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Hjälp mig att hjälpa dig!: – upplevelser och uppfattningar av undersökning med MRT för personer med metastaser i ryggen
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0003-0740-0130
2018 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim was to explore how patients with spinal metastasesexperience a magnetic resonance imaging examination (MRI). Furthermore,the purpose was to investigate the radiographers’ perceptions of the patients’care needs and what measures can be taken to relieve the suffering associatedwith an MRI examination.

Methods: The design for all four studies was qualitative with content analysisused in Studies I, III and IV and a phenomenographic approach in Study II.

Main Findings: The results showed that the patients could experience worry,anxiety, insecurity and pain during an MRI examination. These adverse feelingscan be reduced by adjustments to the examination’s routines as well as byadjustments to the examination’s settings. A short break in the middle of theexamination can be beneficial if the patient is involved in the decision regardingthe break or other adjustments made in conjunction with the examination.Radiographers’ perceptions of the caring for patients were influenced by theircaring perspective and their approach towards what they consider to be essentialin the care of patients with spinal metastasis. The radiographers used theirintuition as a moral compass when they decided what, when and how to adjustthe different aspects of the MRI examination. A shortage of time can affect theextent of the adjustments that can be made as well as the establishment of acaring relationship with the patient.

Conclusions: The patients may feel a sense of security when they receive correctinformation prior to and during the examination. Patients want to influencetheir own care. The personalization and adjustments of the examinationroutines need to be performed in agreement with the patient. The radiographersshould not use intuition as the foundation for their care and assumptions aboutthe care needs of the patients should be avoided. The

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2018. , p. 77
Series
Linnaeus University Dissertations ; 320/2018
Keywords [en]
Magnetic resonance imaging, spinal metastasis, patient-centered care
National Category
Health Sciences
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-73039ISBN: 978-91-88761-58-3 (print)ISBN: 978-91-88761-59-0 (electronic)OAI: oai:DiVA.org:lnu-73039DiVA, id: diva2:1198834
Public defence
2018-05-25, Myrdal, Hus K, Växjö, 10:30 (Swedish)
Opponent
Supervisors
Available from: 2018-04-19 Created: 2018-04-19 Last updated: 2018-04-19Bibliographically approved
List of papers
1. The experience of patients with neoplasm metastasis in the spine during a magnetic resonance imaging examination
Open this publication in new window or tab >>The experience of patients with neoplasm metastasis in the spine during a magnetic resonance imaging examination
2014 (English)In: Journal of Radiology Nursing, ISSN 1546-0843, E-ISSN 1555-9912, Vol. 33, no 4, p. 191-198Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to explore the experience of a magnetic resonance imaging (MRI) examination by patients with neoplasm metastasis in the spine. MRI is the most accurate method to diagnose and evaluate suspected metastatic disease in the spine. Patients may experience anxiety because of the fear of pain, fear of the unknown, and the apprehension about what the test might reveal. The study had a qualitative design, and the collected data were analyzed by means of latent content analysis. Twelve semistructured in-depth interviews were carried out starting with the question “Can you tell me about your experience of the MRI examination?” Four themes were identified: “motivation,” “worry and anxiety,” “insecurity,” and “security.” The patients were highly motivated to be examined by MRI, although most of them did experience some degree of worry or anxiety. The level of worry or anxiety was generated by the perception that an MRI examination was unpleasant, uncomfortable, or by the fear of what the result would show. All participants experienced some degree of insecurity, but in different ways, the insecurity of the patient could be reduced and the patients could experience a greater degree of security. The feelings of insecurity or security could be influenced by the radiographer, patients themselves, and MRI equipment. This study shows that most patients usually experience worry and anxiety. If the patients are motivated, they can manage to go through the examination in spite of the previously mentioned adverse feelings. Patients' feelings tend to fluctuate between a sense of insecurity and one of security.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Magnetic resonance imaging, Nursing, Cancer, Nurse-patient relationship
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-73036 (URN)10.1016/j.jradnu.2014.09.001 (DOI)2-s2.0-84920659765 (Scopus ID)
Available from: 2018-04-19 Created: 2018-04-19 Last updated: 2018-05-16Bibliographically approved
2. Caring for patients with spinal metastasis during an MRI examination
Open this publication in new window or tab >>Caring for patients with spinal metastasis during an MRI examination
2018 (English)In: Radiography, ISSN 1078-8174, E-ISSN 1532-2831, Vol. 24, no 1, p. 79-83Article in journal (Refereed) Published
Abstract [en]

Introduction: Magnetic resonance imaging (MRI) is without question the best tool used for diagnosing and evaluating spinal metastasis. An MRI examination is known to be of great value for the treatment planning and survival of these patients. Radiographers have an important role in how the quality of care is experienced by the patients during an MRI examination. The purpose of the study was to describe the radiographers’ perceptions of caring for patients with spinal metastasis during an examination with MRI.

Methods: Phenomenography was used to analyze the data in this study. Ten radiographers, one male and nine females were interviewed about their perception of caring for patients with spinal metastasis during an MRI examination.

Results: The findings showed that the radiographers’ caring perspective influenced their approach towards what they consider to be essential in the care of patients with spinal metastasis. This can impact the extent of the adjustment to the care needs of the patients. Furthermore, the findings showed that there was a strong connection between the radiographers’ care approach and preparedness to personalize the care.

Conclusion: This study shows that it is important to be flexible when providing care for the patients. A person-centered care is achieved when the caring perspective is based on the patient’s view and adjustments are made in agreement with the patient.

Keywords
MRI, Nurse-patient interaction, Care giving
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-65561 (URN)10.1016/j.radi.2017.06.001 (DOI)
Available from: 2017-06-19 Created: 2017-06-19 Last updated: 2018-04-19Bibliographically approved
3. An intervention-based study of how MRI is perceived by patients with spinal metastasis after adjustments to the examination procedures
Open this publication in new window or tab >>An intervention-based study of how MRI is perceived by patients with spinal metastasis after adjustments to the examination procedures
2018 (English)In: Journal of Radiology Nursing, ISSN 1546-0843, E-ISSN 1555-9912, Vol. 37, no 2, p. 119-125Article in journal (Refereed) Published
Abstract [en]

The aim was to explore magnetic resonance imaging (MRI) experiences of patients with spinal metastasis after adjustments to the examination procedures have been made in accordance with the findings from a previous study. MRI is an important medical technology, which is considered to be the first choice of examination method when diagnosing and evaluating spinal metastatic tumors. It is a challenge to care for patients who experience anxiety and pain during an MRI. However, several aspects of the examination can be adjusted to improve the care for these patients. Findings from previous research were used to develop a care intervention, the effects of which are explored in this study. Qualitative deductive-inductive content analysis was used in this study. Eleven patients with spinal metastasis were interviewed about their experiences of going through an MRI scan based on an intervention designed in accordance with the findings from previous research. The findings showed that adjustments to the examination often were perceived as beneficial. However, patients needed to be involved in the decisions that influenced their own care. Time was an important component that affected the need for being prepared as well as the degree of personalization of the examination. This study shows that patients need to be seen as unique individuals, and they need to be able to influence the care that is given to them. The personalization of and adjustments to the examination routines need to be carried out in agreement with the patient.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Magnetic resonance imaging, Neoplasm metastasis, Patient experience
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-73037 (URN)10.1016/j.jradnu.2018.02.001 (DOI)
Available from: 2018-04-19 Created: 2018-04-19 Last updated: 2018-06-15Bibliographically approved

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