Student radiographers' attitudes towards the older patient – A longitudinal study

Towards an improved dementia care experience in clinical radiography practice: A state-of-the-art review

INTRODUCTION

The increasing global incidence rate of dementia and associated co/multimorbidity has consequently led to a rise in the number of people with dementia (PwD) requiring clinical radiography care services. This review aims to explore and integrate findings from diverse settings with a focus on the experiences of PwD and stakeholders, towards the development of a holistic approach for dementia care and management within the context of radiography services.

METHOD

An electronic search was performed across the following databases: PUBMED, CINAHL, Medline, SCOPUS, and ScienceDirect for articles published from January 2009 and June 2023. Articles were included if they fulfilled a predefined criteria mainly focused on experiences of PwD and/or other stakeholders when using the radiography services. Data obtained from the included studies were analysed using a result-based convergent synthesis.

RESULT

Eleven studies from diverse settings met the inclusion criteria. A mix of both positive and negative experiences of PwD and stakeholders were reported following visits to radiology and radiotherapy departments were highlighted across settings. The findings were themed around the need for: person-centred care, effective communication, attitudinal changes of staff, specialised and improved clinical environment and inclusion of caregivers for the care of PwD.

DISCUSSION

This study emphasise the critical importance of adopting holistic approaches to caring for PwD. This involves adopting a person-centred approach, actively involving caregivers, effective communication, and adequate training for radiographers to provide quality services, all in dementia-friendly environments.

CONCLUSION

The experiences of various stakeholders highlight the need for a more holistic approach and strategy for the care and management of PwD within the context of the radiography services. This calls for an urgent need for a comprehensive strategy that includes awareness creation of staff to enhance the quality of care and the overall experience for PwD using the radiography services.

Radiographers' experiences in working with patients living with dementia in Norway - A qualitative study

INTRODUCTION

Imaging departments are seeing an increase in the number of patients living with dementia (PWD), driven by the ageing population and diagnostic benefits offered by medical imaging. This study explored radiographers' experiences during imaging examinations for PWD.

METHODS

A semi-structured interview guide comprising questions about radiographers' experiences, knowledge concerning PWD, challenges faced, and departmental initiatives was developed. Eight radiographers were interviewed, four working in MRI or general imaging, including CT and four in nuclear medicine, at three hospital trusts in Norway. Data analysis was conducted using inductive content analysis as described by Elo and Kyngäs, following a three-step process of preparation, organising and reporting. The qualified radiographers coded, categorised, and defined the themes and sub-themes to report on the findings.

RESULTS

Three main categories emerged: 1. Radiographers' experiences, which included overall challenges and the radiographers' attitudes. 2. Measures undertaken, outlining the actions radiographers take during procedures, and 3.Competencies, highlighting the knowledge possessed by radiographers. Organisational challenges, such as the absence of overarching protocols and insufficient training for radiographers related to PWD, posed difficulties in effectively conducting procedures. Creating a calm environment, collaborating with caregivers, scheduling adequate time for examinations, and possessing good communication skills were viewed as facilitators for conducting examinations successfully.

CONCLUSION

Radiographers perceived imaging of patients living with dementia to be generally uncomplicated. However, challenges in planning for and communicating with patients, particularly for advanced examinations or acute settings, were reported. Establishing dementia-friendly departments and training radiographers in specific communication techniques could be beneficial.

IMPLICATIONS FOR PRACTICE

There is a need for more dementia-friendly imaging departments and communication training for radiographers working with PWD.

Delivering person-centred dementia care: Perceptions of radiography practitioners within diagnostic imaging and radiotherapy departments

INTRODUCTION

Despite abundant literature on the diagnosis of dementia, limited research has explored the lived experiences of radiography practitioners when providing care to people living with dementia in the department.

OBJECTIVES

This qualitative study explored the perceptions and compatibility of current professional guidance by both diagnostic imaging and radiotherapeutic radiography practitioners as well as the key stakeholders involved with developing the Society and College of Radiographers clinical practice guidelines for caring for people with dementia.

METHODS

This was a two-phase multi-method study. Fifteen diagnostic imaging and two therapeutic radiography practitioners from across the UK participated with online focus group discussions. Four key stakeholders involved with the development of the Society and College of Radiographers guidelines took part with individual semi-structured interviews. Data analysis included narrative and thematic analysis.

RESULTS

Participants from both phases identified enablers and barriers to providing person-centred dementia care. Three superordinate themes were identified linked to (1) Working with care partners, (2) Departmental environmental design, and (3) Communication and interprofessional infrastructure.

DISCUSSION

Many radiography practitioners still feel unprepared when caring for people living with dementia despite the clinical practice guidelines. Care partners were identified as having the potential to help alleviate some of the challenges radiographers faced. Participants were also aware of the impact of the departmental environment and recognised that poor way finding designs could lead to frustration. Radiography practitioners were not always aware that a patient was living with dementia prior to their attendance in the department making it difficult for practitioners to make appropriate accommodations such as additional time at appointments or the departmental environment. Our findings suggest there is a need for profession specific education and training for radiography practitioners to support the provision of person-centred dementia care. There is also a need to support the design of dementia friendly diagnostic imaging and radiotherapy departments.

Optimising care and the patient experience for people living with dementia: The perceptions of radiography practitioners

INTRODUCTION

Despite abundant literature on the diagnosis of dementia, limited research has explored the lived experiences by radiography practitioners when delivering care to people living with dementia (PLWD). This study explored the perceptions and compatibility of current professional guidance by both radiography practitioners and key stakeholders involved in developing the Society and College of Radiographers clinical practice guideline document for caring for people with dementia.

