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Nitta K, Matsumoto K, Yokota H, Murata T, Masuda Y, Uno T. Relationship Between Patient-Friendly Audiovisual Systems and MRI Contrast Agent to Adverse Reactions. J Magn Reson Imaging 2024; 59:2013-2020. [PMID: 37572088 DOI: 10.1002/jmri.28951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND Patient-friendly audiovisual (AV) systems in head MRI examinations can potentially reduce patient anxiety and contrast-enhanced MRI (CE-MRI) adverse reactions to gadolinium. PURPOSE To evaluate whether a patient-friendly AV system reduces the rate of adverse reactions to gadolinium-based contrast agents. STUDY TYPE Retrospective. POPULATION Four thousand eight hundred thirty-two outpatients (2462 female) attending for clinical CE-MRI studies. (Gadoteridol: 1971, Meglumine gadoterate: 2733, Gadobutrol: 128.) FIELD STRENGTH/SEQUENCE: Routine CE-MRI of head and neck using a 1.5 T or 3 T scanner with or without a patient-friendly AV system. ASSESSMENT One thousand one hundred fifty-nine patients were scanned on MRI machines equipped with patient-friendly AV systems (AV group) and 3673 on MRI machines without AV systems (control group). Adverse reaction rate and symptoms were reviewed by referring to the system database and electronic medical records and compared between the two groups. Adverse reactions were defined as physiological reactions, such as vomiting and allergic-like reactions, such as urticaria, occurring within 1 hour of contrast injection. We compare patient backgrounds, adverse reaction rate, adverse reactions symptoms and the severity between the two groups. STATISTICAL TESTS Adverse reaction rate with and without a patient-friendly AV system were compared using Fisher's exact test. The relationship between patient-friendly AV systems and the occurrence of adverse reactions was evaluated with logistic regression. Statistical significance was set at P < 0.05. RESULTS Of the 4832 patients enrolled, 65 (1.35%) experienced adverse reactions. The most common adverse reactions in both groups were urticaria and pruritus. Adverse reaction rate was significantly lower in the AV group than in the control group (0.7% vs. 1.6%). No significant difference was observed in the severity (P = 1.000) of adverse reactions and symptoms (allergic-like reaction: P = 0.08, physiologic reaction: P = 1.000) between the two groups. DATA CONCLUSION The patient-friendly AV system significantly reduce adverse reaction occurrence to gadolinium-based contrast agents. EVIDENCE LEVEL 4 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Keisuke Nitta
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Koji Matsumoto
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Hajime Yokota
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Taisuke Murata
- Department of Radiology, Chiba University Hospital, Chiba, Japan
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Yoshitada Masuda
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Takashi Uno
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Wennberg L, Mårtensson J, Langensee L, Sundgren PC, Markenroth Bloch K, Hansson B. Effects of ultra-high field MRI environment on cognitive performance in healthy participants. Radiography (Lond) 2024; 30:95-99. [PMID: 37879122 DOI: 10.1016/j.radi.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/14/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Ultra-high field MRI (UHF MRI) is rapidly becoming an essential part of our toolbox within health care and research studies; therefore, we need to get a deeper understanding of the physiological effects of ultra-high field. This study aims to investigate the cognitive performance of healthy participants in a 7 T (T) MRI environment in connection with subjectively experienced effects. METHODS We measured cognitive performance before and after a 1-h 7T MRI scanning session using a Digit Symbol Substitution Test (DSST) in 42 subjects. Furthermore, a computer-based survey regarding the subjectively experienced effects in connection with the MRI examination was distributed. Similarly, two DSSTs were also performed by a control group of 40 participants. RESULTS Even though dizziness was the strongest sensory perception in connection to the MRI scanning, we did not find any correlation between dizziness and cognitive performance. Whilst the control group improved (p=<0.001) on their second DSST the MRI group showed no significant difference (p=0.741) in the DSST before and after MRI scanning. CONCLUSION Transient effect on cognition after undergoing MRI scanning can't be ruled out as the expected learning effect on the DSST was not observed. IMPLICATIONS FOR PRACTICE Increasing understanding of the possible adverse effects may guide operators in performing UHF MRI in a safe way and with person-centered care. Furthermore, it can guide researchers in setting up research protocols to minimize confounding factors in their fMRI studies due to the transient adverse effects of the UHF environment.
