The aim was to explore magnetic resonance imaging (MRI) experiences of patients with spinal metastasis after adjustments to the examination procedures have been made in accordance with the findings from a previous study. MRI is an important medical technology, which is considered to be the first choice of examination method when diagnosing and evaluating spinal metastatic tumors. It is a challenge to care for patients who experience anxiety and pain during an MRI. However, several aspects of the examination can be adjusted to improve the care for these patients. Findings from previous research were used to develop a care intervention, the effects of which are explored in this study. Qualitative deductive-inductive content analysis was used in this study. Eleven patients with spinal metastasis were interviewed about their experiences of going through an MRI scan based on an intervention designed in accordance with the findings from previous research. The findings showed that adjustments to the examination often were perceived as beneficial. However, patients needed to be involved in the decisions that influenced their own care. Time was an important component that affected the need for being prepared as well as the degree of personalization of the examination. This study shows that patients need to be seen as unique individuals, and they need to be able to influence the care that is given to them. The personalization of and adjustments to the examination routines need to be carried out in agreement with the patient.

Purpose: The aim was to evaluate the impact of age-appropriate information and preparation procedures for children with cancer undergoing radiotherapy on 1) parents and family functioning, parents' anxiety and 2) hospital costs compared to traditional care. Design and Methods: An un-matched quasi-experimental controlled clinical trial was conducted consisting of a control group including 31 parents of 16 children receiving traditional care and an intervention group including 32 parents of 17 children receiving age-appropriate preparation including seven parts. Validated instruments measured parents and family functioning and parents' anxiety. Hospital costs were calculated. Results: Parents in the intervention group showed better communication throughout their child's radiotherapy (p = 0.01) and at their child's last fraction, parental social functioning improved (p = 0.02). Parents of children receiving general anesthesia, regardless of group, showed higher levels of anxiety (p = 0.04). In general, results regarding hospital costs lacked statistical significance. Development of the intervention was calculated to be USD 4.624. Conclusion: Parents who receive age-appropriate information and preparation together with their child benefits in terms of improved communication and social functioning. When children avoid general anesthesia the parents experienced less anxiety and costs for the hospital was lowered. Practice Implication: Age-appropriate preparations consisting of basic, non-costly utilities and a structured approach are important. If more children are able to undergo radiotherapy without general anesthesia, it means for the individual child fewer risks and restrictions, and for the parents decreased anxiety. For the healthcare, it means lower costs, which enables the hospital to prioritize other areas of pediatric care. (C) 2018 Elsevier Inc. All rights reserved.

The aim of this study was to test age-appropriate information and preparation procedures for children with cancer undergoing radiotherapy (RT) for feasibility and effectiveness in terms of the need for general anesthesia (GA) and anxiety. In a quasi-experimental controlled clinical trial, 17 children aged 3–18 years receiving age-appropriate preparation were compared with 16 children in a control group. Feasibility in terms of recruitment, compliance, and acceptability was assessed. Effectiveness was assessed by the number of children who underwent treatment without GA and their respective fractions and validated instruments measured the children’s anxiety and emotional behavior. The preparation parts were delivered as intended without any additional personnel and without dropouts in the intervention group (IG) and therefore found feasible and acceptable. No statistic significances were found concerning the number of children receiving GA or anxiety. However, three children planned for GA in the IG completed their treatments, including 73 fractions awake. Children receiving GA, regardless of group, showed significantly higher negative emotional behavior. Giving children individualized preparation may decrease the need for GA during RT, which gives benefits in terms of fewer risks and restrictions in life for the child and lower costs for health care.

