Determining the MRI Examination Experience: The Relationship Between Waiting Times, Information Provision, and Patient Anxiety

1. Introduction

Magnetic resonance imaging (MRI) has become one of the fundamental tools of diagnostic care in recent decades.[1,2] Consistent with international trends, the number of MRI examinations has increased significantly, which, on the one hand, contributes to improved diagnostic accuracy and, on the other hand, places increased pressure on the healthcare system.[3] This growing demand presents a particular challenge regarding waiting times and resource allocation.[4,5] Consequently, MRI services are often evaluated using structural performance indicators such as access, waiting lists, and capacity utilization.[6] As a result, access to MRI has become an issue of not only organizational relevance but also broader health policy significance.[7,8]

Optimizing structural access has been the focus of numerous studies. Streit et al. demonstrated through a detailed analysis of MRI workflows that scanner capacity is often underutilized, and that the organization of operational processes — such as patient registration, preparation, and exam scheduling — significantly influences the efficient use of resources.[9] Silva-Aravena et al. showed, using a digital twin and reinforcement learning approach, that optimized MRI scheduling can significantly improve equipment utilization while reducing waiting times.[10] These findings highlight that access to MRI can be enhanced through organizational and technological interventions; however, structural optimization alone does not necessarily capture the full spectrum of service quality.[7,11]

Patient satisfaction plays a central role in assessing healthcare quality. The literature clearly supports the notion that a positive patient experience and satisfaction are associated with clinical safety, treatment adherence, and the effectiveness of care.[12,13] According to the WHO, patient satisfaction is a fundamental indicator of healthcare quality, determining the quality of service as experienced by patients and confidence in the healthcare system.[14] In radiology services, where the diagnostic significance of examinations is paramount, it is particularly important to identify factors that influence patient satisfaction during examinations.[15,16,17]

The experience of an MRI examination is a complex phenomenon influenced by physical, psychological, and communication factors.[18,19] The enclosed space, acoustic noise, and the feeling of loss of control often trigger anxiety or a claustrophobic reaction.[20,21] Severe anxiety can lead to premature termination of the examination or patient movement during the procedure, compromising image quality and reducing diagnostic value. In clinical settings, the rate of examination interruptions attributable to claustrophobia can reach 1%.[20] Patient perceptions of the examination are further influenced by diagnostic uncertainty, indication for the examination, and concerns regarding the prognosis.[22] Effective communication, adequate pre-examination information, and the establishment of good rapport have been shown to reduce anxiety and improve patient cooperation during the examination.[23,24]

Al Shanbari et al. conducted an empirical study of anxiety associated with MRI examinations involving 465 patients and found that more than half of the participants experienced moderate anxiety during the examination; however, female patients reported significantly higher levels of anxiety. Their findings highlight that the psychological dimensions of MRI examinations are clinically relevant and may directly influence the assessment of examination quality.[25]

Alghamdi examined patient satisfaction with radiology services across ten hospitals, with the majority of patients reporting high satisfaction; however, waiting times were associated with lower satisfaction.[15] Another study evaluating service quality [26] emphasized that personal communication, detailed information, and emotional support are key factors in creating a positive MRI experience for patients. Experiences gained during the examination influence not only perceptions of the procedure itself but also the overall evaluation of service quality.[27]

Overall, it can be concluded that the evaluation of MRI services is based on two interrelated dimensions: on the one hand, structural access and waiting times[28]; on the other hand, the quality of care experienced during the examination and patient satisfaction.[29,30] Although these areas are well documented individually, few studies are available that analyze these two factors together within an integrated framework. For a comprehensive evaluation of the quality of diagnostic services, it is necessary to explore how access indicators and examination experience are related to each other and how they contribute to the quality of service as perceived by patients.

The aim of this study was to analyze the relationships among access to MRI examinations, the quality of the examination experience, and patient satisfaction using a multicenter sample within a structured research framework. An important objective was to provide, based on available data, comprehensive, gap-filling insights into waiting lists, patient experience (including psychological reactions), and long-term effects in relation to patient satisfaction.

