Medical imaging consultation practices and challenges at public hospitals in the Amhara regional state, Northwest Ethiopia: a descriptive phenomenological study

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Abstract

Background

Medical imaging plays a vital role in the accurate diagnosis, treatment and outcome prediction of many diseases and injuries. However, in many African countries, deserving populations do not have access to the proper medical imaging specialists’ services. As a result, clinicians continue to struggle to provide medical imaging via consultation. However, little is known about conventional referral consultation practices and their challenges. This study, therefore, aimed to explore the practice and challenges of medical imaging service consultation among health professionals and patients in the context of the Ethiopian public healthcare delivery system.

Methods

Descriptive phenomenological study was employed to explore the practice of medical imaging service consultation among health professionals and patients in public hospitals of Amhara region from October 12, 2021 to December 29, 2021. Semi-structured interview guides were prepared separately for key-informant and in-depth interviews. A total of 21 participants (6 hospital managers, 4 medical directors, 4 department heads, 3 medical imaging coordinators and 4 patients) were selected using the maximum variation sampling technique. All interviews were audio-recorded, transcribed verbatim and subjected to inductive thematic analysis using Open Code 4.02 software.

Results

Six major themes emerged following the thematic analysis: (1) medical image service delivery practices; (2) medical imaging consultation modalities; (3) benefits and drawbacks of the consultation modalities; (4) challenges; (5) challenge mitigation strategies; and (6) future recommendations. Image films, compact disks, and telegram apps were the consultation modalities used by the referring clinicians to send the medical images to radiologists. Frequent failure of imaging machines, delayed equipment maintenance, inadequate infrastructure, shortage of budget, lack of radiologists, and low-quality of printed image films were among the challenges influencing the medical imaging consultation service.

Conclusions

This research explored onsite and referral imaging consultation practices. However, there are many challenges encountered by the referring clinicians and the radiologists during the consultation process. These challenges could potentially affect clinicians’ ability to provide timely diagnosis and treatment services which would ultimately affects patient health status and service delivery. Virtual consultation via teleradiology and enhancing clinicians’ competence through long-term and short-term trainings are recommended to improve the referral consultation practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-023-09652-9.

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Saturation in qualitative research: exploring its conceptualization and operationalization

Benjamin Saunders, Julius Sim, Tom Kingstone … (2017)

Saturation has attained widespread acceptance as a methodological principle in qualitative research. It is commonly taken to indicate that, on the basis of the data that have been collected or analysed hitherto, further data collection and/or analysis are unnecessary. However, there appears to be uncertainty as to how saturation should be conceptualized, and inconsistencies in its use. In this paper, we look to clarify the nature, purposes and uses of saturation, and in doing so add to theoretical debate on the role of saturation across different methodologies. We identify four distinct approaches to saturation, which differ in terms of the extent to which an inductive or a deductive logic is adopted, and the relative emphasis on data collection, data analysis, and theorizing. We explore the purposes saturation might serve in relation to these different approaches, and the implications for how and when saturation will be sought. In examining these issues, we highlight the uncertain logic underlying saturation—as essentially a predictive statement about the unobserved based on the observed, a judgement that, we argue, results in equivocation, and may in part explain the confusion surrounding its use. We conclude that saturation should be operationalized in a way that is consistent with the research question(s), and the theoretical position and analytic framework adopted, but also that there should be some limit to its scope, so as not to risk saturation losing its coherence and potency if its conceptualization and uses are stretched too widely.

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A simple method to assess and report thematic saturation in qualitative research

Greg Guest, Emily Namey, Mario Chen (2020)

Data saturation is the most commonly employed concept for estimating sample sizes in qualitative research. Over the past 20 years, scholars using both empirical research and mathematical/statistical models have made significant contributions to the question: How many qualitative interviews are enough? This body of work has advanced the evidence base for sample size estimation in qualitative inquiry during the design phase of a study, prior to data collection, but it does not provide qualitative researchers with a simple and reliable way to determine the adequacy of sample sizes during and/or after data collection. Using the principle of saturation as a foundation, we describe and validate a simple-to-apply method for assessing and reporting on saturation in the context of inductive thematic analyses. Following a review of the empirical research on data saturation and sample size estimation in qualitative research, we propose an alternative way to evaluate saturation that overcomes the shortcomings and challenges associated with existing methods identified in our review. Our approach includes three primary elements in its calculation and assessment: Base Size, Run Length, and New Information Threshold. We additionally propose a more flexible approach to reporting saturation. To validate our method, we use a bootstrapping technique on three existing thematically coded qualitative datasets generated from in-depth interviews. Results from this analysis indicate the method we propose to assess and report on saturation is feasible and congruent with findings from earlier studies.

