Patient involvement and expectations during CT scans. Tinkering to involve patients and offer care in radiographic practice

Introduction
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.

Methods
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.

Results
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.

Conclusion
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.

Implications for practice
Issues were identified that may help professionals to put “the patient first”, thus, improving patient centered care.