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Affiliation(s)
- L Wennberg
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden; Department of Clinical Sciences Lund/ Diagnostic Radiology, Faculty of Medicine, Lund University, Lund, Sweden.
| | - J Mårtensson
- Department of Clinical Sciences Lund/Logopedics, Phoniatrics and Audiology, Faculty of Medicine, Lund University, Lund, Sweden
| | - L Langensee
- Department of Clinical Sciences Lund/Logopedics, Phoniatrics and Audiology, Faculty of Medicine, Lund University, Lund, Sweden
| | - P C Sundgren
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden; Department of Clinical Sciences Lund/ Diagnostic Radiology, Faculty of Medicine, Lund University, Lund, Sweden; Lund BioImaging Centre, Faculty of Medicine, Lund University, Lund, Sweden
| | - K Markenroth Bloch
- Lund BioImaging Centre, Faculty of Medicine, Lund University, Lund, Sweden
| | - B Hansson
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden; Department of Clinical Sciences Lund/ Diagnostic Radiology, Faculty of Medicine, Lund University, Lund, Sweden
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Pennington P, Weinstock-Guttman B, Kolb C, Jakimovski D, Sacca K, Benedict RHB, Eckert S, Stecker M, Lizarraga A, Dwyer MG, Schumacher CB, Bergsland N, Picco P, Bernitsas E, Zabad R, Pardo G, Negroski D, Belkin M, Hojnacki D, Zivadinov R. Communicating the relevance of neurodegeneration and brain atrophy to multiple sclerosis patients: patient, provider and researcher perspectives. J Neurol 2023; 270:1095-1119. [PMID: 36376729 DOI: 10.1007/s00415-022-11405-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022]
Abstract
Central nervous system (CNS) atrophy provides valuable additional evidence of an ongoing neurodegeneration independent of lesion accrual in persons with multiple sclerosis (PwMS). However, there are limitations for interpretation of CNS volume changes at individual patient-level. Patients are receiving information on the topic of atrophy through various sources, including media, patient support groups and conferences, and discussions with their providers. Whether or not the topic of CNS atrophy should be proactively discussed with PwMS during office appointments is currently controversial. This commentary/perspective article represents perspectives of PwMS, providers and researchers with recommendations for minimizing confusion and anxiety, and facilitating proactive discussion about brain atrophy, as an upcoming routine measure in evaluating disease progression and treatment response monitoring. The following recommendations were created based on application of patient's and provider's surveys, and various workshops held over a period of 2 years: (1) PwMS should receive basic information on understanding of brain functional anatomy, and explanation of inflammation and neurodegeneration; (2) the expertise for atrophy measurements should be characterized as evolving; (3) quality patient education materials on these topics should be provided; (4) the need for standardization of MRI exams has to be explained and communicated; (5) providers should discuss background on volumetric changes, including references to normal aging; (6) the limitations of brain volume assessments at an individual-level should be explained; (7) the timing and language used to convey this information should be individualized based on the patient's background and disease status; (8) a discussion guide may be a very helpful resource for use by providers/staff to support these discussions; (9) understanding the role of brain atrophy and other MRI metrics may elicit greater patient satisfaction and acceptance of the value of therapies that have proven efficacy around these outcomes; (10) the areas that represent possibilities for positive self-management of MS symptoms that foster hope for improvement should be emphasized, and in particular regarding use of physical and mental exercise that build or maintain brain reserve through increased network efficiency, and (11) an additional time during clinical visits should be allotted to discuss these topics, including creation of specific educational programs.
