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Social media has emerged as a common source of dermatological information. Monitoring the patterns of social media use and engagement is important to counteract the limitations of social media. However, evidence in Vietnamese dermatology patients is lacking.
This study aimed to explore social media use and engagement by dermatology patients and to identify factors associated with social media use and engagement.
A cross-sectional study was conducted with 519 participants at the Vietnam National Hospital of Dermatology and Venereology during September to November 2018. Data about sociodemographic characteristics, social media use, and social media engagement were collected. Multivariate logistic and tobit regression models were used to identify factors associated with social media use and engagement.
Interest in information about “cosmetic, beauty, and skincare techniques” was the greatest (184/519, 46.2%). The mean engagement score was 8.4 points (SD 2.4 points). Female patients were more likely to use social media (odds ratio [OR] 2.23, 95% CI 1.23-4.06) and be interested dermatological information on social media (OR 3.09, 95% CI 1.35-7.09). Women also had higher social media engagement scores (coefficient=0.68, 95% CI 0.17-1.18). Higher social media engagement scores were related with Instagram use (coefficient=0.58, 95% CI 0.00-1.15) and higher credibility scores for “family members” (coefficient=0.15, 95% CI 0.03-0.26) and “dermatology companies” (coefficient=0.22, 95% CI 0.04-0.39).
This study discovered high social media usage among dermatology patients. However, only moderate utilization and credibility levels were reported regarding the use of social media as a source of dermatological information. More efforts should focus on involving dermatologists in the development of individualized information on social media targeting specific groups of dermatology patients.
Dermatological diseases are popular health issues and the leading causes of disability and mortality worldwide. Skin diseases contributed to 1.79% of the global burden of diseases in 2017; of the skin diseases, dermatitis, acne vulgaris, psoriasis, and urticaria represented the greatest burden [
Internet has played a key role in health care by reducing the cost of health service delivery [
Social media is well-recognized as a useful aid for health care providers to communicate and support patients [
Social media is frequently used by patients to solicit advice related to dermatological concerns, has the potential to advance professional training in dermatology, and can facilitate new research methods [
Vietnam is among the countries with a high burden of dermatological diseases. A recent estimate indicates that skin disorders accounted for 2.3% of the disease burden in Vietnam in 2017 [
A cross-sectional study was performed at the Vietnam National Hospital of Dermatology and Venereology (NHDV) from September to November 2018. The NHDV was chosen due to the diversity of dermatology illnesses and the background of treated patients. As a leading hospital for dermatology and venereology diagnosis and treatment in Vietnam, the NHDV receives patient referrals from health facilities at various levels. A convenient sampling technique was adopted to recruit participants for this study. Sample size calculation was conducted using inputs determined based on a study of a similar topic in 13 European countries [
We built a structured questionnaire to collect data concerning the sociodemographic status of participants and their social media use and engagement regarding dermatological issues and information. The questionnaire also assessed various aspects of health status and service utilization, based on data from other studies exploring these topics [
Data about age, gender, education, marital status, occupation, and living location were collected.
In this study, we collected information about the type of social network sites the participants visited and used frequently for dermatology care (eg, What are the social media sites that you use frequently for dermatology care?) and the types of dermatological information in which they were interested to find online. In addition, we asked the participants to rate the credibility of the dermatological information sources on social media including family members, friends/relatives, celebrities (including medical professionals/clinics), television programs/magazines, dermatological product retailers (people who sell dermatology-related products), and dermatology companies (companies manufacturing and selling dermatology-related products). To obtain the credibility score, each source was rated on a scale from 0 points (Totally not credible) to 10 points (Totally credible).
Data on social media engagement were collected using three questionnaire items: searching for dermatological information on social media, sharing dermatological information on social media, and applying dermatological information obtained from social media. Each item used a Likert scale with five response levels: “always” (5 points) to “never” (1 point). Then, we calculated the engagement score by summing the scores of the three items. The highest possible score was 15 points, and the lowest possible score was 3 points. This approach was adapted from the Social Media Engagement theory [
We analyzed the data using Stata version 15.0 (Stata Corp. LP, College Station, TX). Multivariable logistic regression analysis was used to determine the factors correlated with social media use and interest in any dermatological information on social media. Multivariable tobit regression analysis was used to identify the factors associated with the engagement score. Potential explanatory variables included sociodemographic characteristics (age, gender, education, marital status, and occupation), social network platforms, and the credibility score. Stepwise forward selection strategies were combined with the multivariable regressions to reduce the models. A value of 0.2 of the log-likelihood’s
The Institutional Review Board of the NHDV approved the study protocol (document number 855/HDDDBVDLTU dated September 7, 2018).