2. Materials and Methods

Prior to the commencement of sampling, the study received official approval. The ethical clearance number certifying the ethical basis of the research is BM/26297-1/2023. Target institutions for the study were hospitals in Hungary equipped with MRI machines. Sampling was conducted through purposive selection, taking into account the institutions’ geographical locations and the availability of MRI services. During data collection, sampling was conducted across all NUTS 2 regions in Hungary (Figure 1). The selection of institutions within each region was based on the 2023 hospital bed count report published by the National Health Insurance Fund of Hungary.[31] University clinical centers within the NUTS 2 region were excluded because of their extremely large bed capacity, unique regional location, and level of progressiveness, which would have significantly distorted the comparison. As a result, the study better captured the institutional differences within the classic public hospital structure.

The study included one state-funded hospital located in a city with county rights in each NUTS 2 region, as specialized outpatient care capacities in Hungary are concentrated in these types of settlements. Although the Erzsébet Teaching Hospital and Rehabilitation Institute in Sopron (the second-largest in the region) and the Szent Borbála Hospital of Komárom-Esztergom County (Tatabánya) (the third-largest in the region) are not the institutions with the largest number of beds, it was with these institutions that collaboration during data collection could be realized.

In the case of the Budapest and Pest NUTS 2 region (formerly the Central Hungary region), two institutions were included in the analysis. A key consideration was ensuring representation of both a Buda-based and a Pest-based institution, given the differences in the socioeconomic characteristics of the patient populations.[31] On the Pest side, the Military Hospital currently has the largest number of beds among non-clinical-level institutions, while on the Buda side, János Hospital has the largest number of inpatient beds.

In total, the study was conducted at eight healthcare facilities.

Data were collected using a structured, paper-based questionnaire completed on-site by patients after the MRI scan examination.

During the study period in 2025, a total of 742 adult patients (aged ≥18) voluntarily participated in the survey at one of the eight designated institutions. The questionnaire was completed anonymously following written informed consent. Inclusion criteria for the study sample were: undergoing an MRI examination at a participating institution; being of legal age and legally competent; being able to complete the questionnaire independently; and completing and signing the consent form. Exclusion criteria were not meeting the inclusion criteria, and incomplete questionnaire responses (defined as <80% completion). A total of 756 responses were received, of which 14 were excluded for not meeting the minimum completion threshold.

Descriptive statistical analyses were also conducted during the quantitative research. In this context, mean, standard deviation, median, and minimum and maximum values were calculated for continuous variables, while frequency measures were used to present categorical variables. Multivariate regression analysis was performed to identify factors influencing overall satisfaction with the MRI examination. Variables representing organizational, communication, environmental, personal, and perceptual dimensions of the care process were included in the model. Factors examined included waiting lists, the quality of information provided, the distracting effect of the high-pitched noise during the scan, and the sense of isolation during the procedure. Additional considerations involved personal aspects of the MRI examination, such as staff competence and hygiene. Perceptions of the overall quality of the MRI examination were also assessed, particularly regarding effectiveness and safety. Data recording and statistical analyses were performed using IBM SPSS Statistics version 27.0. Results were considered statistically significant at a 95% confidence interval (p < 0.05).

3. Results

The satisfaction dimension was assessed using six variables, which were rated on a 1–4 Likert scale.

Overall patient evaluations of the MRI examination were favorable. The average overall satisfaction score was 3.76 ± 0.47. The most highly rated aspects were staff competence (3.87 ± 0.41), hygiene (3.77 ± 0.48), and confidence in the effectiveness (3.66 ± 0.52) and safety (3.67 ± 0.54) of the examination. The disruptive effect of the beeping sound received a lower rating (2.10 ± 0.94), whereas the perceived disruption of being alone was minimal (1.64 ± 0.85). Access to MRI scanning varied considerably, with a mean waiting time of 51.71 ± 53.7 days and a median of 31 days. Staff kindness was excluded from the regression analysis due to its strong correlation with competence (r = 0.769; p <0.001). The number of missing responses varied across variables, with the highest rates observed for waiting time (n = 115) and overall satisfaction (n = 43) (Table 1).

Overall patient satisfaction and factors influencing their evaluation of the MRI examination

Multivariate regression analysis was used to examine factors influencing overall satisfaction with the MRI examination, which included the following: waiting list, information provided, the distracting effect of the beeping sound, being alone during the examination, personal factors related to the MRI examination (staff competence and hygiene), and perceptions related to the quality of the MRI examination (effectiveness and safety of the MRI examination).

In the first model, staff competence has a statistically significant effect (β=0.591) on satisfaction with the MRI examination. As satisfaction with staff competence increases, overall satisfaction also increases. The model is significant, F=310.96, p<0.001.

