Assessment of Iraqi Patient Knowledge Regarding MRI Safety Before Scanning
MRI is a crucial imaging tool that provides diagnostic information without ionizing radiation. This study aims to evaluate Iraqi patients' knowledge, perception, and experience during MRI examinations. Conducted from November 2022 to February 2023, the research assesses patients' attitudes towards MRI safety issues through a questionnaire. The findings will help improve patient education and alleviate anxiety related to MRI scanning.
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ASSESSMENT OF IRAQI PATIENT KNOWLEDGE REGARDING MRI SAFETY BEFORE THE SCANNING By: Mohammed Jasim, Ali Hussien, Zainab Mahmood, Zainab Mahdi, Noor Al-Shams Kareem 1 Supervised By: Dr. Qays Ahmed
LIST OF CONTENTS Introduction Aims of the study Patients and methods Results Discussion Conclusion 2
INTRODUCTION Magnetic Resonance Imaging (MRI) is a non-invasive imaging tool that provides 3D images with diagnostic, anatomical and physiological information of the body. It plays a vital role in the disease detection, diagnosis, and treatment monitoring. 3
The most important advantage of MRI not using ionizing radiation like other imaging modalities such as Computed tomography (CT) makes it relatively safer for users, particularly pregnant women and children who are at greater risk of the harmful effects of ionizing radiation. 4
There is a possibility that these technological advances could increase patients' confusion regarding the MRI environment which could increase their anxiety. Patient information is essential for reducing anxiety, promoting awareness, compliance and satisfaction among patients and helping them deal with their illness and prognosis. 5
AIMS OF THE STUDY To assess patients knowledge. To assess patients perception. To assess patients experience during MRI examinations. 6
PATIENTS AND METHODS This is a descriptive cross-sectional study conducted from November 2022 and February 2023 to assess patients' knowledge and attitudes toward the safety of MRI. A questionnaire designed to contain variables related to knowledge and attitudes towards MRI safety issues. 7
Study design and duration: A cross-sectional study with analytic component of 8 months duration Study settings: This study was conducted among randomly selected patients from Al-Kindy Teaching Hospital Sampling techniques: a convenient sample of (200) from a wide variety of patients with different educational backgrounds. from MRI services in Al- Kindy Teaching Hospital. 8
Data Analyses Data was analyzed using SPSS statistical software version (22.0) and descriptive statistics to estimate mean scores of knowledge and attitudes by gender, age group, and education level, and a chi-square test was used to find out if there was any significant between knowledge of MRI safety and certain demographic data. The level of significance is typically set at a value of (0.05) or less. 9
RESULTS A total of 200 questionnaires were distributed, and 200 were returned, which represents a response rate of 100%. 10
TABLE 1 DEMOGRAPHIC DATA OF THE PARTICIPANTS Variable No. 103 97 11 78 95 16 158 42 15 % 51.5 48.5 5.5 39 47.5 8 79 21 7.5 Male Female <20 20-40 41-60 >60 Married Single Illiterate Gender Age Marital Status Intermediate 26 13 Level of education Primary Secondary 39 40 19.5 20 11 University 80 40
Business 32 16.5 Domestic 57 28.5 Employee 44 22 Occupation Freelancer 51 25.5 Student 16 8 Rural 13 6.5 Residence Urban 187 93.5 12 Total 200 100
TABLE 2 KNOWLEDGE OF PATIENTS TOWARDS MRI SAFETY AND ASSESSMENT OF STUDY PARTICIPANT ATTITUDES ABOUT MRI SAFETY Questions No. (%) 1.Do you know preparation guidelines before MRI scan ? Yes No 137 (68.5%) 63 (31.5%) 2.Are you aware of the types of radiation used in MRI ? Yes No 90 (45%) 110 (55%) 3.Do you know there is noise produced by MRI scanner ? Yes No 168 (84%) 32 (16%) 4.Do you think the MRI scanner is on if there are no patients ? Yes No 5.Do you know there is a contrast agent used in some cases ? Yes No 13 (6.5%) 187 (93%) 13 88 (44%) 112 (56%)
6.Are you aware of the adverse effects of the contrast agent ? Yes No 23 (11.5%) 177 (88.5%) 7.Do you know why patients undergo MRI with contrast agents must have their creatinine levels (glomerular filtration rate or GFR) checked ? Yes No 34 (17%) 166 (83%) 8.Can a pregnant woman be scanned b MRI ? Yes No 7 (3.5%) 193 (96.5%) 9.Can a pregnant woman be giving an MRI contrast agent ? Yes No 10 (5%) 190 (95%) 10.Have you done an MRI scan before ? Yes No 101 (50.5%) 99 (49.5%) 11.Have you read or heard about the MRI safety procedures ? Yes No 14 149 (74.5%) 51 (25.5%)