Of the 519 dermatology patients participating in the study, 62.8% (326/519) resided in urban areas. The mean age was 35.7 years (SD 13.7 years), and the greatest proportion of participants was 18-30 years old. Participants were mostly women (282/506, 55.7%), had completed at least a vocational education (341/517, 66.0%), and were married or had a partner (323/518, 62.4%). The most commonly reported occupation was freelancing (176/518, 34.0%), followed by white-collar job (145/518, 28.0%). Atopic dermatitis accounted for the greatest proportion of dermatology diseases (127/519, 24.4%), followed by contact dermatitis (75/519, 14.5%) and skin fungal infections (57/519, 11.0%;
Facebook (359/392, 91.6%) and Zalo (247/392, 63.2%) were the most commonly used social media platforms. Information about “cosmetic, beauty, and skin care techniques” was sought by the most participants (184/397, 46.3%), followed by “general information about dermatology diseases” (168/397, 42.5%) and “medical institutions for dermatology disease treatment” (132/397, 32.6%). Regarding the credibility score of information sources on social media, “family members” and “television programs/magazines” scored the highest (mean 6.9 points, SD 2.3 points; mean 6.9 points, SD 2.2 points, respectively). Information from dermatological product retailers scored the lowest (mean 4.8 points, SD 2.3 points). No differences were found between men and women regarding the credibility of information sources or the social network platforms used (
Sociodemographic and clinical characteristics of the participants, N=519.
Characteristics | n (%) | ||
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Urban | 326 (62.8) | |
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Rural | 193 (37.2) | |
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18-30 years | 239 (47.1) | |
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31-40 years | 114 (22.5) | |
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41-50 years | 72 (14.2) | |
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51-60 years | 46 (9.1) | |
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>60 years | 36 (7.1) | |
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Male | 224 (44.3) | |
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Female | 282 (55.7) | |
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Up to secondary school | 73 (14.1) | |
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Upper secondary school | 103 (19.9) | |
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Vocational education and higher | 341 (66.0) | |
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Single | 195 (37.6) | |
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Having a partner/married | 323 (62.4) | |
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Unemployed | 13 (2.5) | |
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Freelancer | 176 (34.0) | |
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White-collar worker | 145 (28.0) | |
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Blue-collar worker | 70 (13.5) | |
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Student | 62 (12.0) | |
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Other | 52 (10.0) | |
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Atopic dermatitis | 127 (24.4) | |
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Contact dermatitis | 75 (14.5) | |
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Psoriasis | 29 (5.6) | |
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Skin infections | 13 (2.5) | |
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Skin fungal infections | 57 (11.0) | |
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Urticaria | 44 (8.5) | |
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Warts | 16 (3.1) | |
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Zona | 31 (6.0) | |
Age (n=507), years | 35.7 (13.7)a |
aMean (SD).
Social media use among dermatology patients, with comparisons between genders.
Characteristics | Total sample | Men | Women | ||
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Yes | 393 (79.7) | 156 (71.9) | 237 (85.9) | .00a |
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No | 100 (20.3) | 61 (28.1) | 39 (14.1) |
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Facebook (n=392) | 359 (91.6) | 144 (92.3) | 215 (91.1) | .67a |
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Instagram (n=391) | 103 (26.3) | 35 (22.4) | 68 (28.8) | .16a |
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Zalo (n=392) | 247 (63.2) | 89 (57.4) | 158 (66.9) | .06a |
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Other (n=392) | 18 (4.6) | 5 (3.2) | 13 (5.5) | .29a |
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Cosmetic, beauty, and skin care techniques (n=397) | 184 (46.3) | 30 (19.1) | 154 (64.2) | <.001a |
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Medical institution for cosmetic surgery or beauty salons (n=397) | 95 (23.9) | 18 (11.5) | 77 (32.1) | <.001a |
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Beauty or cosmetic surgery experts (n=397) | 60 (15.1) | 10 (6.4) | 50 (20.8) | .10a |
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General information about dermatology diseases (n=397) | 168 (42.3) | 68 (43.3) | 100 (41.7) | .75a |
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Preventive methods for dermatology disease (n=397) | 90 (22.7) | 41 (26.1) | 49 (20.4) | .19a |
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Treatment methods for dermatology diseases (n=397) | 95 (23.9) | 41 (26.1) | 54 (22.5) | .41a |
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Medical institutions for dermatology disease treatment (n=397) | 132 (33.2) | 51 (32.5) | 81 (33.8) | .79a |
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Medication for dermatology disease treatment (n=397) | 128 (32.2) | 54 (34.4) | 74 (30.8) | .46a |
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Treatment experiences from people who had undergone dermatology disease treatment (n=397) | 80 (20.2) | 28 (17.8) | 52 (21.7) | .35a |
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Others (n=396) | 8 (2.0) | 3 (1.9) | 5 (2.1) | .91a |
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Family members (n=397) | 6.9 (2.3) | 7.1 (2.1) | 6.8 | .33b |
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Friends/relatives (n=392) | 6.5 (2.1) | 6.5 (2.1) | 6.5 | .60b |
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Celebrities (including famous medical professionals) (n=387) | 5.7 (2.4) | 5.7 (2.4) | 5.7 | .66b |
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Television programs/magazines (n=399) | 6.9 (2.3) | 7.1 (2.1) | 6.8 | .19b |
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Dermatological product retailers (n=386) | 4.8 (2.3) | 4.9 (2.3) | 4.8 | .65b |
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Dermatology companies (n=390) | 5.2 (2.4) | 5.1 (2.3) | 5.2 | .92b |
aChi-squared test.
