Abstract

Objectives: There is anecdotal and quantitative evidence suggesting that the impact of undergoing a spinal MRI can be significant, to date there has been no "living experience" research conducted. This study focuses on the "lived experience" of the patient journey. The objectives were to explore the themes emerging from the three stages of this journey; a) ordering, b) having the scan, c) receiving the results. This could be fed back to local services; radiography, physiotherapy/musculoskeletal services and orthopaedics.
Design:
Eighteen patients over the age of 18 were recruited from a specialist spinal assessment clinic having undergone MRI for lumbar or neck pain, in line with National Institute of Clinical Excellence (NICE) guidelines where it states, "Consider imaging in specialist settings of care (for example, a musculoskeletal interface clinic or hospital) for people with low back pain with or without sciatica only if the result is likely to change management" . They were contacted by telephone for a semi-structured interview in an outpatient setting. The qualitative data collected were subjected to a thematic analysis. Data was initially coded and organised into themes by the interviewer/ lead researcher.
Results:
These were presented in three sections: before, during and after the scan. In the before stage three themes emerged; relief/gratitude, uncertainty/worry and confirmation/ reassurance. In the 'during' stage, there were three areas to explore with sub – themes for each: Information, (poor and well informed); physical (neutral and negative); and emotional (anxiety). In the after stage there were two sections with sub themes: waiting for the results (anxiety) and understanding of the results (medical management or self management). The overall experience had a positive theme.
Conclusions:
The participants in this study had warranted a scan when seen in the spinal assessment clinic in accordance with NICE guidelines. From the themes emerging it suggests that a number of these patients did not fully understand the reasoning for ordering the imaging, holding beliefs/hopes that it might fix their pain. Further exploration is needed around patient understanding when imaging is appropriate, how it might help them and that the specialist clinicians are communicating this information effectively prior to the imaging.