IntroductionMagnetic resonance imaging (MRI) is without question the best tool used for diagnosing and evaluating spinal metastasis. An MRI examination is known to be of great value for the treatment planning and survival of these patients. Radiographers have an important role in how the quality of care is experienced by the patients during an MRI examination. The purpose of the study was to describe the radiographers’ perceptions of caring for patients with spinal metastasis during an examination with MRI.MethodsPhenomenography was used to analyze the data in this study. Ten radiographers, one male and nine females were interviewed about their perception of caring for patients with spinal metastasis during an MRI examination.ResultsThe findings showed that the radiographers’ caring perspective influenced their approach towards what they consider to be essential in the care of patients with spinal metastasis. This can impact the extent of the adjustment to the care needs of the patients. Furthermore, the findings showed that there was a strong connection between the radiographers’ care approach and preparedness to personalize the care.ConclusionThis study shows that it is important to be flexible when providing care for the patients. A person-centered care is achieved when the caring perspective is based on the patient’s view and adjustments are made in agreement with the patient.

Background: The aim of radiotherapy is to provide a cure and/or symptomatic relief for children with cancer. Treatment is delivered on a daily basis, 5 days per week, over the course of 5 to 35 days. Many parents find that leaving their children alone during treatment and exposing them to radiation is a challenging experience. To gain an understanding of parents’ lived experiences, 10 parents were asked to keep a diary while their children underwent radiotherapy. Methods: A descriptive inductive design with a hermeneutic-phenomenological approach was chosen to analyze the diaries. The parents were asked to write down their lived experiences while their children underwent radiotherapy. Daily notes, both short and long, were desirable. Findings: The parents described radiotherapy as a balancing act involving a constant attempt to maintain a balance between coercing and protecting their children in order to improve their children’s chances of survival. Meanwhile, the parents themselves were struggling with their own despair and feelings of powerlessness. While protecting their children, they experienced a sense of hope and felt that they had gained control. Conclusion: Parents’ daily written reflections are important for clinical practice and provide vital knowledge. Parents need support when focusing on coercing and protecting their children and help with information and routines that enable them gain control.

Purpose: The aim was to explore radiotherapy nurses' perceptions of their experiences of caring for children undergoing radiotherapy treatment for cancer.Method: Semi-structured interviews of 12 nurses were conducted. The interviews were analysed using a phenomenographical approach.Results: All interviewees were women, and the group's mean age was 49 years. Caring for children during radiotherapy treatment was perceived as a complex task. Their perceptions included views on providing holistic care, creating a sense of security and being committed. Through holistic care the radiotherapy nurses took responsibility regarding care for the child and family, technical aspects of the radiotherapy procedure and the development of their profession. They tried to create a sense of security through individualized information and preparation, through teamwork with the child and family, and regarding anaesthetic personnel (if needed) while balancing the care they gave related to the child, to the family, to anaesthetic personnel, and to their own tasks. The radiotherapy nurses perceived themselves as committed in their care and reported being emotionally affected by sadness, but also joy.Conclusions: By clarifying radiotherapy nurses perceptions of caring for children guidelines can be developed to lessen anxiety and increase the sense of security amongst children undergoing radiotherapy treatment and their family members. (C) 2015 Elsevier Ltd. All rights reserved.

The aim of the study was to explore the experience of a magnetic resonance imaging (MRI) examination by patients with neoplasm metastasis in the spine. MRI is the most accurate method to diagnose and evaluate suspected metastatic disease in the spine. Patients may experience anxiety because of the fear of pain, fear of the unknown, and the apprehension about what the test might reveal. The study had a qualitative design, and the collected data were analyzed by means of latent content analysis. Twelve semistructured in-depth interviews were carried out starting with the question “Can you tell me about your experience of the MRI examination?” Four themes were identified: “motivation,” “worry and anxiety,” “insecurity,” and “security.” The patients were highly motivated to be examined by MRI, although most of them did experience some degree of worry or anxiety. The level of worry or anxiety was generated by the perception that an MRI examination was unpleasant, uncomfortable, or by the fear of what the result would show. All participants experienced some degree of insecurity, but in different ways, the insecurity of the patient could be reduced and the patients could experience a greater degree of security. The feelings of insecurity or security could be influenced by the radiographer, patients themselves, and MRI equipment. This study shows that most patients usually experience worry and anxiety. If the patients are motivated, they can manage to go through the examination in spite of the previously mentioned adverse feelings. Patients' feelings tend to fluctuate between a sense of insecurity and one of security.

