Jagadeesh Harshita, Bernstein Mark
Division of Neurosurgery, Toronto Western Hospital, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada,
Acta Neurochir (Wien). 2014 Feb;156(2):375-81. doi: 10.1007/s00701-013-1935-2. Epub 2013 Nov 24.
Incidental findings are common on MRI. Our study examined how patients are told about their incidental finding as well as anxiety until the neurosurgical consultation and afterward.
Qualitative research methodology was used. Thirty-two participants were interviewed using open-ended questions. Answers were transcribed and analyzed for themes.
The level of patient satisfaction for the initial breaking of the news averaged 4.1 (range 1-5). Four themes were identified: (1) emotional stress over incidental findings are partially dependent on how the news was communicated; (2) breaking worrisome news is best done in person, but telephone communication can sometimes be acceptable; (3) patients are divided about how much information they wish to get about incidental findings before going for an MRI; (4) waiting for the neurosurgical consultation is a stressful time without adequate support.
When dealing with an unexpected MRI finding, patients are anxious about the situation. Our study exposes ways the experience could be made more comfortable for patients right from the start, from being told the news in a calm and sympathetic manner, to providing support for patients while they wait for a meeting with a neurosurgeon, to expediting the neurosurgical consultation.
MRI检查中偶然发现很常见。我们的研究调查了患者在神经外科会诊前及会诊后如何被告知其偶然发现以及焦虑情况。
采用定性研究方法。使用开放式问题对32名参与者进行访谈。对答案进行转录并分析主题。
患者对首次得知消息的满意度平均为4.1(范围1 - 5)。确定了四个主题:(1)对偶然发现的情绪压力部分取决于消息的传达方式;(2)告知令人担忧的消息最好亲自进行,但电话沟通有时也可接受;(3)患者对于在进行MRI检查前希望获得多少关于偶然发现的信息存在分歧;(4)等待神经外科会诊是一段压力大且缺乏足够支持的时期。
在处理MRI意外发现时,患者对这种情况感到焦虑。我们的研究揭示了从一开始就让患者体验更舒适的方法,从以平静和同情的方式告知消息,到在患者等待与神经外科医生会诊时提供支持,再到加快神经外科会诊。