Qualitative research design and approaches in radiography

A review of visual ethnography: Radiography viewed through a different lens

INTRODUCTION

The objective of this article is to provide a short review of the research methodology 'visual ethnography'.

METHOD

The review article will provide a summary of the foundations of visual ethnography, outline the key debates and refer to some of the main authors working in this field.

RESULTS

Visual Ethnography is both a methodology and a method of research. It should be selected for research in radiography when research questions seek to focus upon aspects or elements of a culture. A research plan that is designed using a visual ethnographic approach should be flexible and take into account the requirements of the researcher and research participants. Visual methods of research include the use of various images, for example, photographs, collage, film or drawings. Visual methods are commonly employed together with interviews, conversations and observation. The approach enables researchers to generate new and unique insights into cultures.

CONCLUSION

This review of visual ethnography provides background information that informs an introduction to the methodology. It demonstrates a methodology with the potential to explore culture and expand knowledge of radiography practice.

IMPLICATIONS FOR PRACTICE

The authors suggest that for future studies visual ethnography is a methodology that can expand the paradigm of radiography research.

Healthcare provider and patient perspectives on diagnostic imaging investigations

BACKGROUND

Much has been written about the patient-centred approach in doctor-patient consultations. Little is known about interactions and communication processes regarding healthcare providers' and patients' perspectives on expectations and experiences of diagnostic imaging investigations within the medical encounter. Patients journey through the health system from the point of referral to the imaging investigation itself and then to the post-imaging consultation. AIM AND SETTING: To explore healthcare provider and patient perspectives on interaction and communication processes during diagnostic imaging investigations as part of their clinical journey through a healthcare complex.

METHODS

A qualitative study was conducted, with two phases of data collection. Twenty-four patients were conveniently selected at a public district hospital complex and were followed throughout their journey in the hospital system, from admission to discharge. The second phase entailed focus group interviews conducted with providers in the district hospital and adjacent academic hospital (medical officers and family physicians, nurses, radiographers, radiology consultants and registrars).

RESULTS

Two main themes guided our analysis: (1) provider perspectives; and (2) patient dispositions and reactions. Golden threads that cut across these themes are interactions and communication processes in the context of expectations, experiences of the imaging investigations and the outcomes thereof.

CONCLUSION

Insights from this study provide a better understanding of the complexity of the processes and interactions between providers and patients during the imaging investigations conducted as part of their clinical pathway. The interactions and communication processes are provider-patient centred when a referral for a diagnostic imaging investigation is included.

Action research in radiography: What it is and how it can be conducted

Action research is a form of research that investigates and describes a social or work situation with the aim of achieving a change which results in improvement. This article emphasizes the potential for action research to be a useful research method in radiography. A search was conducted to determine the extent to which action research has been utilized in radiography. Although action research has been used in a number of health-care settings, there are no published examples of action research being utilized in a clinical medical imaging department. Action research is discussed in detail, along with an example guide for an action research study. Action research has been identified as a useful way to affect change, to involve radiographers in the research process, and to introduce evidence-based practice to radiography.

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.