Meeting Patient Information Needs Before Magnetic Resonance Imaging: Development and Evaluation of an Information Booklet

Assessment of patients' knowledge and perceptions of MRI scans and safety in Saudi Arabia

Background

This study was conducted to assess the levels of knowledge about MRI scans and safety measures among patients in Saudi Arabia.

Methods

This cross-sectional study was conducted at nine Saudi Arabian hospitals and utilized a questionnaire comprising 22 items that evaluated patients' knowledge regarding MRI scans and safety measures, divided into four sections. The questions encompassed patients' sociodemographic data (A), knowledge about MRI (B), safety measures (C), and communication (D). Descriptive statistics were used to characterize the participant demographics and responses.

Results

Out of 446 MRI patients, 60.5% correctly identified that MRI does not involve ionizing radiation, and 78% recognized MRI as a diagnostic tool. Further, 94.2% knew that metal objects are not allowed in MRI rooms. However, 80.3% incorrectly believed that pregnant patients cannot undergo MRI at any time, 57% thought the MRI scanner is turned off when not in use, and 72.6% did not recognize any MRI-compatible devices. About 62% were unaware of the need for kidney function tests with contrast agents, and 43% reported anxiety during MRI scans. Overall, 57% of the patients had limited knowledge of MRI safety, with 39.5% considering their understanding adequate. Educational attainment and employment status were significantly associated with improved MRI knowledge. Most participants sought information from healthcare professionals.

Conclusion

This study highlights the need to educate patients about MRI procedures and safety protocols. Significant gaps remain in patients' knowledge, especially regarding safety measures. Higher levels of educational attainment and employment status were linked to greater levels of MRI knowledge, suggesting the importance of targeted educational interventions. Healthcare professionals were the patients' main information sources; nevertheless, comprehensive and accessible information is necessary. Improved communication and training for healthcare providers can enhance patient understanding and experiences during MRI scans.

"I think this could be a big success" - A mixed methods study on practitioner perspectives on the acceptance of a virtual reality tool for preparation in MRI

INTRODUCTION

A key part of a radiographer's role within MRI is providing the required emotional support to help patients succeed with a scan. Being informed is important; whilst information leaflets and videos are commonly used, these can be limited in their representation of the experience. Virtual reality tools are being shown to reasonably replicate a scan experience, having a positive impact on patient satisfaction and anxiety. The aim was to obtain the views of practitioners on the use and implementation of such a tool in practice.

METHODS

A mixed methods study was conducted looking at the use of a virtual scan experience for patients prior to MRI. Nine radiographers attended two focus group sessions to see the tool and undergo a virtual experience. Following this, a survey based on the technology acceptance model was completed along with a semi-structured discussion about its use.

RESULTS

Perceived usefulness, ease of use, attitude and intention to use were all positive towards the virtual scan tool. All practitioners saw value in such a tool and how it could be implemented within practice, highlighting areas for improvement and development.

CONCLUSION

The practitioner's perspective was that access to such a virtual scan experience could be of use to better prepare and support those patients needing extra support before a real scan. Acknowledgement of having time to discuss patient concerns was noted and this could provide a means of doing so away from busy scanning lists whilst not taking up additional time.

IMPLICATIONS FOR PRACTICE

Use of VR tools could be a conduit through which trust and rapport are built in advance away from busy scanning lists, thereby not impacting on operational throughput and hindering efficiency.

Effects of aromatherapy and music therapy on patients' anxiety during MRI examinations: a randomized controlled trial

OBJECTIVES

Many patients experience anxiety during MRI examinations. However, little attention has been focused on decreasing patient anxiety and minimizing on-site cancellations. Here, we aimed to investigate the effects of aromatherapy and music therapy on alleviating anxiety during MRI examinations.

METHODS

This single-center, double-blinded, randomized control trial was conducted between November 1, 2021, and January 10, 2022. Patients undergoing MRI examinations were assigned randomly into either the aromatherapy group (AG), music therapy group (MG), aromatherapy plus music therapy group (AMTG), or routine care group (RG) at a ratio of 1:1:1:1. Aromatherapy was conducted through inhalation of lavender oil. Music therapy was performed using Pachelbel's Canon in D major. The primary outcome was the change in anxiety before and after the MRI scan, assessed using both the State-Trait Anxiety Inventory form 1 (STAI-1) and Self-Rating Anxiety Scale (SAS). The second outcome was the participant's comfort, measured using Kolcaba's General Comfort Questionnaire (GCQ).