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The qualitative research interview.

Barbara DiCicco-Bloom, Benjamin Crabtree (2006)

Interviews are among the most familiar strategies for collecting qualitative data. The different qualitative interviewing strategies in common use emerged from diverse disciplinary perspectives resulting in a wide variation among interviewing approaches. Unlike the highly structured survey interviews and questionnaires used in epidemiology and most health services research, we examine less structured interview strategies in which the person interviewed is more a participant in meaning making than a conduit from which information is retrieved. In this article we briefly review the more common qualitative interview methods and then focus on the widely used individual face-to-face in-depth interview, which seeks to foster learning about individual experiences and perspectives on a given set of issues. We discuss methods for conducting in-depth interviews and consider relevant ethical issues with particular regard to the rights and protection of the participants.

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Author and article information

Contributors

Araya Mesfin Nigatu:

ORCID: http://orcid.org/0000-0002-0850-265X

hitdt2005@gmail.com

Tesfahun Melese Yilma: tesfahunmelese@gmail.com

Lemma Derseh Gezie: lemmagezie@gmail.com

Yonathan Gebrewold: yonna_g@yahoo.com

Monika Knudsen Gullslett: monika.gullslett@usn.no

Shegaw Anagaw Mengiste: Shegaw.Mengiste@usn.no

Binyam Tilahun: binigcms@gmail.com

Journal

Journal ID (nlm-ta): BMC Health Serv Res

Journal ID (iso-abbrev): BMC Health Serv Res

Title: BMC Health Services Research

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6963

Publication date (Electronic): 24 July 2023

Publication date PMC-release: 24 July 2023

Publication date Collection: 2023

Volume: 23

Electronic Location Identifier: 787

Affiliations

[1 ]GRID grid.59547.3a, ISNI 0000 0000 8539 4635, Department of Health Informatics, Institute of Public Health, , University of Gondar, ; Gondar, Ethiopia

[2 ]GRID grid.59547.3a, ISNI 0000 0000 8539 4635, Department of Epidemiology and Biostatistics, Institute of Public Health, , University of Gondar, ; Gondar, Ethiopia

[3 ]GRID grid.59547.3a, ISNI 0000 0000 8539 4635, Department of Radiology, College of Medicine, Author’s Information, , University of Gondar, ; Gondar, Ethiopia

[4 ]GRID grid.463530.7, ISNI 0000 0004 7417 509X, Faculty of Health and Social Sciences, , University of South-Eastern Norway, ; Drammen, Norway

[5 ]GRID grid.463530.7, ISNI 0000 0004 7417 509X, Management Information Systems, , University of South-Eastern Norway, ; Drammen, Norway

Author information

Araya Mesfin Nigatu http://orcid.org/0000-0002-0850-265X

Article

Publisher ID: 9652

DOI: 10.1186/s12913-023-09652-9

PMC ID: 10367423

PubMed ID: 37488569

SO-VID: f707c1af-32d1-4e78-91ff-0f65f5322ecb

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 7 November 2022

Date accepted : 6 June 2023

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100007861, University of Gondar;

Award ID: 05/2886/2013

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: medical imaging,radiology consultation services,challenges,ethiopia

Data availability:

ScienceOpen disciplines: Health & Social care

Keywords: medical imaging, radiology consultation services, challenges, ethiopia

Medical imaging consultation practices and challenges at public hospitals in the Amhara regional state, Northwest Ethiopia: a descriptive phenomenological study

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Most cited references 45

Saturation in qualitative research: exploring its conceptualization and operationalization

A simple method to assess and report thematic saturation in qualitative research

The qualitative research interview.

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