RPS 1214 - Patient-focused radiography practice

Author Block: C. Devereux, M. F. F. McEntee, R. Young; Cork/IE
Purpose or Learning Objective: Dementia is an umbrella symptom, encompassing a number of different diseases. It results in progressive cognitive decline. Diagnostic imaging plays a major role in the diagnosis of dementia, however patients with dementia attend from imaging for diagnosis of all diseases and injuries. Caring for them in a short visit can be challenging. The aim of this study is to determine Irish radiographers' opinions towards caring for patients with dementia in the radiology department and to examine the protocols that exist.
Methods or Background: This was a qualitative study, which utilised two focus groups to collect study data. A total of eleven radiographers participated in the data collection. The focus groups were transcribed and thematically analysed using NVivo software.
Results or Findings: Participants reported being apprehensive in caring for patients with dementia. No guidelines existed for caring for patients with dementia in Irish radiology departments. The themes that emerged were: (1) practice concerns (patient care, distress, quality of imaging fear, physical violence, safety, consent, justification, compassion), (2) change management of patient care (improving practice, willingness to change), (3) infrastructure and staffing (time, scheduling, carers, support) and (4) knowledge and attitudes (experience, expectations, knowledge, understanding, stigma).
Conclusion: Radiographers have concerns about caring for patients with dementia. There is a lack of knowledge about dementia care amongst the participants. Improvements in knowledge should be addressed. The development and implementation of best practice guidelines to care for patients with dementia would standardise the care of patients.
Limitations: Only one researcher interpreted and analysed the focus group data. Going forward it would be worth assessing radiographers in multiple hospitals, both within the public and private sectors.
Ethics committee approval: The ethical approval for this study was obtained from the Social Research Ethics Committee, UCC, Ireland, (CT-SREC-2020-41).
Funding for this study: No funding was received for this study.

Author Block: E. Kjelle, A. M. Myklebust; Drammen/NO
Purpose or Learning Objective: To assess how healthcare managers and personnel experience the quality, organisation and value of a rural telemedicine, remote-controlled CT stroke evaluation service.
Methods or Background: Semi-structured interviews were conducted and covered ten individual and one focus-group interview including managers, paramedics, radiographers, and junior doctors. The interview guide consisted of the following themes: experience of working with the service, task shifting, quality, management and challenges. Interviews were recorded and transcribed before thematic content analysis was used to develop a narrative of the findings.
Results or Findings: Findings were categorised into teamwork, quality, value of the service, organisation of the project, and from project to permanent service. Participants perceived the service as valuable for patients and the local community. The service included task shifting where paramedics positioned the patient in the CT-scanner, while the radiographer ran the scan remotely. This required education, training and changing of routines to facilitate the telemedicine service. The participants experienced the process as both challenging and interesting. The service was considered to improve patient care and health services in the community.
Conclusion: The service was perceived as valuable to the local community and of high quality. Communication, training, flexibility, and cooperation within and between the departments locally, as well as with the external hospitals appears to be a key factor for a successful implementation and long-term sustainability of the service.
Limitations: This study has a combination of one focus group and several individual interviews. This was due to two factors: the ongoing COVID-19 pandemic and the difficulty in recruitment. This combination may lead to a different depth in data obtained from managers in the focus group compared to managers and personnel in the individual interviews.
Ethics committee approval: Yes - NSD 358427.
Funding for this study: Not applicable.

Author Block: A. Chukwuani¹, D. Omiyi², A. Ginigeme³, A. Umunna⁴; ¹Birmingham/UK, ²Bradford/UK, ³Washington, DC/US, ⁴Manchester/UK
Purpose or Learning Objective: The aim of this paper is to review the current state of imaging service delivery for elderly cancer patients, and examine how to shape the future direction of clinical imaging service delivery to cater for an increasingly ageing population.
Methods or Background: Due to ageing, cancer is majorly a disease of the elderly. It is also clearly established that clinical imaging plays a central role in the diagnosis and management of cancer. Clinical imaging is utilised at all stages of the cancer patient pathway: diagnosis, staging, selecting the appropriate therapy, and follow up. In a nutshell, an increasingly ageing population means more cancer cases, resulting in more demand for imaging service needs.
Results or Findings: The elderly have special needs, and the imaging study of the elderly poses unique challenges. The current heterogenous models of care are majorly adapted to local priorities, needs and available resources. There is an urgent need to draw up models of care specially tailored to address the needs of the elderly in imaging. With the NHS Long Term Plan mapped out, it is hoped that the care for elderly cancer patients should see a significant boost in resource allocation. Some of these resources could be channelled into drawing up plans on how to ensure the provision of dedicated imaging service for elderly cancer patients.
Conclusion: Looking into the future, imaging service will require a lot of investment in imaging equipment, and human resources - skillfully trained to effectively understand and cater for the special needs of an increasingly ageing population.
Limitations: This paper is the result of review of available literature, and focused on the UK experience.
Ethics committee approval: Ethics Committee approval was obtained for this study.
Funding for this study: This study was self-funded by the researchers.