bMann-Whitney test.
Engagement with social media among dermatology patients, with comparisons between genders.
Characteristics | Total sample | Men | Women | ||
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No | 19 (4.8) | 10 (6.3) | 9 (3.8) | .24a |
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Yes | 380 (95.2) | 149 (93.7) | 231 (96.3) |
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No | 74 (18.6) | 36 (22.8) | 38 (15.9) | .09a |
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Yes | 323 (81.4) | 122 (77.2) | 201 (84.1) |
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No | 58 (14.6) | 30 (18.9) | 28 (11.8) | .05a |
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Yes | 339 (85.4) | 129 (81.1) | 210 (88.2) |
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Very useful | 47 (11.8) | 17 (10.8) | 30 (12.4) | .39a |
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Useful | 182 (45.6) | 73 (46.2) | 109 (45.2) |
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Neutral | 154 (38.6) | 58 (36.7) | 96 (39.8) |
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Not useful | 14 (3.5) | 9 (5.7) | 5 (2.1) |
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Completely not useful | 2 (0.5) | 1 (0.6) | 1 (0.4) |
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Social media engagement score, mean (SD) (n=399) | 8.4 (2.5) | 8.0 (2.7) | 8.7 (2.2) | .00b |
aChi-squared test.
bMann-Whitney test.
The results of three multivariable regression models are displayed in
Respondents who were married/had a partner had a higher likelihood of being interested in dermatology information (OR 2.37, 95% CI 1.01-5.53). Regarding social media engagement, higher scores were present for patients using Instagram and who rated the credibility of “family members” and “dermatology companies” higher. Meanwhile, lower social media engagement scores were related with higher credibility scores for dermatological product retailers.
Factors associated with social media use and engagement in multivariable regression models.
Characteristics | Uses social media | Interest in any dermatological information on social media | Social media engagement score | ||||||||
ORa | 95% CI | OR | 95% CI | Coefficient | 95% CI | ||||||
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Male | refb | —c | — | ref | — | — | ref | — | — | |
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Female | 2.23 | 1.23-4.06 | .008 | 3.09 | 1.35-7.09 | .008 | 0.68 | 0.17-1.18 | .009 | |
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18-30 years | ref | — | — | — | — | — | — | — | — | |
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31-40 years | 0.45 | 0.16-1.27 | .132 | — | — | — | — | — | — | |
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41-50 years | 0.07 | 0.03-0.19 | .000 | — | — | — | — | — | — | |
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51-60 years | 0.02 | 0.01-0.06 | .000 | — | — | — | — | — | — | |
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>60 years | 0.01 | 0.00-0.04 | .000 | — | — | — | — | — | — | |
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Unemployed | ref | — | — | — | — | — | — | — | — | |
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Freelancer | 1.48 | 0.16-13.61 | .729 | — | — | — | — | — | — | |
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White-collar worker | 1.68 | 0.18-15.73 | .648 | — | — | — | — | — | — | |
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Blue-collar worker | 0.40 | 0.04-3.81 | .428 | — | — | — | — | — | — | |
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Student | 0.85 | 0.07-9.81 | .894 | — | — | — | — | — | — | |
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Other | 1.74 | 0.16-18.57 | .648 | — | — | — | — | — | — | |
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Urban | — | — | — | ref | — | — | — | — | — | |
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Rural | — | — | — | 2.24 | 0.74-6.83 | .156 | — | — | — | |
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Single | — | — | — | ref | — | — | — | — | — | |
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Married | — | — | — | 2.37 | 1.01-5.53 | .047 | — | — | — | |
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No | — | — | — | ref | — | — | ref | — | — | |
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Yes | — | — | — | 2.82 | 0.85-9.37 | .090 | 0.64 | –0.26-1.55 | .163 | |
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No | — | — | — | — | — | — | ref | — | — | |
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Yes | — | — | — | — | — | — | 0.58 | 0.00-1.15 | .049 | |
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Family members | — | — | — | — | — | — | 0.15 | 0.03-0.26 | .012 | |
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Dermatological product retailers | — | — | — | — | — | — | –0.19 | –0.38-0.00 | .049 | |
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Dermatology companies | — | — | — | — | — | — | 0.22 | 0.04-0.39 | .016 |
aOdds ratio.
