Evaluation of the Diagnostic Compliance Between Dermatologist and Patients and Factors Affecting This Agreement

Abstract

Hastan›n tan›s› ile dermatologun tan›s› aras›ndaki iliflki uyumlu, uyumsuz ve bilmeyen olmak üzere üçe ayr›ld›. Üç grupta yafl, cinsiyet, e¤itim seviyesi, hastal›k süresi ve fliddetinin etkisi istatistiksel olarak karfl›laflt›r›l›rken; uyumlu ve uyumsuz grupta ayr›ca, tan›n›n kimin taraf›ndan kondu¤u (kendisi, doktor), kendisi koydu ise bilgi kayna¤› (arkadafl, aile büyükleri, medya, kendi fikri), doktor koydu ise doktorun uzmanl›k alan› (dermatolog ve di¤er doktorlar), daha önce tedavi görmesi ve tan›d›¤› bir kiflide bu hastal›ktan olmas›n›n etkisi araflt›r›ld›. Bulgular: Hastalar›n 829'unun (%56,1) uyumlu, 278'inin (%18,8) uyumsuz tan› koydu¤u, 372'sinin (%25,5) bilmedi¤i saptand›. Genç-lerde, kad›nlarda, e¤itim seviyesi yüksek olanlarda, hastal›k süresi uzun ve fliddeti fazla olanlarda, tan›s› daha önceden dermatolog taraf›ndan konulanlar ile, bilgi kayna¤› arkadafl çevresi olanlarda, ve tan›d›¤› bir kiflide benzer hastal›ktan olmas› durumunda tan› uyumu artmaktayd›. Tan› uyumu en fazla olan hastal›klar, akne vulgaris (%95,6), tinea unguium (%82,3) ve tinea pedis (%78,9) iken, en düflük olan hastal›klar numuler dermatit (%10,2), ürtiker (%11,9) ve liken planus (%25,9) idi. Sonuç: Çal›flmam›zda sonuç olarak Türkçe'de karfl›l›¤› olan veya orijinal ismi ile kullan›lan bir hastal›¤a sahip hastalarda dermatolog-hasta tan› uyumu yüksek olarak saptanm›flt›r. (Türkderm 2011; 45: 14-8) Anahtar Kelimeler: Dermatolog, hasta, tan›, uyum Summary Background and Design: According to the ICD-coding system, 862 diseases of the cutaneous and subcutaneous tissues. Only few diseases have a Turkish equivalent or a corresponding term in Turkish language. Our aim was to investigate the diagnostic agreement between dermatologist and patients and the factors affecting this agreement. Material and Method: The study involved 1479 cooperating patients aged 18 years or above who had applied to Dermatology Outpatient Clinic of Haydarpafla Numune Training and Research Hospital between September 2009 and April 2010 and had a disease with a Turkish name or original term. The patients were divided into three groups as their diagnoses were compatible or incompatible to the dermatologist's diagnosis or were unfamiliar. The groups were compared statistically for age, gender, education level, effects of disease duration and severity. The groups showing agreement and disagreement were additionally explored for: diagnosing person (patient or physician); when diagnosed by the patient, the information source (friends, parents, media, patient's own idea); when diagnosed by a physician, the specialization field (dermatology or other specialties); previous treatment and effect of disease presence in individuals in the patient's environment. Results: It was found that 829 (56.1%) patients' diagnoses were compatible, while 278 (18.8%) were incompatible to the dermatologist's diagnosis and 372 (25.5%) were unfamiliar. The agreement between diagnoses was higher in females, youngsters, and in patients with higher education levels, longer disease duration a...