But what does it mean to us? Radiographic patients and carer perceptions of compassion.

INTRODUCTION: An increased focus on compassion was one of the recommendations in the Francis Report following an inquiry into failures of care at the Mid Staffordshire NHS Trust in 2010. Responses to the Francis report did not take up the question of what compassion meant and how its recommendations might be meaningfully implemented in radiography practice. As part of two wider doctoral research studies, the findings presented in this paper reveal patients and carers perspectives of how compassionate care is experienced, based on an exploration of their experiences, views and attitudes in order to better understand its meaning and application in radiographic practice. METHODS: A constructivist approach was taken with appropriate ethical approval. Using a combination of interviews, focus groups, co-production workshops and online discussion forums the authors explored the experiences and opinions of patients and carers about compassion in radiotherapy and diagnostic imaging. Data were transcribed and analysed thematically. RESULTS: The thematically mapped findings are presented under four sub-themes: The values of caring vs the 'business' values of the NHS, Person-centred care, Characteristics of the radiographer and Compassion in the radiographer-patient interaction. CONCLUSION: Looking at compassion through a patient's lens has highlighted how person-centred care consists of components not attributable to radiographers alone. The personal values of a radiographer must not only align with those of the profession they seek to join, but the value placed on compassion must also be reflected in the environment in which they practice. Alignment signifies patients are part of a compassionate culture. IMPLICATIONS FOR PRACTICE: Equal emphasis should be placed on both technical and caring practices in order to stop the profession being perceived as target-driven, rather than one which ensures patients are at the heart of practice.

Compassionate communication: Keeping patients at the heart of practice in an advancing radiographic workforce.

INTRODUCTION: Compassion is a poorly understood concept in diagnostic and therapeutic radiography, but an increase in its focus was recommended in the Francis Report (2013). Much of the healthcare literature including policy and protocol has focussed on benchmarking and individualising compassion. Two separately conducted doctoral research projects, one therapeutic and one diagnostic, aimed to conceptualise compassion in order to understand its meaning and behavioural expression. METHODS: A constructivist approach was taken with appropriate ethical approval. Patients and carers, student radiographers and radiographers took part in interviews and focus groups and tweets were harvested from a Twitter journal club discussion between radiographers of the second author's published literature review. Data were transcribed and analysed thematically. FINDINGS: Key aspects of communication are fundamental to giving compassionate patient-centred care. These include verbal and non-verbal cues, actively listening and engaging and establishing rapport with the patient. Specific skills associated with these are also identified in these studies. CONCLUSION: Keeping the patient as a person at the centre of radiographic practice in the rapidly evolving technical and cultural environment in which it exists requires timely and appropriate behavioural expressions of compassion from radiographers deploying a range of highly specific communication and interpersonal skills. IMPLICATIONS FOR PRACTICE: When undertaking reflective practice, radiographers could consider key aspects of how they communicate with patients, including: verbal (in particular the language they use with patients and their tone of voice); non-verbal (especially eye contact and smiling and their body language). They could also usefully explore and develop skills in reading their patients' body language as well as their own in order to pick up subtle or hidden cues that might suggest a patient is suffering emotionally or psychologically. Finally, they could think about the sort of targeted questions they could ask of patients when welcoming them into the x-ray or treatment room that would both facilitate the procedure and leave the patient feeling that their radiographer had taken a genuine interest in them and their situation. These reflections could then be used to possibly modify their existing communications with their patients.

Navigating the maze: Qualitative research methodologies and their philosophical foundations.

OBJECTIVES: One of the three objectives of the Society and College of Radiographers is the promotion and dissemination of research in radiography and radiotherapy. This article aims to assist in the production of high standard research by explaining how transparency in reporting the underpinning philosophical basis of a qualitative study can be achieved in addition to the more customary descriptions of how data were collected and analysed. KEY FINDINGS: Unlike their quantitative equivalent, qualitative research methodologies are less well understood and reported in radiography research, in particular the philosophical and epistemological assumptions which underpin the methods used. CONCLUSION: Demonstrating consistency between the philosophical position taken and the methods used within a study is an important aspect of research quality. IMPLICATIONS FOR PRACTICE: Qualitative research can offer valuable insights into the social, organisational, behavioural and interpersonal aspects of medical imaging practice. These may include wellbeing, attitudes, perceptions and beliefs, leadership, management practices, education, professionalism and a wide range of issues around patients' experiences during medical imaging. Patient care and outcomes can be positively impacted as a result of acquiring these insights.

"It's what's behind the mask": Psychological diversity in compassionate patient care.

INTRODUCTION: The Francis Report recommended an increased focus on compassion in healthcare, and recognition and non-judgmental acceptance of diversity is fundamental in compassionate patient care. The aim of this study was to achieve a wider understanding of diversity that includes individual patient needs, expectations, perceptions and feelings during diagnostic imaging. METHODS: Using thirty-four semi-structured interviews with individual patients, this qualitative study explored their experiences of undergoing diagnostic radiography examinations and asked what compassionate care meant to them and how it is perceived and manifested in the brief, task-focussed and highly technical diagnostic projection imaging encounter. Data were analysed using Thematic Analysis. RESULTS: Four key themes were identified from the analysis; these were: feelings and vulnerability; hidden emotions; professionalism and valued qualities and communication. CONCLUSION: Diversity is defined not only in terms of socio-cultural differences but also psychological ones, i.e. individual emotional and attitudinal characteristics, some of which may be consciously or unconsciously concealed. In order that patients are treated equitably and all of their care needs met, recommendations include a broader focus in education and training to include adapting communication skills and techniques in perception and expression of non-verbal cues. Further research into the pressures specific to the time-pressured, task-focussed, highly technical and rapid turnover environment of projection imaging radiography and how this impacts upon compassionate patient care would make a useful contribution to the field.