Creating person-al space for unspoken voices during diagnostic medical imaging examinations: a qualitative study.

BACKGROUND: There is emerging interest in person-centred care within a short-lived yet complex medical imaging encounter. This study explored this event from the viewpoint of patients referred for an imaging examination, with a focus on the person and their person-al space. METHODS: We used convenience sampling to conduct semi-structured interviews with 21 patients in a private medical imaging practice in Australia. The first phase of data analysis was conducted deductively, using the six elements of the person-centred, patient-journey framework of the Australian Commission on Safety and Quality in Healthcare: transition in; engagement; decisions; well-being; experience; and transition out. This was followed by inductive content analysis to identify overarching themes that span a patient's journey into, through and out of an imaging encounter. RESULTS: The transition-in phase began with an appointment and the first point of contact with the imaging department at reception. Engagement focused on patient-radiographer interactions and explanations to the patient on what was going to happen. Decisions related primarily to radiographers' decisions on how to conduct a particular examination and how to get patient cooperation. Participants' well-being related to their appreciation of gentle treatment; they also referred to past negative experiences that had made a lasting impression. Transitioning out of the imaging encounter included the sending of the results to the referring medical practitioner. Person-al vulnerabilities emerged as a cross-cutting theme. Patients' vulnerability, for which they needed reassurance, pertained to uncertainties about the investigation and the possible results. Healthcare professionals were vulnerable because of patient expectations of a certain demeanour and of pressure to perform optimal quality investigations. Lastly, patients' personal lives, concerns and pressures - their person-al 'baggage' - shaped their experience of the imaging encounter. CONCLUSION: To add value to the quality of the service they deliver, radiography practitioners should endeavour to create a person-al space for clients. Creating these spaces is complex as patients are not in a position to judge the procedures required by technical imaging protocols and the quality control of equipment. A reflective tool is proposed for radiographers to use in discussions with their team and its leaders on improving person-centred care and the quality of services in their practice.

'It is just part of life': patient perspectives and experiences of diagnostic imaging referrals.

Referral for a medical imaging examination is an integral part of the medical consultation; however, not much is known about patients' experience of these referrals. The life-world experiences and perspectives of patients as 'persons' referred for an imaging investigation are explored through the lens of person-centred and whole-person care. Individual interviews were conducted with 22 patients referred for an imaging investigation. The findings were interpreted in terms of the journey of a patient; that is, the processes the patient undergoes as a person in the course of a referral for a diagnostic imaging investigation as part of the disease and its treatment. Participants' life and health journeys are described in terms of three themes: (1) events leading to an imaging examination; (2) the imaging referral experience embedded within the medical encounter; and (3) the integration of the findings of the imaging examination into their everyday life. Health practitioners should be mindful of the complexity of medical consultations that include a referral for an imaging investigation.

Exploration of gynaecological cancer high dose-rate brachytherapy treatment: a pilot study.

INTRODUCTION: Performing brachytherapy on female patients with gynaecological cancer is a sensitive procedure, apart from it being an intricate investigation. The aim of this study: establishing gynaecological cancer patients' expectations, experiences and understandings of the high dose-rate brachytherapy treatment procedure. Exploring these patients' life-worlds provides further insights into improving their preparedness and experiences. METHODS: A qualitative research design with a descriptive phenomenological research approach was used. Recruitment entailed using purposive sampling. To obtain rich insights into the lived experiences, data was acquired through semi-structured interviews until data saturation. RESULTS: Major challenges were experienced with mixed thoughts and feelings, from negative trauma to desires being fulfilled. These patients should have received more information regarding their upcoming brachytherapy treatment. This would have alleviated some of their fears and anxieties, which would in turn have provided them with a better brachytherapy treatment experience. Envisaged outcomes and desires are used to cope. Patients influence each other negatively, so they rather wanted to "see for themselves". CONCLUSION: Despite some disappointments and negative experiences throughout the brachytherapy continuum, the patients were left with a positive outlook, saying that it is an excellent and necessary treatment. Further studies should be done to elaborate on fulfilments of recommendations in the brachytherapy department of radiation oncology.