Exploring patient-centred preparatory information provision in the digital era: an investigation among MRI and CT medical imaging outpatients

Many patients undergoing magnetic resonance imaging (MRI) and computed tomography (CT) scans experience elevated anxiety. Patients should be informed about the procedural, behavioural, psychosocial and sensory aspects of preparation before these procedures. Providing preparatory information the way patients prefer is central to high-quality, patient-centred care and may improve patient outcomes. eHealth shows promise for delivering patient-centred preparatory information, as patient education websites can be tailored to individuals’ preferences. However, little research has assessed whether patients’ preferences for receiving a range of preparatory information items are met before MRI and CT procedures. Furthermore, no studies have examined MRI and CT patients’ ability to locate and apply online health information, a concept termed eHealth literacy, necessary for patients to engage with and benefit from eHealth. This thesis addresses these knowledge gaps by evaluating MRI and CT outpatients’ experiences of, and preferences for receiving, preparatory information. It also examines issues related to measuring and describing eHealth literacy. Four published papers based on one cross-sectional study are included. Paper One assesses patient-perceived information receipt, concluding that provision of preparatory information linked to guideline recommendations needs improvement. Paper Two evaluates patient preferences for receiving this information, with findings highlighting a need for improved elicitation of, and responsiveness to, patients’ preferences. Paper Three evaluates the factorial validity of the eHealth Literacy Scale (eHEALS). Findings support a three-factor eHEALS structure and raise questions about existing interpretations of eHEALS data. Paper Four is the first to apply exploratory analyses to identify four subgroups of patients, characterised as having low to very high eHEALS factor scores. Collectively, this body of work indicates that patient-centred preparatory information provision before MRI and CT procedures should be enhanced. However, not all patients perceive that they can engage meaningfully with eHealth. eHealth should be offered alongside other information modes to improve patient-centred preparation before MRI and CT procedures.