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

Abstract

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 Search strategy The search strategy aimed to find both published and unpublished studies, and was conducted over a period from June – September 2010.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.