patients responded either somewhat satisfied satisfied included table c different methodologies information presented given patient previous medical encounters orange versus specialist blue factors 80 n 12 15 participants selected differentiating specialist encounter previous medical encounters study confirms prior findings demonstrate vls specialist encounters lead improved qol4 furthermore study revealed specialist encounter improved patients health literacy education satisfaction previous reports show patients vls may receive adequate information education condition speciality referral2 addressing patients concerns regarding prior experience health care2 able differentiate characteristics visit increased understanding vls confidence management overall satisfaction characteristics patient demonstration topical treatments utilizing patients photograph personalized education left significant impressions patients since treatment nonadherence population relates misunderstanding treatment quantity location2 7 simple techniques described may potentially address adherence challenges5 8 hope findings implemented amongst healthcare providers encounter patients limitations pilot study include small sample size selection recall observation biases annotated patient photographs demonstrations much apply topical treatments incorporated encounters dermatologic conditions requiring topical treatments future studies assess whether techniques translate improved patient treatment adherence clinical outcomes vls would like thank dr libby edwards originally created lichen sclerosus informational handout modified dr melissa mauskar authors declare conflict interests e kolitz data curation formal analysis resources writing original draft writing review editing j pineider data curation project administration resources writing original draft writing review editing mauskar conceptualization supporting investigation methodology project administration resources supervision writing original draft writing review editing rutherford conceptualization formal analysis investigation methodology project administration resources supervision writing original draft writing review editing data sharing applicable article datasets generated analysed current study please note publisher responsible content functionality supporting information supplied authors queries missing content directed corresponding 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