RESULTS

A total of 200 participants (mean age: 48.3 ± 14.9 years; 126 [63.0%] females) were enrolled, with 50 per group. The mean anxiety scores of the AMTG showed greater reduction compared with the AG, MG, and RG (ΔSTAI-1: 6.5 vs 2.6 vs 2.7 vs 1.9, p < 0.001; ΔSAS: 4.0 vs 1.4 vs 1.7 vs 0.6, p < 0.001). The mean GCQ score of the AMTG was higher compared with the AG, MG, and RG (98.0 vs 92.6 vs 91.2 vs 89.2, respectively, p < 0.001).

CONCLUSION

Aromatherapy combined with music therapy is effective for reducing patients' anxiety and improving their comfort level during MRI scans.

KEY POINTS

• In this randomized control trial of 200 participants undergoing MRI scans, aromatherapy plus music therapy is effective in reducing STAI-1 and SAS, as well as improving GCQ scores. • Although there was a significant difference between the aromatherapy plus music therapy and the single-intervention modalities, no significant differences were observed between the aromatherapy and music therapy themselves for state anxiety and comfort score. • Aromatherapy plus music therapy is a safe, non-invasive, nonpharmacological, and inexpensive patient-centered intervention for reducing anxiety and improving comfort in adults undergoing MRI examinations.

Assessment of Patient Knowledge Level Towards MRI Safety Before the Scanning in Saudi Arabia

Purpose

Magnetic resonance imaging (MRI) is an important diagnostic method in modern clinical medicine. Patients’ ‎‎knowledge about MRI is of utmost importance for optimizing the workflow, ‎safety, and patient comfort and saving valuable time for the MRI department. This study investigates patient knowledge levels regarding MRI safety before an MRI examination.

Patients and Methods

A cross-sectional survey was completed by 200 patients who required MRI. Recruitment occurred over eight weeks in ‎governmental and private hospitals in Saudi ‎Arabia; both hospitals and participants were selected randomly. The ‎questionnaire was given to the patients prior to ‎their MRI scans. Descriptive statistics and chi-square tests were performed to identify relationships between knowledge of MRI safety and selected demographic groupings (age, gender, education level, income level). It also evaluates their source of information and assesses the patient’s previous experience regarding MRI scans.‎

Results

The study sample consisted of 200 patients from 230 surveys distributed in ‎Saudi Arabia, and the response rate was ~ 87%. Depending on the P-values of the chi-square statistical test to find the relationship between ‎socio-demographic factors and patient’ knowledge level, the results showed a significant association (p-value=0.006) between age and gender and the level of knowledge relating to MRI safety issues. A similar significance (p-value=0.042) is observed between the knowledge level of patients and their educational level and annual income. In addition, a highly significant association (p-value<0.001) is found between education level or previous experience and whether people seek information about MRI safety.

Conclusion

The study findings suggest that a complex combination of factors affects patient knowledge regarding MRI safety before an MRI examination. Hence, the hospital and radiological department must ‎‎provide the ‎patient with accurate information about MRI.‎

Effects of an information booklet on patient anxiety and satisfaction with information in magnetic resonance imaging: A randomized, single-blind, placebo-controlled trial

INTRODUCTION

Magnetic resonance imaging (MRI) is an important modality in diagnostics and treatment follow-up. However, MRI can be perceived as unpleasant even though the examination is non-invasive. Patients' knowledge of the MRI procedure is usually scarce, which may enhance patient anxiety at examination. We investigated the effects on anxiety and satisfaction with an information booklet on MRI compared to a placebo booklet delivered to adult patients prior to their first MRI examination.

METHODS

This randomized, single-blind, placebo-controlled trial included 197 patients. The intervention group (n = 95) received a booklet about MRI prior to the examination, whereas the control group (n = 102) received a placebo booklet of the same size and layout but containing general information. The State Trait Anxiety Inventory with supplementary questions from the Quality from the Patient's Perspective questionnaire were used as patient-reported outcome measures.

RESULTS

Anxiety did not differ between the groups, either prior to MRI or during the examination, but those who received the placebo booklet were at higher risk of experiencing high anxiety prior to the MRI examination (odds ratio 2.64; P = 0.029). The intervention group was more satisfied with the information received (P = 0.044), and a majority of participants in both groups (≥87%) considered it important to obtain information on the MRI procedure.

