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PET/CT in oncology: Patient experience, image quality and the value of information
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. (Radiologi)
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim was to investigate patients’ experiences with a PET/CT examination, satisfaction with care provided in connection to the examination and whether web-based information can improve satisfaction with care and image quality, compared to standard care. An additional aim was to explore how satisfaction with care and image quality is associated with health-related quality of life (HRQoL) and perceived stress. Methods: Study I and IV included patients with known or suspected malignancy scheduled for an 18F-FDG PET/CT examination. Study II included prostate cancer patients with known or suspected bone metastases scheduled for an 18F-fluoride PET/CT examination, and study III included head and neck cancer patients scheduled for an 18F-FDG PET/CT examination in a fixation mask. Study I and II had cross-sectional designs, study III used a phenomenological methodology according to Max van Manen, and study IV was a randomized controlled trial. Results: Study I and II found that many patients did not know before what a PET/CT examination was but were satisfied with care provided by the nursing staff. In study II the image quality was high and there was no difference in image quality between those patients that experienced pain or discomfort during the PET/CT and those that did not. Study III showed that the patient’s lifeworld was changed during the PET/CT examination and the use of coping strategies helped the patient to endure the examination procedure. In study IV the overall satisfaction, satisfaction single-variables and image quality was high in the intervention group and standard care group. There was no statistically significant difference between patients the intervention group and standard care group. However, there was slightly higher number of detected image quality defects in the standard care group. In study I and IV there were some statistically significant correlations between patient satisfaction and HRQoL (p<0.01-0.05). Conclusion: The results of this thesis may be used to improve patient information and care in connection to PET/CT examinations and thereby help optimize PET/CT imaging procedure. However, the results need to be investigated in larger populations.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. , p. 80
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1414
Keywords [en]
PET/CT, patient experience, image quality.
National Category
Medical and Health Sciences
Research subject
Medical Science
Identifiers
URN: urn:nbn:se:uu:diva-336784ISBN: 978-91-513-0197-6 (print)OAI: oai:DiVA.org:uu-336784DiVA, id: diva2:1167046
Public defence
2018-02-15, Skoogsalen, Ing.78, akademiska sjukhuset, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2018-01-25 Created: 2017-12-17 Last updated: 2018-03-07
List of papers
1. Patient Experience of an 18F-FDG-PET/CT Examination:: Need for Improvements in Patient Care
Open this publication in new window or tab >>Patient Experience of an 18F-FDG-PET/CT Examination:: Need for Improvements in Patient Care
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2015 (English)In: Journal of Radiology Nursing, ISSN 1546-0843, Vol. 34, no 2, p. 100-108Article in journal (Refereed) Published
Abstract [en]

The aims of this study were to investigate the patients' knowledge about and experience of an 18F-fluoro-deoxy-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) examination and to investigate the self-reported feelings of stress, level of physical activity, and health-related quality of life (HRQoL) and to find out if this was related to how they experienced the examination. A cross-sectional survey was used to collect information on 198 patients with known or suspected malignancy. As many as 32% to 63% were satisfied with the nursing staff, the communication, and the professional skills. Most patients did not know beforehand what an FDG-PET/CT examination was. The HRQoL, level of perceived stress, and physical activity were relatively low. A better HRQoL, lower level of perceived stress, and a higher level of physical activity were correlated to a more positive experience and higher education to more knowledge about the examination (p < .01–.05). The information before the examination needs to be improved. The results may be used to improve patient care and optimize imaging procedures.