In the second model, predictors of staff competence and confidence in the effectiveness of the examination account for 43.4% of the variance in satisfaction (R²=0.434). The predictor variable professional competence has a significant positive influence on overall satisfaction (β=0.482; t=14.430; p<0.001). In the second model, the inclusion of the variable confidence is also significantly associated with satisfaction (β=0.311; t=9.316; p<0.001) and accounts for 8.5% of the variance in satisfaction with the MRI examination.

The perception variable in the third model of the regression analysis accounted for 2.7% of the variance in satisfaction with the MRI examination. The disturbance effect of being alone significantly influences overall satisfaction; the effect of the predictor variable is negative (β = -0.166; t = -5.336; p<0.001).

Overall satisfaction with hygiene has a positive effect on satisfaction with the MRI examination (β=0.160; t=4.132; p<0.001). This predictor variable plays a relatively minor role in assessing satisfaction, increasing the explanatory power of the model by approximately 1.5%.

In the fifth model, the inclusion of the variable confidence in the safety of the examination is also significantly associated with satisfaction (β=0.101; t=3.007; p=0.011).

Finally, the sixth model shows that the quality of information provided regarding the MRI examination also influences overall satisfaction (β=0.0821; t=2.443; p=0.015). It can be concluded from the standardized regression coefficients that, among the confidence-related factors, confidence in the effectiveness of the examination (β=0.208) has a greater impact on overall satisfaction than the perception of safety (β=0.100). In terms of personal factors, the competence of healthcare professionals (β=0.349) is more significant for overall satisfaction than satisfaction with hygiene (β=0.128).

In the present study, the confounding effects of two variables—waiting list and the beeping sound - were excluded (t = −0.216, p = 0.829 and t = 1.476, p = 0.141).

In summary, 48.8% of the variance in satisfaction with the MRI examination is explained by the six predictor variables included in the model, while the remaining variance (over 50%) is accounted for by other factors not included in the model. A key determinant of satisfaction with the MRI examination was, on the one hand, the assessment of personal factors and staff competence, and on the other hand, patient perceptions of confidence in the effectiveness of the examination. In contrast, the feeling of isolation experienced during the MRI examination had a negative impact on satisfaction. Hygiene, perceived safety, and information provision had a comparatively smaller influence on overall satisfaction.

Key results of the hierarchical regression analysis are presented in Table 2.

4. Discussion

The aim of our study was to use a multivariate regression model to identify the most important factors determining patient satisfaction with MRI examinations. Our results are consistent with international findings, which indicate that experience with MRI is shaped by both technological and procedure-related factors, such as examination environment, noise levels, and waiting times, as well as by aspects of human interaction, particularly staff communication, patient-centered information provision, and establishment of confidence in the examination.[24,32,33] Previous studies in radiology and MRI settings indicate that staff behavior and communication, along with waiting time, are among the most important determinants of patient experience, while targeted, patient-centered communication has also been shown to reduce MRI-related anxiety.[16,28] The 48.8% of variance explained by the final model (Figure 2) can therefore be interpreted as indicating strong explanatory power within the context of regression models examining subjective, psychological, and attitudinal outcomes. This also corresponds to a substantial effect size according to Cohen’s traditional effect size logic.

The Role of Healthcare Professionals

The most important finding of our study is that the competence of healthcare professionals proved to be the strongest positive predictor. In fact, this variable was already dominant in the first model, and its effect remained significant even after the inclusion of other variables. Our results show that patients form their professional assessment of the staff not solely based on technical competence, but also on communication skills, empathy, and professional demeanor.[34,35] During MRI examinations, which are technologically complex and often anxiety-inducing for patients, staff competence can serve as a particularly important indicator of quality, as it contributes to the predictability of the procedure, the patient’s sense of security, and the development of confidence in the examination process.[35,36] Through the expertise of healthcare professionals, patients perceive not only technical competence but also empathetic attention and a confident, supportive presence, which significantly shape the overall experience of the examination.[34]

Confidence in the Effectiveness of the Examination and Sense of Safety

An interesting dichotomy emerges when analyzing confidence-related factors. Our data show that confidence in the effectiveness of the examination is a stronger determinant of satisfaction than the perceived sense of safety during the procedure. This shows that patient attitudes toward MRI examinations are fundamentally shaped by their hope and confidence in the diagnostic value: the primary goal for patients is to obtain an accurate diagnosis, and for this purpose, they appear willing to tolerate the discomfort associated with the examination. At the same time, appropriate communication and information provided in advance remain essential, as they reduce patient anxiety, enhance overall satisfaction, and help patients perceive the examination not only as safe but also as diagnostically meaningful. [19,24] For clinical practice, these findings imply that patient information should not focus solely on risk reduction; it is at least equally important to clearly communicate the purpose, expected benefits, and diagnostic significance of the examination for patients. [19]