CONCLUSION

Written MRI information decreases the risk of high anxiety levels before MRI and improves patient satisfaction with the information. Further research is needed to investigate whether written information prior to MRI is beneficial not only from the perspective of the patient but may also be cost-effective.

IMPLICATIONS FOR PRACTICE

Written MRI information prior to the examination is recommended in radiography care.

Quality of Care of Medical Imaging Services at a Teaching Hospital in Ghana: Clients' Perspective

BACKGROUND

The Ministry of Health of Ghana is committed to delivering client-focused, quality-driven, and results-oriented medical imaging services. However, there remained a lack of empirical evidence regarding the state of the various dimensions of quality needed to establish evidence-based strategies to strengthen the medical imaging system. This study assessed the quality of care of medical imaging services from clients' perspective at a teaching hospital in order to inform policy.

METHODS

This research was a descriptive cross-sectional study using a mixed method approach based on the dimensions of quality of care in medical imaging: capacity and sustainability, timeliness, safety, equity, patient centeredness, and effective communication.

QUANTITATIVE METHOD

A 5-point Likert scale questionnaire was used. A total of 191 clients aged ≥18 years were recruited during medical imaging services at the imaging department of the hospital. A simple random sampling technique was used to select participants. Data were analyzed using Stata version 13. Descriptive analyses were carried out.

QUALITATIVE METHODS

Purposive sampling strategy was applied to recruit 12 in-depth interview participants. Reflective interview guide starting with demographic characteristics and followed by the dimensions of quality of care was used. Qualitative data were analyzed using thematic analysis.

QUANTITATIVE RESULTS

Overall, there is low quality of care 2.8 (standard deviation [SD] = 0.6). There is low quality with regards to timeliness 2.8 (SD = 0.4), patient centeredness 2.7 (SD = 0.7), equity 2.8 (SD = 0.2), effective communication 2.7 (SD = 0.7), and safety 2.5 (SD = 0.3). Quality of care in relation to capacity and sustainability is high 3.4 (0.6). Only 73 (38.2%) of the clients are currently satisfied with the quality of care, and only 39.8% will recommend others to access care at the imaging department. Only 66 (34.6%) of clients are of the view that staff behavior instills confidence.

QUALITATIVE RESULTS

The qualitative study shows a lack of equity, timeliness, and patient-centeredness in terms of care and privacy. There is a perceived lack of compliance with radiation protection protocols, and there exist wide communication gaps between clients and staff. Furthermore, there is a lack of capacity and sustainability in relation to the reliability and availability of functional equipment. There is, however, high appraisal from clients regarding the neatness and availability of staff.

CONCLUSION

A majority of clients are not satisfied with the quality of care of the medical imaging services. Improved interaction with clients, availability of functional equipment, and effective communication during the care process between the patients and the imaging professionals such as provision of timely information during the waiting period and explanation of procedure will help enhance the quality of care.

Training health professionals in patient-centered communication during magnetic resonance imaging to reduce patients' perceived anxiety

OBJECTIVE

We examined how a patient-centered communication training program for magnetic resonance imaging (MRI) affected health professional (HP) practice and patients' perceived anxiety (PA).

METHODS

We implemented an intervention program. Six of the 17 eligible HPs completed the study. The proportion of observed desired behaviors (PODBs), including MRI procedure explanation (MRI-PE), communication, and MRI checking procedures was measured using an observation grid. We tested 182 patients (85 pre-, 58 post-, and 39 at follow-up) for PA pre- and post-MRI.

RESULTS

The Bayesian ANOVA effect size suggested moderate evidence of improvement in HP PODBs, pre- to post-intervention. Use of MRI-PE declined between post-intervention and follow-up (6 months later). Observed changes in PA, pre- to post-MRI, could be related to time constraints and perceived pressure to explain the exam in detail once institutional routines are reestablished.

CONCLUSION

In MRI units, time constraints condition the performance of HPs who address patients' PA.

PRACTICE IMPLICATIONS

"Real workplace" interventions that promote better patient-centered communication and provide each patient with a comprehensive explanation of MRI procedures also appear to improve HP PODBs.

Medical Imaging Outpatients' Experiences With Receiving Information Required for Informed Consent and Preparation: A Cross-Sectional Study

BACKGROUND

Medical imaging outpatients often experience inadequate information provision and report high levels of anxiety. However, no studies have assessed patients' receipt of preparatory information in this setting.

OBJECTIVE

To examine medical imaging outpatients' perceived receipt or non-receipt of preparatory information from health professionals and imaging department staff prior to their procedure.