Author Block: N. Stogiannos¹, J. Harvey-Lloyd², A. Brammer³, C. Papadopoulos⁴, B. J. Nugent¹, J. McNulty⁵, C. S. d. Reis⁶, K. Cleaver⁷, T. O'Regan¹, C. M. Simcock¹, K. Marais¹, S. Parveen¹, G. Pavlopoulou¹, D. Bowler¹, S. Gaigg¹, C. Malamateniou¹; ¹London/UK, ²Suffolk/UK, ³Manchester/UK, ⁴Luton/UK, ⁵Dublin/IE, ⁶Lausanne/CH, ⁷Greenwich/UK
Purpose or Learning Objective: To map out the perspectives, needs, and preferences of autistic service users who have experienced an MRI examination in the UK. To gain an insight into the main barriers and facilitators to inclusive and safe MRI examinations when scanning autistic adults or children.
Methods or Background: Two online surveys were used, one for autistic individuals over 16 years of age, and the other for parents/carers of autistic individuals, with prior MRI experience. Snowball sampling was employed; the surveys were distributed through the researchers’ networks and through the autistic community on Twitter, LinkedIn and Facebook, the National Autistic Society and the London Autism Group. The surveys were open between February 1st and April 30th, 2021. Patient and public involvement was employed during all stages of the project. The SPSS software was used for statistical analyses.
Results or Findings: A total of 128 valid responses were received (112 autistic adults and 16 parents/carers of autistic children). The main barrier to a successful MRI scan was poor communication either between healthcare services or between patients and practitioners. Non-disclosure of autism occurred in more than half of the responses (53,6%). Failure to provide customised MRI examinations or autism-friendly MRI environments with reasonable adjustments (82.9%) were major contributing factors to a poor patient experience.
Conclusion: Current practice in MRI scanning is not taking into account the autistic service user’s needs. Optimal communication throughout and provision of reasonable environment adjustments is vital to ensure inclusive MRI scanning practices.
Limitations: Both research design and methodology, and recruitment of participants were impacted by COVID-19 restrictions. Convenience sampling means results should be interpreted with caution.
Ethics committee approval: School of Health Sciences, City, University of London Research Ethics Committee [ETH1920-1988].
Funding for this study: Society and College of Radiographers CORIPS grant scheme [SCoR 155-50011HY].

Author Block: N. Stogiannos¹, J. Harvey-Lloyd², B. J. Nugent³, A. Brammer⁴, S. Carlier⁵, K. Cleaver⁶, J. McNulty⁷, C. S. d. Reis⁵, C. Malamateniou¹; ¹London/UK, ²Suffolk/UK, ³Edinburgh/UK, ⁴Manchester/UK, ⁵Lausanne/CH, ⁶Greenwich/UK, ⁷Dublin/IE
Purpose or Learning Objective: To explore radiographic practices, training/educational needs, as well as the UK radiographers’ perspectives when scanning autistic service users with MRI.
Methods or Background: An online survey was constructed on Qualtrics and pilot-tested by field experts. All UK-based MRI radiographers were invited to participate. The snowball sampling technique was employed. The survey was distributed by three recruitment agencies between December 2020 and February 2021 on social media. Descriptive and inferential statistics were used to analyse the results using the SPSS software.
Results or Findings: This study received 130 valid responses. Effective communication between the patient and the MRI radiographer, adjusted MRI unit environment, and customisation of the MRI examination were found to be beneficial for a successful MRI examination. However, a persistent lack (but also desire) of autism-related training was noted (75.6%). Poor patient-practitioner communication, lack of training (41.5%), lack of Special Educational Needs experts (38.6%), and lack of specific guidelines (37.7%), were the main barriers to a successful MRI examination.
Conclusion: Reasonable adjustments are required when scanning autistic individuals, mainly in the context of communication and the MRI unit environment. Formal training is required for MRI radiographers, and guidelines should also be established to assist them in clinical practice.
Limitations: The number of responses and the use of convenience sampling mean that the results cannot be seen as representative of the UK-based MRI radiographers, but they still offer some useful insights. Also, the COVID-19 pandemic has negatively impacted the recruitment of radiographers as they were working on the frontline during the second national lockdown.
Ethics committee approval: School of Health Sciences, City University of London Research Ethics Committee [ETH1920-1988].
Funding for this study: The Society and College of Radiographers CORIPS grant scheme [SCoR 155-50011HY].

Author Block: S. Ellul¹, F. Zarb², K. Borg Grima², D. Mizzi²; ¹Zurrieq/MT, ²Msida/MT
Purpose or Learning Objective: This study aimed to investigate whether the introduction of music medicine (MM) during mammography examinations, has an effect on the anxiety level experienced by clients undergoing breast cancer screening.
Methods or Background: This study followed a quantitative, prospective, and experimental design. Participants were imaged according to the local breast cancer screening protocol, with the experimental group being exposed to MM, selected based on the literature. Anxiety levels were measured before and after each mammogram via the State-Trait Anxiety Inventory for Adults research tool.
Results or Findings: Participants in both experimental and control groups experienced a statistically significant increase in anxiety levels before the mammogram, when compared to their normal anxiety levels (p=<0.001). Both groups experienced a statistically significant decrease in anxiety levels after the mammogram when compared to their anxiety levels before the mammogram (experimental group: p=0.005; control group: p=0.001). No significant statistical difference (p=0.907) in the anxiety levels after the mammograms was recorded between the experimental and control groups.
Conclusion: Anxiety levels indicated that mammography screening induces anxiety and that anxiety levels were reduced in both groups after the mammography examination. A variable contributing to this reduction could be MM. Thus, MM could be used in the clinical setting since it is non-invasive and cheap. Nonetheless, in this study MM had no statistical significant effect in decreasing anxiety levels during mammography screening.
Limitations: Due to the cost of the research tool, the study had a small sample size (n=50). Thus, only MM was investigated as a variable and no music choice was given to participants. Further studies with a larger sample size, a choice of music from different genres and investigating other variables which affect anxiety levels are recommended.
Ethics committee approval: Approval was obtained from the University of Malta Research Ethics Committee (code:562601062020).
Funding for this study: Not applicable.