Lost in Translation? Examining the Risk-Benefit Communication Process Prior to a Pregnant Patient Receiving Medical Imaging with Ionising Radiation

Abstract

This work considers risk-benefit communication for the case of the pregnant patient receiving imaging with ionising radiation which is cited as a source of anxiety for many women and their health care providers. Within this work both the perspectives of the healthcare professional and the patient have been considered. A cross sectional observational study was utilised to assess the knowledge, attitudes and confidence of the healthcare worker when communicating risks and benefits of radiological imaging. In addition to this a qualitative study using grounded theory methodology was undertaken to explore the pregnant patients experiences, perceptions and understanding of the communication they received. Sixty two local healthcare professionals across the domains of radiology, medical physics, emergency medicine and obstetrics and gynaecology participated and completed the cross sectional study questionnaire. Results obtained within this study indicate deficiencies in the knowledge and confidence of front-line staff in delivering radiation risk-benefit communication. Twenty patients participated in the grounded theory study. The established theory describes how a pregnant patient invokes an emotional and cognitive engagement with the risk-benefit information they receive. The emergent grounded theory has established that expectant mothers are often faced with the dilemma of proceeding with an investigation that they believe will put them and their baby at risk. The continued health of baby and self is of ultimate importance to pregnant mothers and this maternal conviction shapes and drives the expectant mothers resolve to rationalise the need to proceed with imaging despite the overarching and competing negative biases and concerns that they may also have. The established model allows us to predict behaviours within patients that may allow for proactive strategies for shaping counselling narratives to address identified maternal concerns. Results obtained from both aspects of this work contribute to the understanding of how healthcare professionals can both refine and improve counselling methods to facilitate effective risk-benefit communication prior to imaging the pregnant patient.

Date of Award	31 Dec 2023
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Julia-Claire Handley (Supervisor)