METHOD

Computed tomography and magnetic resonance imaging outpatients at one Australian hospital self-completed a touchscreen computer survey assessing their perceived receipt of 33 guideline-recommended preparatory information items.

RESULTS

Of 317 eligible patients, 280 (88%) consented to participate. Eight percent (95% confidence interval: 5%-12%) of participants reported receiving all information items. The median number of information items not received was 18 (interquartile range: 8-25). Items most frequently endorsed as "not received" were: how to manage anxiety after (74%) and during the scan (69%). Items most commonly endorsed as "received" were: reason for referral (85%) and how to find the imaging department (74%).

CONCLUSION

Few medical imaging outpatients recalled receiving recommended preparatory information. Preparatory communication needs to be improved to better meet patient-centered service imperatives.

Prevalence and correlates of patient-centred preparatory information provision to computed tomography and magnetic resonance imaging outpatients: A cross-sectional study

OBJECTIVE

Responsiveness to information preferences is key to high-quality, patient-centred care. This study examined the top ten preparatory information items not delivered in accordance with medical imaging outpatients' preferences, and patient characteristics associated with reporting a greater number of unmet information preferences.

METHODS

Magnetic resonance imaging and computed tomography outpatients were recruited consecutively in one major public hospital waiting room. Participants self-administered a touchscreen computer questionnaire assessing their sociodemographic and scan characteristics, and unmet preferences for 33 guideline-endorsed preparatory information items.

RESULTS

Of 317 eligible patients, 280 (88%) consented to participate. Given equal rankings, the top ten unmet information preferences included 13 items which were endorsed by at least 25% of participants, and commonly related to receiving 'too little' information. One item related to the pre-scan period, seven items to the scan period and five items to the post-scan period. None of the patient characteristics examined were significantly associated with reporting a greater number of unmet information preferences.

CONCLUSION

There is room to improve responsiveness to medical imaging outpatients' preparatory information preferences. Improvements should be targeted at individuals, rather than groups defined by sociodemographic or scan characteristics.

PRACTICE IMPLICATIONS

A standardised approach to addressing individual patient's information preferences is needed.

The patient experience of high technology medical imaging: a systematic review of the qualitative evidence

BACKGROUND

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, dehumanisation, and an uncomfortable or unusual experience. There is now a small but worthwhile qualitative literature base focusing on the patient experience in high technology imaging. There is no current qualitative synthesis of the literature on the patient experience in high technology imaging. It is therefore timely and worthwhile to produce a systematic review to identify and summarise the existent literature exploring the patient experience of high technology imaging.

OBJECTIVES

To identify the patient experience of high technology medical imaging.

INCLUSION CRITERIA

Studies that were of a qualitative design that explored the phenomenon of interest, the patient experience of high technology medical imaging. Participants included anyone who had undergone one of these procedures.

SEARCH STRATEGY

The search strategy aimed to find both published and unpublished studies, and was conducted over a period from June - September 2010. No time limits were imposed on this search strategy. A three-step search strategy was utilised in this review.

METHODOLOGICAL QUALITY

All studies that met the criteria were selected for retrieval. They were then assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardised critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument.

DATA EXTRACTION

Data was extracted from papers included in the review using the standardised data extraction tool from the Joanna Briggs Institute Qualitative Assessment and Review Instrument.

DATA SYNTHESIS

Research findings were pooled using the Qualitative Assessment and Review Instrument.

RESULTS

Following the search and critical appraisal processes, 15 studies were identified that were deemed of suitable quality to be included in the review. From these 15 studies, 127 findings were extracted, forming 33 categories and 11 synthesised findings. These synthesised findings related to the patient experience, the emotions they felt (whether negative or positive), the need for support and information, and highlighted the importance of imaging to the patient.

CONCLUSION

The synthesised findings in this review highlight the diverse, unique and challenging ways in which people experience imaging with MRI and CT scanners. All health professionals involved in imaging need to be aware of the different ways each patient may experience imaging, and provide them with ongoing support and information.

IMPLICATIONS FOR PRACTICE

The implications for practice are derived directly from the results of the meta-synthesis, and each of the 11 synthesised findings.

IMPLICATIONS FOR RESEARCH

There is still scope for further high methodological qualitative studies to be conducted in this field, particularly in the field of nuclear medicine imaging and Positron Emission Tomography. Further studies may be conducted in certain patient groups, and in certain age ranges. No studies were found assessing the experience of children undergoing high technology imaging.