A prospective study was undertaken to investigate the impact of an information leaflet on parental knowledge,
anxiety and satisfaction.
A CT information leaflet for parents was designed,
which acted as the intervention for this study.
The study was conducted in two phases.
The first phase involved parents in a control group,
which did not receive the CT information leaflet.
The second phase examined parents in the study group,
who received the CT information leaflet with the CT appointment letter at least 14 days before the CT appointment.
The two phases were structured to prevent the control group coming into contact with the intervention group.
Information Leaflet Design Process
The information leaflet was designed to inform parents and allow them to sufficiently prepare their child before coming to the CT department.
The leaflet was designed under guidance from the hospital Children’s Health Information Centre (CHIC).
Key stakeholders in the design process included radiographers,
radiologists,
medical physicists and parents.
Participants
Those who met the inclusion criteria (Figure 1) were invited to participate in the research study on the day of the CT appointment.
To avoid selection bias all participants which met the inclusion criteria were invited to participate during both phases.
Participation and response rates were quite good.
The participation rate for the control group was 88% (15 out of a potential 17 participants).
The participation rate for the study group was 93% (14 out of a potential 15 participants).
The response rate was 100% for both groups.
The simplicity of the questionnaires possibly contributed to the high participation and response rates.
Questionnaires
Participants were required to complete questionnaires before and after the CT scan.
The pre-scan questionnaire was designed to evaluate the parent’s knowledge and understanding of CT,
their personal information seeking behaviors and parental anxiety before their child’s CT scan.
The parent’s level of knowledge was evaluated with 9 statements which the parent had to decide if they were true or false through tick boxes.
Each statement could be marked as ‘true’,
‘false’ or ‘don’t know’.
These statements were similar to statements used in the study conducted by Maher et al. [8] and Chesson et al. [2] as they were deemed relevant.
Visual analogue scales (VAS) were used to measure anxiety.
The descriptive words at the opposite ends of the scale were ‘not anxious at all’ and ‘extremely anxious’. The parent was also asked to provide detail on possible causes of anxiety for them to allow a more in depth understanding of the causes of parental anxiety when coming for a CT scan.
The second questionnaire was brief to encourage participation.
Parents were required to complete this section after their child had their CT scan.
The VAS was employed to measure parental satisfaction with their visit to the CT department,
how prepared they felt they were for the CT appointment and how useful they found the information they received for their scan.
The descriptive terms used for the above three measures were:
- ‘very unsatisfied’ and ‘extremely satisfied’
- ‘totally unprepared’ and ‘very prepared’
- ‘not helpful at all’ and ‘very helpful’
The questionnaires were piloted with 10 parents to ensure clarity and ease of understanding.
Minor adjustments in language were made with wording before finalising the questionnaire.
Administration staff were involved in providing the questionnaires to parents when they checked in for the appointment.
This was to avoid introducing bias and influence into the study.
The questionnaires were completed in the privacy of a quiet waiting area in the CT department.
The parent was given an envelope to seal the questionnaire in once completed and the questionnaires were stored in the designated boxes within the CT department.
Data Analysis and Statistics
The results were collated and coded into a password protected spreadsheet.
Descriptive and inferential statistics were calculated to demonstrate the results while the Mann Whitney U test was used to test statistical significance.
The probability statistic (p-value) for each test was then compared against the criteria of 0.05 to determine if the findings were statistically significant (see Figure 2).