Nikolaos Stogiannos1 and Christina Malamateniou2
1City, University of London, United Kingdom, 2City, University of London, London, United Kingdom
Synopsis
Magnetic resonance imaging (MRI) examinations may be overwhelming for autistic individuals, given their sensory differences and heightened anxiety in conjunction with the challenging MRI environment. Effective communication between the patients and the radiographers, and between healthcare services proved to be vital for improving both the image quality and the patient experience. MRI radiographers should receive autism-related training to provide better care to these patients. Technology should be employed to familiarise these patients with the MRI procedure.
Introduction
Autistic individuals often need a magnetic resonance imaging
(MRI) examination for various reasons. The challenging MRI unit environment, in
conjunction with the relatively long scan times, may overwhelm autistic service
users undergoing MRI scans [1]. Given their sensory sensitivities and some social
and communication challenges which autistic individuals often experience, MRI
departments should opt for inclusive environments and person-centred approaches
to achieve optimal image quality, reduce patient anxiety and claustrophobia,
and improve patient experience.
This study aimed to identify all relevant literature related to person-centred care for autistic individuals in MRI, to explore any challenges that both MRI radiographers and autistic service users may face, to reveal any gaps in radiography training and to provide recommendations for future practice.Methods and materials
This study comprised of a) a systematic review to gather
all relevant literature regarding person-centred adjustments which can be used in
MRI of autistic individuals, in order to avoid the use of sedation or
anaesthesia [1], b) a cross-sectional study to explore the perspectives of MRI
radiographers in the UK [2], and c) a cross-sectional study which sought to
investigate the patients’ and their caregivers’ experiences with MRI, by
mapping out any barriers to and enablers of MRI scanning along with their
recommendations for practice change.
The systematic review identified 4442 articles across 9 electronic databases, and finally, 21 eligible articles were included. The study regarding MRI radiographers in the UK received 130 valid responses through an online survey, while the last study aiming at autistic service users received a total of 128 responses (112 adults, 16 parents/carers). Appropriate statistical tests were applied as required.Main findings
This study revealed that personalised communication approaches are vital for improving patient experience and scan outcomes, while adjusting the MRI unit environment in order to be more 'autism-friendly' is also of great value for addressing the autistic users' sensory differences. Technology-based aids and software should be widely used both for optimising the scans and for helping with patient familiarisation.
MRI radiographers in the UK present with a lack of knowledge and relevant training, however, they are eager to learn more. Academic curricula should be changed to include autism-related training while specific guidelines should be issued on how to effectively manage these patients.
Effective communication between radiographers and the patients was highlighted as vital for a safe and optimal MRI scan, and also healthcare services should co-ordinate to provide optimal care to autistic service users. Patient experience was negatively affected by increased acoustic noise and poor physical comfort during the scans. Acknowledgements
We greatly appreciate the Society and College of Radiographers, as well as the City Radiography Research Fund for providing funding for this research project. Also, the autistic community and our autistic consultants for providing us with invaluable guidance and knowledge related to this research.References
1.Stogiannos N, Carlier S, Harvey-Lloyd JM, Brammer A,
Nugent B, Cleaver K, McNulty JP, Sa dos Reis C, Malamateniou C. A systematic
review of person-centred adjustments to facilitate magnetic resonance imaging
for autistic patients without the use of sedation or anaesthesia. Autism 2021.
In Press. https://doi.org/10.1177%2F13623613211065542
2.Stogiannos N, Harvey-Lloyd JM, Nugent B, Brammer A,
Carlier S, Cleaver K, McNulty JP, Sa dos Reis C, Malamateniou C. Autism-friendly
MRI: Improving radiography practice in the UK, a survey of radiographer
practitioners. Radiography 2021;28(1):133-141. https://doi.org/10.1016/j.radi.2021.09.003