TABLE 3 ASSOCIATION BETWEEN EDUCATION LEVEL & QUESTIONS Education Question Do you know preparation guidelines before MRI scan ? Are you aware of the types of radiation used in MRI ? Do you know there is noise produced by MRI scanner ? Do you think the MRI scanner is on if there are no patients ? Illiterate (15) Intermediate (26) Primary (39) Secondary (40) University (80) Total P-Value No Yes 10 5 12 14 15 24 12 28 14 66 63 137 0.001** No Yes 9 6 16 10 16 23 25 15 44 36 110 90 0.332 No Yes 4 11 5 21 7 32 6 34 10 70 32 168 0.673 No Yes 15 0 24 2 36 3 38 2 74 6 187 13 0.831 15
Do you know there is a contrast agent used in some cases ? Are you aware of the adverse effects of the contrast agent ? No Yes 11 4 11 15 23 16 23 17 44 36 112 88 0.404 No Yes 12 3 25 1 33 6 32 8 75 5 177 23 0.086 Do you know why patients undergo MRI with contrast agents must have their creatinine levels (glomerular filtration rate or GFR) checked ? No Yes 13 2 24 2 30 9 34 6 65 15 165 34 0.550 Can a pregnant woman be scanned b MRI ? 16 No Yes 14 1 25 1 38 1 39 1 77 3 193 7 0.953
Can a pregnant woman be giving an MRI contrast agent ? No Yes 15 0 25 1 37 2 36 4 77 3 190 10 0.520 Have you done an MRI scan before ? No Yes 11 4 13 13 15 25 20 20 40 40 99 101 0.256 Have you read or heard about the MRI safety procedures ? No Yes 6 9 8 18 15 24 7 33 15 65 51 149 0.068 17
TABLE 4 ASSOCIATION BETWEEN RESIDENCE & QUESTIONS rural (13) urban (178) Residence Question Total P_ Value Do you know preparation guidelines before MRI scan ? No Yes 6 7 57 130 63 137 0.239 Are you aware of the types of radiation used in MRI ? Do you know there is noise produced by MRI scanner ? No Yes 7 6 103 84 110 90 0.931 No Yes 4 9 28 159 32 168 0.133 Do you think the MRI scanner is on if there are no patients ? No Yes 13 0 174 13 187 13 18 0.326
Do you know there is a contrast agent used in some cases ? No Yes 11 2 101 86 112 88 0.032** Are you aware of the adverse effects of the contrast agent ? No Yes 11 2 166 21 177 23 0.650 Do you know why patients undergo MRI with contrast agents must have their creatinine levels (glomerular filtration rate or GFR) checked ? No Yes 10 3 156 31 166 34 0.546 19
Can a pregnant woman be scanned b MRI ? No Yes 12 1 181 6 193 7 0.395 Can a pregnant woman be giving an MRI contrast agent ? No Yes 13 0 177 10 190 10 0.392 Have you done an MRI scan before ? No Yes 7 6 92 95 99 101 0.746 Have you read or heard about the MRI safety procedures ? No Yes 5 8 46 141 51 149 0.267 20
TABLE 5 ASSOCIATION BETWEEN GENDER & QUESTIONS Male (103) Female (97) Gender Question Total P_ Value Do you know preparation guidelines before MRI scan ? No Yes 38 65 25 72 63 137 0.091 Are you aware of the types of radiation used in MRI ? Do you know there is noise produced by MRI scanner ? No Yes 53 30 57 40 110 90 0.299 No Yes 15 88 17 80 32 168 0.568 Do you think the MRI scanner is on if there are no patients ? 21 No Yes 98 5 89 8 187 13 0.331
Do you know there is a contrast agent used in some cases ? No Yes 62 40 50 47 112 88 0.218 Are you aware of the adverse effects of the contrast agent ? No Yes 89 14 88 9 177 23 0.339 Do you know why patients undergo MRI with contrast agents must have their creatinine levels (glomerular filtration rate or GFR) checked ? No Yes 91 12 75 22 166 34 0.038** 22
Can a pregnant woman be scanned b MRI ? No Yes 99 4 94 3 193 7 0.761 Can a pregnant woman be giving an MRI contrast agent ? No Yes 97 6 93 4 190 10 0.581 Have you done an MRI scan before ? No Yes 47 56 52 45 99 101 0.259 Have you read or heard about the MRI safety procedures ? No Yes 29 74 22 75 51 149 0.357 23
TABLE 6 ASSOCIATION BETWEEN MARITAL STATUS & QUESTIONS Married (158) Single (42) Total Marital status Question P_ Value Do you know preparation guidelines before MRI scan ? No Yes 52 106 11 31 63 137 0.405 Are you aware of the types of radiation used in MRI ? No Yes 83 75 27 15 110 90 0.174 Do you know there is noise produced by MRI scanner ? No Yes 26 132 6 36 32 168 0.733 Do you think the MRI scanner is on if there are no patients ? 24 No Yes 148 10 39 3 187 13 0.849
Do you know there is a contrast agent used in some cases ? No Yes 90 68 22 20 112 88 0.595 Are you aware of the adverse effects of the contrast agent ? No Yes 140 18 37 3 177 23 0.926 Do you know why patients undergo MRI with contrast agents must have their creatinine levels (glomerular filtration rate or GFR) checked ? No Yes 137 21 29 13 166 34 0.007** 25