bReference group.
cNot applicable.
Our study found that, despite social media use by a high proportion of dermatology patients, utilizing this platform as a source of credible information for dermatological issues remains modest. Women were more likely to be interested in dermatological information on social media and be engaged with social media. The findings suggest that increased dermatologist involvement in contributing to online dermatological content and more effort to develop targeted, individualized information should be considered to take advantage of social media platforms.
Previous studies have documented the modest use of social media to find or share health-related content and particularly dermatology-related information. Despite reportedly high general social media engagement (85.0-99.3% of the participants reported regular access of at least one social media platform), only 19.0-31.7% of the participants reported accessing dermatology-related information [
The higher percentage of use found in our study may reflect the increased popularity of social media in health care, due to technological advances and recent changes in the public perception of social media [
Regarding the sources of dermatological information on social media sites, our findings showed that the highest credibility scores were given to information received from family members, friends, televisions programs, and magazines. This popularity of informal information sources further highlights the lack of active contribution from dermatological health care providers and dermatologists to health information online. Dermatologists have expressed concern that patients might be misled by other social media indicators (eg, number of followers) without checking the educational background and clinical experience of information providers [
In addition, the sociodemographic characteristics of our participants were associated with their level of concern regarding dermatological information on social media and social media engagement. Women, married respondents, and Facebook users were more likely to be interested in dermatological issues on social media. These findings suggest that Facebook, in particular, could serve as the primary social media platform for disseminating dermatological information to targeted groups of online users. For example, this information could focus on dermatological issues that are most relevant to women and married individuals. Previous studies have argued the potential of Facebook for knowledge distribution, owing to its large user base, versatility in providing information in various forms, and capacity to allow for interactions and connections between users [
One of the implications that can be drawn from our findings is that the presence of dermatologists on social media platforms to provide official, scientific, evidence-based dermatological information should be increased. To facilitate this, the marketing capabilities of dermatology health facilities should be enhanced, so they can reach a wider population. And, patient-physician communication should be encouraged through social networking sites, notably Facebook, with careful consideration of privacy protection measures. The adoption of the Law on Cybersecurity in Vietnam provided stricter regulations on the content and transfer of data online and can be expected to impact the extent of online channel use by both patients and physicians. This should be taken into consideration when designing communication and education campaigns and programs. Regarding content, dermatological information should be created and distributed in an individually customized manner, targeting specific groups with relevant information.
This study has certain limitations. First, the self-reported nature of the questionnaire may have introduced recall bias. Second, although effort was made to enhance the diversity of participants by conducting research at a central dermatological hospital, the adoption of a convenient sampling technique and the fact that the study was conducted at a single hospital could affect the generalizability of our study. In addition, although the instrument we used to measure social media engagement has a theoretical background and provides valuable insights on the topic, it has not been officially validated. There are also several possible research considerations and directions not yet covered in our study that may be recommended for further studies. Further research may benefit from studying other online media platforms such as Google and YouTube that have considerable influence on dermatology patients in developed countries [
In conclusion, this study found high levels of social media use among dermatology patients, but only a moderate level of utilization and credibility regarding the use of social media as a source of dermatological information. Sociodemographic characteristics were associated with dermatology-related social media use and engagement. The results of this study recommend enhancing the involvement of dermatologists on social media platforms, in terms of knowledge contribution through social media for both patients and the general public. In addition, more efforts should be given in developing individualized information that targets specific groups of dermatology patients.
National Hospital of Dermatology and Venereology.
odds ratio.
Our thanks to Vietnam National Hospital of Dermatology and Venereology that gave us permission and support to conduct this study. In addition, we are grateful to all the patients who gave us their time and willingness to participate in this study.
None declared.