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By: 1 The Joanna Briggs Institute, Faculty of Health Sciences, The University of Adelaide Adelaide, South Australia 5005

 

Medical imaging plays an important role in the patient’s journey through illness and disease. For many conditions and ailments, medical imaging, whether it is a simple chest X-ray or a complex scan, plays a pivotal role in the diagnosis and therapeutic management of illness. Diagnostic imaging may refer to a range of medical procedures, including radiographic and nuclear medicine procedures, Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Positron Emission Tomography (PET), Ultrasound (US), and Single Photon Emission Computed Tomography (SPECT), along with other imaging investigations. Medical imaging is an ever-changing field, and there have been significant advancements in imaging techniques and technologies over the years. The amount of imaging and the subsequent costs associated with it have been rising rapidly in many parts of the world for the last 30 years, leading to a larger percentage of people being exposed to these different imaging modalities. However, the improvements in imaging technology do not necessarily guarantee similar advanced inpatient care. All the different modalities used in the imaging process are highly technical in nature, with sophisticated equipment utilized in everyday practice. Due to this, the patient and patient care can often be ignored or overlooked, as the focus of the imaging, the technician is directed largely towards the technology and not the patient.

In the past, there has been an emphasis on quantitative research designs in medical imaging, resulting in a significant lack of literature on the experience of the individual that is undergoing examination. Research in medical imaging largely stems from the positivist paradigm, where hypotheses are tested through quantitative research designs. However, quantitative research designs are not always suitable to answer all questions generated from the medical imaging process, as they are limited to observations and data that can be measured and analyzed mathematically using statistical methods. For questions looking at experience, perception, meanings, understanding, and acceptance of imaging, qualitative methodologies are the most appropriate.  It is thought that the information generated from qualitative studies will support the clinician when dealing with patients, and assist in improving communication with the patient and understanding and addressing their concerns, making the procedure more acceptable to the patient.

In recent times it has been identified that there is a role for qualitative research in medical imaging, as the paradigm shifts from technology focussed to patient-focused research. The aim of this research is to ‘more clearly define what radiographers do and how they do it. Equally important is the need to identify issues relating to the patient in medical imaging, and the need to highlight the patient’s experience and perspective of health care. 

Medical imaging generates a unique interface between high-level technology and the patient and has been described as a human-technical science. This is a meeting of two worlds, with technology and machines used to improve patient outcomes on the one side, and the social encounter with the patient and provision of holistic care on the other. The machine-oriented drive towards better technology and images to improve outcomes largely sits within the positivist approach of natural sciences, whilst the patient encounter is more fitting to an interpretive approach, which can lead to increased understanding. Both of these approaches are appropriate forms of inquiry for medical imaging research, and can both be considered important and complementary to each other. The question being asked should direct the choice of the research approach. Multi-method studies, incorporating both qualitative and quantitative approaches, may be useful to inform medical imaging professionals.

There exists in the literature some discussion on the patient experience in diagnostic imaging, reported in both quantitative and qualitative studies, and in articles based on expert opinion. One example is a qualitative study utilizing grounded theory methods including twenty-six individuals who underwent Computed Tomography or Magnetic Resonance Imaging. Although many of the participants were satisfied and pleased with their care, others experienced fear and anxiety. In Magnetic Resonance Imaging, this fear has been shown to stem from claustrophobia.  Radiophobia can also be an issue for people undergoing diagnostic imaging, as they fear exposure to radiation through these procedures. 12 Another issue raised in the literature is dehumanization, as patients’ insides are transposed as images on a screen.  Another study used a phenomenological design to investigate the experience of persons with hearing disabilities in the medical imaging department. These patients encountered a wide range of difficulties during their journey through the imaging department. There were communication problems from reception and throughout the procedure, and many found their imaging distressing. Another phenomenological study investigated a patient’s lived experience of Magnetic Resonance Imaging and identified the common theme that Magnetic Resonance Imaging procedures felt like ‘being in another world. 

When presenting to an imaging department, the person who is to be imaged is often in a vulnerable state, and out of their comfort zone. It is the role of the medical imaging technician to produce a high-quality image and facilitate patient care throughout the imaging process. Qualitative research is necessary to better inform the medical imaging technician and to help them to understand the experience of the person being imaged. Some issues that have been identified in the literature include fear, claustrophobia, dehumanization, and an uncomfortable or unusual experience. There is now a small but worthwhile qualitative literature base focusing on the patient experience in medical imaging. It is therefore timely and worthwhile to produce a systematic review to identify and summarize the existent literature exploring the patient experience of diagnostic imaging.

To learn more: https://journals.lww.com/jbisrir/fulltext/2010/08081/the_patient_experience_in_medical_imaging__a.20.aspx

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Source: Institute, 1 T. J. B. (n.d.). The patient experience in medical imaging: A qualitative… : JBI evidence synthesis. LWW. Retrieved March 23, 2022, from https://journals.lww.com/jbisrir/fulltext/2010/08081/the_patient_experience_in_medical_imaging__a.20.aspx