Jun 11, 2020
Full-body skin examinations (FBSEs) are routine in dermatology
practice but can create anxiety for some patients. Dr. Vincent
DeLeo talks to Dr. Atieh Jibbe about
reducing patient anxiety caused by FBSEs based on results from
a patient questionnaire. They discuss factors that may contribute
to patient anxiety and common body areas that patients prefer to
exclude from FBSEs. They also provide tips for residents in
training. “If you walk a patient through the exam as you’re doing
it, it makes them feel a little bit more in control of the
situation rather than just unexpectedly revealing certain parts of
their body,” Dr. Jibbe explains.
We also bring you the latest
in dermatology news and research:
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Key takeaways from this episode:
- Patients may have differences in comfort level during FBSEs,
based on factors such as religious practices, the sex of the
clinician, or concerns about undressing and/or wearing a gown.
- It is important to recognize and discuss potential concerns
with patients before starting the exam. “Oftentimes, I think the
lack of acknowledgment of [a patient’s] anxiety or the lack of
acknowledgment of the fact that we are doing a sensitive exam can
make people feel more uncomfortable,” Dr. Jibbe explained.
- Results from a pre-encounter patient questionnaire indicated
there was a female predominance in exclusion of certain body parts
examined and preference for being asked what areas they wanted
examined. “Also we found that more females [reported] a [positive]
change in their anxiety level after the postexamination survey,”
Dr. Jibbe noted.
- When asked which areas to exclude from FBSEs, the genitals were
most commonly excluded among both men and women. Other areas
included the buttocks, breast/chest, legs, feet, and abdomen.
- It is important for clinicians to identify themselves as soon
as they walk into the examination room to reduce patient anxiety.
“Patients are more apt to be more comfortable if they know who you
are, your name, what your role is in the health care profession,
and what you’re doing for them,” Dr. Jibbe advises.
- Begin the exam by asking the patient to point out the areas or
lesions he/she is worried about: “That immediately gives you a
segue to go start an exam, and I feel that a patient would be more
comfortable if they’re indicating on their body what they want you
to start looking at, and then you can transition to the full-body
skin exam from there,” Dr. Jibbe says.
Hosts: Nick Andrews; Vincent
A. DeLeo, MD (Keck School of Medicine of the University of
Southern California, Los Angeles)
Atieh Jibbe, MD (University of Kansas Medical Center, Kansas
Disclosures: Dr. DeLeo is a consultant for
Esteé Lauder. Dr. Jibbe reports no conflict of interest.
Show notes by:
Alicia Sonners, Melissa Sears
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