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Table 3 Themes and recommendations from the patient’s perspective. Five core themes relating to the patient experience emerged from the data and from this we identified the following recommendations for paediatric MRI

From: Can quantitative MRI be used in the clinical setting to quantify the impact of intra-articular glucocorticoid injection on synovial disease activity in juvenile idiopathic arthritis?

Theme 1: Clear expectations
Knowing fully what to expect relaxes both the child and their family and helps alleviate any concerns or uncertainties.
Recommendations:
 • Provide detailed information to alleviate any concerns or uncertainties both prior to the scan and on the day itself. This should include detailed directions and guidance on what will happen on the day with enough information so the parent/carer can answer any questions the child may have.
 • Offer the opportunity to ask questions beforehand (e.g. telephone call from clinical team prior to appointment).
 • Provide the opportunity to view scanner beforehand.
Theme 2: Creation of relaxing environment
Extra touches that make families feel at home help create a relaxing environment and create a more positive experience in which to have the scan.
Recommendations:
 • Use trained paediatric staff to put both child and parent/carer at ease. Communication to be on a first name basis and whilst familiarity can add an extra layer of relaxation, it is also acceptable to be simply introduced on the day.
 • Use staff experienced in inserting cannulas in children to avoid extra stress that difficulties with their insertion can cause.
 • Give the opportunity for child to listen to music of their choice during the scan.
 • Give the option for parent/carer or member of staff to accompany child into scanner.
 • Ensure pace of appointment is not rushed and is led by the child and parent/ carer’s needs.
 • Care to be taken regarding scan setting wherever possible to reduce unnecessary concerns (e.g. having scan alongside cancer unit viewed as not ideal).
Theme 3: Child centred approach
Scan experience can further be improved by adopting a child centred approach in which the child is seen as key and in control of the situation.
Recommendations:
 • Direct discussion at child.
 • Provide child friendly information leaflets as well as parent versions.
 • Give the option for toys to distract child if required by child and parent/carer.
• Provide ‘completion certificate’ at the end and postcard in the post.
Theme 4: Increased understanding of the condition
An extra layer of positivity can be added to the experience by using the scan as a way to educate the families further about the child’s condition and increase their understanding of what the scan is able to show.
Recommendations:
 • Allow the opportunity to view images after the scan alongside detailed guidance on what the images show and where possible enable patients to take a copy (e.g. photo) they can show other family members, friends or teachers at school.
Theme 5: Linking in to current treatment plan(s)
Effective management enabling linking into current treatment plans viewed positively by families.
Recommendations:
 • Link in to current treatment plan wherever possible. For example providing the opportunity to take bloods at the same time as giving contrast seen as useful especially since many children do not like needles.