METHODS

This was a two-stage qualitative multi-method study. Fifteen diagnostic and two therapeutic radiography practitioners from across the UK participated with three asynchronous online discussion forums. One core member and three members from the key stakeholder group participated with individual semi-structured interviews. Data analysis included narrative and thematic analysis.

RESULTS

Participants from both stages identified enablers and barriers to providing person-centred care (PCC) to PLWD. Three superordinate themes were identified linked to (1) Challenges in delivering person-centred care to people living with dementia, (2) The need for role specific education and training, and (3) Partnership working with carers. Challenges in delivering care included time and resource pressures. The lack of dementia specific education compounded these difficulties. Care partners were seen as an asset to providing care.

CONCLUSION

Providing PCC to meet the individual needs of PLWD can be challenging in practice. This is often due to time and resource implications. There were also issues with the identification of PLWD prior to their attendance in the department. Carers could help to alleviate some challenges. There is a need for profession specific education and dementia awareness training to support the provision of PCC to PLWD.

IMPLICATIONS FOR PRACTICE

Dementia training needs to be specifically tailored for radiography practitioners to bridge the gap between guidelines and clinical practice rather than being generalised from other disciplines.

Simulation-based holistic education in physiotherapy interns to increase empathy toward older adults and individuals with disabilities

Background

The proportion of older adults and individuals with disabilities in the general population increases each year. Thus, clinical clerkships designed for physiotherapy interns should provide more than simply knowledge and skills. For such interns to be able to handle the requirements of their future jobs, clerkships must enable them to develop empathy and positive attitudes toward patients. This study investigated the effect of simulation-based, holistic health-care education on physiotherapy interns’ empathy, attitudes, and knowledge. 

Methods

A parallel-group design. Thirty physiotherapy interns from a medical institution were enrolled as participants, with experimental and control groups each comprising 15 participants. Both groups received standard clinical training. However, the experimental group received an additional 3.5 h of simulation-based holistic health-care education. The Jefferson Scale of Empathy, Kogan’s Attitudes Toward Old People Scale, the Attitudes Towards the Elderly Scale, the Knowledge About Aging Scale, Knowledge of the Situation of Older People Scale, Perceptions of Working with Older People Scale, and Care Willingness Scale were used in a pretest and posttest.

Results

After the intervention period, we observed substantial between-group differences of 6.4 points on the Jefferson Scale of Empathy (p = 0.001), 7.7 points on Kogan’s Attitudes Toward Old People Scale (p = 0.002), 3.5 points on the Attitudes Toward the Elderly Scale (p = 0.002), 2.5 points on Knowledge About Aging (p = 0.055), 4.5 points on the Knowledge of the Situation of Older People Scale (p < 0.001), and 2.1 points on Perceptions of Working with Older People Scale (p = 0.046).

Conclusion

Simulation-based, holistic health-care education can significantly improve the empathy, knowledge, and attitudes of physiotherapy interns.

The impact of ageing simulation education on healthcare professionals to promote person-centred care towards older people: A literature review

AIM

This review aimed to explore the impact of ageing simulation for healthcare professional education to promote person-centred care towards older people.

BACKGROUND

Ageing simulation is an emerging educational approach to facilitate the learning of healthcare professionals on ageing and older people. However, there is limited evidence available exploring its use and impact on the person-centred care of older people.

DESIGN

An integrative review approach was used.

METHODS

Four databases were searched from January 2010 to April 2020 including CINAHL, MEDLINE, Web of Science and PsychINFO, 21 papers were identified and analysed.

RESULTS

Three interrelating themes were identified to outline the findings across the reviewed studies: ageing simulation use (theme 1), characteristics (theme 2) and impact (theme 3). Results showed literature available on ageing simulation is varied, ranged in study quality and applied several ageing simulation iterations making comparisons across the studies difficult.

CONCLUSIONS

Despite these challenges it was clear ageing simulation is a promising educational approach currently being used to promote person-centred care for older people in healthcare professionals. Ageing simulation successfully improved the ageing knowledge, empathy levels and attitudes towards older people of healthcare professionals.

An exploration of medical student attitudes towards older persons and frailty during undergraduate training

INTRODUCTION

Older persons and patients with frailty constitute an ever increasing proportion of hospital patients. Improving student attitudes towards both groups is important in preparing future doctors for this demographic shift. We aimed to investigate medical student attitudes towards older persons and frailty over an entire medical school cohort.

METHODS

All current Brighton and Sussex Medical School students were invited to complete an online questionnaire consisting: (i) the Australian Ageing Semantic Differential (AASD), (ii) the Medical Condition Regard Scale (MCRS) with regards to frailty, (iii) a qualitative question asking participants to record three words regarding both a person over 70 years and frailty.

RESULTS

187 students participated (66% female, 25.2% response rate). Participants reported positive attitudes with mean scores of 73.45/114 on the AASD and 52.4/66 on the MCRS. The most positive attitudes towards both older persons and frailty were held by year 1 students, and most negative by year 3 and year 4 students for older persons and frailty, respectively. Examining AASD subgroups, students held negative attitudes towards the instrumentality (function) of older persons (mean score: 17.6/36) with significant variation across year groups (p < 0.05), with the most negative attitudes expressed in year 3. Word clouds of qualitative responses showed that medical students consider the two concepts differently with frailty attracting more negative associations.

CONCLUSION

Generally medical student attitudes were positive towards older persons and frailty. However, these declined when focusing on the functionality, with word cloud analysis of attitudes revealing a dichotomy between the quantitative and qualitative data surrounding frailty.