Examination-Related Anxiety

The only consistently negative predictor in the model was the disruptive effect of being alone. This finding is consistent with the international literature on MRI, which indicates that the enclosed space of the examination room, the requirement to remain motionless, and the associated sense of loss of control cause significant stress for patients.[36,37] Qualitative studies similarly highlight that supportive interaction with the radiographer, trust-based communication, and adequate pre-examination preparation play key roles in managing fear, discomfort, and perceived loss of self-control, whereas the absence of these factors negatively affects the examination experience. [36] Our findings clearly demonstrate that the feeling of confinement alone can reduce patient satisfaction. Although hygiene and quality of information provided are important determinants of patient experience, a conclusion consistent with radiology satisfaction surveys in which cleanliness, comfort, access to information, and service organization are repeatedly identified as key factors; however, the literature shows that these positive factors do not necessarily fully offset the negative psychological burden associated with MRI examination conditions.[32]

Surprisingly Non-Significant Factors: Waiting List and Noise

One of the most interesting findings of the study is that, contrary to our initial expectations, the length of the waiting list and the high-pitched noise typical of MRI scans did not remain significant factors in the final model. Previous studies in the literature suggest that waiting time can influence patient satisfaction; however, this effect is often mediated more by patients’ perceived or subjectively experienced waiting time than by the actual duration of the wait.²⁸ Accordingly, among patients who have already undergone the examination, earlier administrative delays may recede into the background, particularly if the experience during the procedure itself is positive.¹⁶ Similarly, MRI noise is widely recognized in the literature as an important source of physical discomfort. Nevertheless, reviews on patient experience indicate that overall satisfaction is primarily shaped by personal interactions, including the quality of communication, a sense of control, and confidence in the diagnostic value of the examination.[32,38] Our findings suggest that patients tend to regard technological characteristics and administrative constraints partly as given conditions, whereas factors directly influencing the perceived quality and usefulness of the examination have a greater impact on their assessment of satisfaction.

Strengths and Limitations

In addition to its large sample size and comprehensive nationwide coverage, a key strength of this study lies in its multidimensional assessment of patient satisfaction with MRI examinations, incorporating technological, organizational, psychological, and interpersonal interaction factors simultaneously. The use of a multivariate regression model enabled the identification of the relative contribution of individual predictors and highlighted that staff competence, confidence in the effectiveness of the examination, and the experience of isolation are key determinants of patient experience. The practical value of the study is further reinforced by the direct applicability of its findings to radiology quality improvement initiatives, particularly in the areas of patient-centered communication, pre-examination information provision, and examination support.[39]

The most significant limitation of this study is its cross-sectional design, which precludes causal interpretation of the observed associations. Patient satisfaction was assessed using a self-report questionnaire; therefore, the findings may have been affected by respondent bias, current emotional state, or the immediate experience of the examination. Although the model demonstrated meaningful explanatory power, the remaining variance indicates that additional factors such as prior MRI experience, predisposition to claustrophobia, clinical diagnosis, examination duration, or previous experiences with the healthcare system may also influence satisfaction. Furthermore, the study was conducted within a specific institutional setting; therefore, the generalizability of the findings to other levels of care or radiology departments with differing organizational structures should be interpreted with caution.

5. Conclusions

Our findings indicate that patient satisfaction with MRI examinations is not determined solely by technological or organizational factors but is also strongly shaped by the human and communicative environment experienced by patients. The competence of healthcare professionals, confidence in the effectiveness of the examination, and the disruptive effect of being alone emerged as key predictors, suggesting that a professional and supportive presence, along with a clear understanding of the purpose of the examination, are fundamental components of perceived quality of care. From a clinical perspective, these findings highlight that, alongside improvements in capacity and access, the development of MRI services requires a deliberate focus on strengthening patient-centered communication, providing adequate pre-examination information, and implementing interventions aimed at reducing the feeling of isolation. Future longitudinal and interventional studies should further examine the extent to which such targeted improvements translate into enhanced patient experience and satisfaction outcomes.