Holm S, Mussmann B R, Olesen F
UCL University College, Radiography Education, Denmark.
Department of Radiology, Odense University Hospital, Denmark. Research and Innovation Unit of Radiology, University of Southern Denmark, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
Radiography (Lond). 2023 Aug;29(5):935-940. doi: 10.1016/j.radi.2023.07.005. Epub 2023 Jul 29.
This study investigated how patients expected and experienced to be put first and cared for in diagnostic imaging settings and how putting the patient first was operationalized in practice.
A qualitative field study was conducted in two Danish hospitals to investigate patients' expectations and experiences of care and involvement during CT examinations. Data collection methods included semi-structured interviews and participant observations of five examination cases. Three Computed Tomography (CT) guided lung biopsy intervention studies and two conventional CT studies of the chest of patients being investigated for lung cancer in Fast Track Cancer Referral Programs (FTCRP) were included.
Patients reported low expectations of receiving care and being involved during examinations. Perceptions of receiving care predominantly consisted of being received in a kind, personalized manner. Expectations of involvement in the procedure were reported in terms of readiness to do as they were told, complying with requests put to each patient. Concepts of care and involvement were challenged in their formal meanings and found to be entangled in complex interactions within sociotechnical boundaries.
Patient's expectations of receiving care and being involved in the diagnostic imaging procedures, were expressed in noncommittal terms, and were overshadowed by patients' focus on getting through the examination, in order to get an answer to their tentative diagnose. The concepts of care and patient involvement were negotiated and reconceptualized within the sociotechnical framework of the diagnostic imaging situation of the individual patient. The concept of "tinkering" is suggested as a means of understanding how patientcare is performed during diagnostic imaging procedures.
Issues were identified that may help professionals to put "the patient first", thus, improving patient centered care.
本研究调查了患者在诊断成像环境中对被置于首位并得到护理的期望和体验，以及在实践中如何将患者置于首位。
在丹麦的两家医院进行了一项定性实地研究，以调查患者在CT检查期间对护理和参与的期望与体验。数据收集方法包括对五个检查病例的半结构化访谈和参与观察。纳入了三项计算机断层扫描（CT）引导下的肺活检干预研究以及快速癌症转诊计划（FTCRP）中对肺癌患者进行的两项胸部常规CT研究。
患者报告在检查期间获得护理和参与的期望较低。对获得护理的认知主要包括以亲切、个性化的方式接待。对参与检查过程的期望是按照告知的去做，遵守对每位患者提出的要求。护理和参与的概念在其正式意义上受到挑战，并被发现在社会技术边界内的复杂互动中相互交织。
患者对获得护理和参与诊断成像程序的期望表达得并不明确，并且被患者对完成检查以获得初步诊断答案的关注所掩盖。护理和患者参与的概念在个体患者诊断成像情况的社会技术框架内进行了协商和重新概念化。建议使用“修补”概念来理解在诊断成像程序中如何提供患者护理。
确定了一些可能有助于专业人员“将患者置于首位”从而改善以患者为中心的护理的问题。