Can a pregnant woman be scanned b MRI ? No Yes 153 5 40 2 193 7 0.617 Can a pregnant woman be giving an MRI contrast agent ? No Yes 151 7 39 3 190 10 0.473 Have you done an MRI scan before ? No Yes 78 80 21 21 99 101 0.942 Have you read or heard about the MRI safety procedures ? No Yes 40 118 11 31 51 149 0.908 26
DISCUSSION The aim of this study was to assess the knowledge and attitudes of Iraqi patients toward the safety of magnetic resonance imaging (MRI). The findings showed that the respondents had good knowledge about MRI. In addition, patients were asked to do MRI examinations and were told they should be aware of the relevant safety issues. 27
Furthermore, this study showed that most of the patients had read or heard about the MRI safety procedures (74.5%). In contrast, 31.5% responded that they were not aware of the patient preparation before the MRI procedures. Additionally, 88.5% of the participants did not recognize the adverse reactions of MRI contrast agents. Notably, 84% were aware of the noise produced by the MRI scanner. The responses of the participants reflected low levels of patient knowledge regarding adverse reactions to MRI contrast agents and to the types of radiation used in MRI. 28
Furthermore, the patients lacked knowledge of the preparation guidelines before MRI procedures. However, the majority had read or heard about MRI safety procedures. Approximately 55% of respondents did not know the type of radiation used in MRI and 45% did know the type of radiation used in MRI. This is not surprising; in a previous study, the majority (85%) of health care professionals in the Kingdom of Saudi Arabia and responded incorrectly that ionizing radiation is used for brain MRI in larger amounts than thorax X-rays. Another study reported poor knowledge about radiation exposure among radiographers, interns, and resident doctors. 29
CONCLUSION This study finds that the combination of factors contributing to patients' knowledge of MRI safety in the Iraqi population is complex. In particular, the combination of education, age group, income, gender and whether the information was requested before an MRI examination determines the patient's level of knowledge. By profiling patients around these factors and providing information in a variety of formats, Health care providers are able to better target patients to receive information prior to the examination and increase their availability to co- operate in an MRI examination. Although the target population of this study was Iraq, the findings could have broader implications. 30
RECOMMENDATION This study found significant differences between groups in the sources of information used and the extent of the information requested. It is important to further adapt this research to other locations to ensure that societal and cultural factors do not bias the results. It may be advantageous to profile patients prior to an MRI to determine groups according to their preferred style and format of resources. Each department and treating physician should provide patients with access to a variety of resources (eg. websites, printed, material, face-to-face information sessions) that fit their profile. This would provide them with a better understanding of the potential problems they need to be aware of. 31
QUESTIONNAIRE 1STPART 1-Gender Male Female 4-Level of education Illiterate Primary Intermediate Secondary University 2-Age Less than 20 years 20-40 years 41-60 years More than 60 years 5-Occupation Employee Freelancer Business Domestic Student 3-Marital status Single Married 6-Residence Urban Rural 32
QUESTIONNAIRE 2NDPART 1-Do you know the preparation guidelines before MRI scanner ? Yes No 2-Are you aware of the types of radiation used in MRI ? Yes No 3-Do you Know there is noise produced by MRI scanner ? Yes No 4-Do you think the MRI scanner is on if there are no patients ? Yes No 33
QUESTIONNAIRE 2NDPART CONTI. 5-Do you know that there is a contrast agent used in some cases ? Yes No 6-Are you aware of the adverse reactions to MRI contrast agents ? Yes No 7-Do you know why patients undergoing MRI with contrast agents must have their creatinine levels (glomerular filtration rate or GFR) checked ? Yes No 34
QUESTIONNAIRE 2NDPART CONTI. 8-Can a pregnant woman be scanned by MRI ? Yes No 9-Can a pregnant woman be giving an MRI contrast agent ? Yes No 10-Have you had done an MRI scan before ? Yes No 11-Have you read or heard about the MRI safety procedures ? Yes No 35
THANK YOU 36