As a magnetic resonance imaging (MRI) examination lasts about 45 minutes and as the technique is sensitive to motion, children are often given sedation or anesthesia. The aim of this study was to examine whether children aged three to nine years could undergo MRI while awake and achieve adequate image quality if age-adjusted routines were used. A two-group controlled experimental design was used. Thirty-six children were assigned to a control group and underwent MRI with the prevalent routines. Thirty-three children were assigned to an intervention group and underwent the MRI while awake. The age-adjusted routine included a booklet and a story book, a model of the MRI scanner with the MRI sound, and a DVD film during the examination. In the control group, 30 children underwent the examination under anesthesia and 6 underwent the examination while they were awake. All had acceptable examinations. In the intervention group, 33 children had their examination while awake and 30 of them had acceptable examinations. The parents’ satisfaction with the care was assessed to be equal or higher in the intervention group and the costs were calculated to be lower. Thus, many children receiving age-appropriate preparation and distraction can undergo MRI examinations while awake.

Children diagnosed with brain tumour often have repeated Magnetic Resonance Imaging (MRI) examinations. As the examination duration often is about 30 to 90 minutes and the technique signify that movement give rise to poor image quality the children are often sedated or anaesthetized. The purpose of this ongoing study is to assess possible benefits of increasing and adjusting preparations and realization in the care for children undergoing MRI examinations. By giving the children the means to prepare themselves for the examination and means to distract them during the examination, the goal is to decrease the number of children having sedation or anaesthesia during the MRI.

AIM:The aim of this study was to illuminate patients' lived experience during magnetic resonance imaging.BACKGROUND:Magnetic resonance imaging has increased in importance since the early 1980s and is today a common useful diagnostic tool. Although magnetic resonance imaging are non-invasive and considered painless, many patients experience anxiety, sometimes so strong that the scan has to be terminated.DESIGN AND METHODS:The study had an inductive design and a hermeneutic phenomenological methodology was used.RESULTS:The essential theme of going through magnetic resonance imaging was a feeling of being in another world. The strange environment and isolation inside the scanner made the participants' experiences unusual, with varying degrees of difficulty dealing with it. Being in the other world caused a threat to the participants' self-control. There was a relation between threat to self-control, effort and need for support in the sense that the magnitude of threat to self-control had an impact on the effort it took to handle the situation and on the need for support, and conversely that the support received could affect the effort and threat to self-control.CONCLUSIONS:The study shows that the information received and the interaction between patients and staff have a significant influence on patients' lived experiences. The individual experience of threat to self-control requires the need for support to be individualized and care need to be adjusted for each patient.

Purpose: To evaluate whether increased written information to patients prior to magnetic resonance imaging (MRI) decreases patient anxiety and image motion artifacts.Material and Methods: A two-group controlled experimental design was used. Of 242 patients, 118 received routinely given basic written information (control group) while 124 were given increased written information (intervention group). To measure patient anxiety before and during scanning, the self-report psychometric test State-Trait Anxiety Inventory (STAI) was used. After MR examination, the patients answered a questionnaire on satisfaction with the written information. The images were assessed with regard to motion artifacts.Results: Motion artifacts were present in fewer patient images in the intervention group than in the control group (4.0% versus 15.4%; P = 0.003). There was no significant difference between the control and the intervention group regarding patient anxiety and satisfaction with the information. Women in both groups showed a higher level of anxiety than the men did.Conclusion: Increased information about the MRI scanning procedure and expected experiences during the scan may help patients to lie still during the sequences, with a decrease in motion artifacts. However, further research is needed to evaluate the effect of other interventions on patient anxiety during MRI scanning.