Place, publisher, year, edition, pages
Elsevier, 2015
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-254492 (URN)10.1016/j.jradnu.2014.11.008 (DOI)
Available from: 2015-06-08 Created: 2015-06-08 Last updated: 2017-12-17Bibliographically approved
2. Assessment of Whether Patients' Knowledge, Satisfaction, and Experience Regarding Their 18F-Fluoride PET/CT Examination Affects Image Quality.
Open this publication in new window or tab >>Assessment of Whether Patients' Knowledge, Satisfaction, and Experience Regarding Their 18F-Fluoride PET/CT Examination Affects Image Quality.
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2016 (English)In: Journal of Nuclear Medicine Technology, ISSN 0091-4916, E-ISSN 1535-5675, Vol. 44, no 1, p. 21-5Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to investigate patients’ previous knowledge, satisfaction and experience regarding a (18F)-fluoride positron emission tomography / computed tomography examination ((18F)-fluoride PET/CT) and to explore whether experienced discomfort during the examination or pain was associated with reduced image quality. A further aim was to explore whether patients’ health-related quality of life (HRQoL) was associated with their satisfaction and experiences of the examination. Methods: Fifty consecutive patients with a histopathological diagnosis of prostate cancer who were scheduled for (18F)-fluoride PET/CT were asked to participate in the study, which was performed between November 2011 and April 2013. A questionnaire was used to collect information regarding the patients’ previous knowledge and experience of the examination. Image quality assessment was performed according to an arbitrary scale. The EORTC-QLQ-C30 and QLQ-PR25 were used to assess HRQoL. Results: Forty-six patients (96%) completed the questionnaires. Twenty-six per cent of participants did not know at all what a (18F)-fluoride PET/CT examination was. The majority (52-70%) were to a very high degree satisfied with the care provided by the nursing staff but less satisfied with the information given prior to the examination. The image quality was similar in patients who were exhausted or claustrophobic during the examination and those who were not. No correlations between HRQoL and the participants’ experience of (18F)-fluoride PET/CT were found. Conclusion: The majority of participants were satisfied with the care provided by the nursing staff, but there is still room for improvement especially regarding the information prior to the examination. Long examination time may be strenuous, for the patient but there was no difference in image quality between patients who felt discomfort during the examination or pain and those who did not.

National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-268918 (URN)10.2967/jnmt.115.167536 (DOI)
Available from: 2015-12-11 Created: 2015-12-11 Last updated: 2017-12-17Bibliographically approved
3. It's a question of endurance: patients with head and neck cancer experiences of 18F-FDG PET/CT in a fixation mask
Open this publication in new window or tab >>It's a question of endurance: patients with head and neck cancer experiences of 18F-FDG PET/CT in a fixation mask
2017 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 29, p. 85-90, article id S1462-3889(17)30082-0Article in journal (Refereed) Published
Abstract [en]

PURPOSE: This study aimed to explore how patients with head and neck cancer experienced undergoing an (18)F-fluoro-deoxy-glucose positrons emissions tomography/computed tomography ((18)F-FDG PET/CT) examination in a fixation mask.

METHOD: Interviews were conducted with nine patients with known or suspected head and neck cancer who were scheduled for the examination for the first time. The phenomenological method according to van Manen and his four lifeworld existentials; lived space, lived body, lived time, and lived relation was used to analyse the interviews.

RESULTS: The thoughts and feelings of the patients during the PET/CT examination varied, some found it very difficult, while others did not. However, for all the patients, it was an experience that required some form of coping to maintain composure for example distraction.

CONCLUSIONS: PET/CT examnation in a fixation mask may be strenuous for some patients. Patients need more detailed information, including suggestions for coping behaviours, prior to the examination, as well as higher level of support during and after the examination. The results of this study may be used to improve patient care and optimize the procedure of PET/CT examination in a fixation mask.

Keywords
FDG PET/CT, Fixation mask, Head and neck cancer, Phenomenology
National Category
Other Medical Sciences
Research subject
Caring Sciences; Radiology
Identifiers
urn:nbn:se:uu:diva-326834 (URN)10.1016/j.ejon.2017.05.009 (DOI)000407405700013 ()28720271 (PubMedID)
Note

Title in WoS: It's a question of endurance Patients with head and neck cancer experiences of F-18-FDG PET/CT in a fixation mask

Available from: 2017-07-31 Created: 2017-07-31 Last updated: 2017-12-17Bibliographically approved
4. Effects of web-based information on patient satisfaction and image quality in patients undergoing an 18F-FDG PET/CT examination: a randomized controlled trial
Open this publication in new window or tab >>Effects of web-based information on patient satisfaction and image quality in patients undergoing an 18F-FDG PET/CT examination: a randomized controlled trial
(English)Manuscript (preprint) (Other academic)
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-335669 (URN)
Available from: 2017-12-17 Created: 2017-12-17 Last updated: 2018-01-08Bibliographically approved

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