Healthcare provider and patient perspectives on diagnostic imaging investigations

Abstract

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.

Distributed decision making in action: diagnostic imaging investigations within the bigger picture

“…This can be attributed to the fragmented contributions of providers, who each come with an own interpretation of the retrospective, current and prospective knowledge at his or her disposal when making decisions. Because of radiation safety issues, it is proposed that a provider–patient‐centred approach mediated through and by technology may be a more appropriate perspective . According to Epstein et al., the locus of responsibility for shared decision making rests with the physician…”

“…Shadowing necessitated multiple data collection strategies, which included observations at the multiple points of provider–patient contact, patient entry and exit interviews, individual interviews with attending providers, informal conversations with patient and provider participants and document analysis. The details of the data collection methodology have been described elsewhere . Most of the case study shadowing lasted 1–3 h, with a few lasting 2 weeks ( n = 1) or 2 months ( n = 2).…”

“…A similar process was followed for the focus group interviews. The themes identified in the case studies were then compared with the themes emerging from the focus groups . These themes were subsequently interpreted in relation to the framework described below.…”

“…The details of the data collection methodology have been described elsewhere. 16 Most of the case study shadowing lasted 1-3 h, with a few lasting 2 weeks (n = 1) or 2 months (n = 2). Most medical consultations, as well as patient and provider interviews, were audio-recorded and detailed field notes were made of observations and informal interactions.…”

Critical steps in developing professional standards for the International Continence Society

“…Objective assessment of dysfunction meets patients expectations also (or especially?) to date . Modern era healthcare, however, also demands, more than in the early days of ICS, that patients quality of life and well‐being are taken into account and that minimal or not invasive management is recommended to them, where possible.…”