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Affiliation(s)
- Penny Pennington
- Advisory Council, Buffalo Neuroimaging Analysis Center, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Channa Kolb
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Dejan Jakimovski
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA
| | - Katherine Sacca
- Advisory Council, Buffalo Neuroimaging Analysis Center, Buffalo, NY, USA
| | - Ralph H B Benedict
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Svetlana Eckert
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Marc Stecker
- Advisory Council, Buffalo Neuroimaging Analysis Center, Buffalo, NY, USA
| | - Alexis Lizarraga
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Michael G Dwyer
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA.,Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Carol B Schumacher
- Advisory Council, Buffalo Neuroimaging Analysis Center, Buffalo, NY, USA
| | - Niels Bergsland
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA.,IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Patricia Picco
- Advisory Council, Buffalo Neuroimaging Analysis Center, Buffalo, NY, USA
| | | | - Rana Zabad
- University of Nebraska Medical Center, Omaha, NE, USA
| | - Gabriel Pardo
- Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | | | - Martin Belkin
- Michigan Institute for Neurological Disorders (MIND), Farmington Hills, MI, USA
| | - David Hojnacki
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA. .,Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA.
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Comparing patient acceptability of MR-guided radiotherapy to conventional CBCT on two Elekta systems: a questionnaire-based survey. JOURNAL OF RADIOTHERAPY IN PRACTICE 2022. [DOI: 10.1017/s1460396922000206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background and Purpose:
The magnetic resonance linear accelerator system (MR Linac) is a novel piece of radiotherapy (RT) equipment allowing the routine application of daily MR-guided treatment adaptation. The hardware design required for such technical capabilities and the increased complexity of the treatment workflow entails a notable departure from cone beam computed tomography (CBCT)-based RT. Patient tolerability of treatment is paramount to RT practice where high compliance is required. Presented is a comparative analysis of how such modality specific characteristics may ultimately impact the patient experience of treatment.
Materials and Methods:
Forty patients undergoing RT for prostate cancer (PCa) on either the MR Linac (n = 20) or a CBCT-based linac (n = 20) were provided with a validated patient reported outcomes measures (PROM’s) questionnaire at fraction 1 and fraction 20. The 18-item questionnaire provided patient responses recorded using a 4-point Likert scale, 0 denoting a response of ‘Not at all’, 1 ‘Slightly’, 2 ‘Moderately’ and 3 signifying ‘Very’. The analysis provided insight into both comparisons between modalities at singular time points (fractions 1 and 20), as well as a temporal analysis within a single modality, denoting changing patient experience.
Results:
Patients generally found the MR Linac treatment couch more comfortable, however, found the increase in treatment duration harder to tolerate. Responses for all items remained stable between first and last fraction across both cohorts, indicating minimal temporal variation within a single modality. None of the responses were statistically significant at the 0·01 level.
Conclusion:
Whether radiotherapy for PCa is delivered on a CBCT linac or the MR Linac, there is little difference in patient experience with minimal experiential variation within a single modality.
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Shimokawa K, Matsumoto K, Yokota H, Kobayashi E, Hirano Y, Masuda Y, Uno T. Anxiety relaxation during MRI with a patient-friendly audiovisual system. Radiography (Lond) 2022; 28:725-731. [PMID: 35428571 DOI: 10.1016/j.radi.2022.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 03/19/2022] [Accepted: 03/24/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Many patients experience anxiety, not limited to claustrophobia, before magnetic resonance imaging (MRI) examination. We performed a non-randomized controlled trial to evaluate whether a patient-friendly audiovisual (AV) system in the MR scanner room reduces patient anxiety. METHODS We randomly selected 61 participants from outpatients who required brain MRI examination. Patients were informed that they could choose to undergo an MRI examination with a patient-friendly AV system (Ambient Experience, Philips Healthcare, Best, The Netherlands) or the standard system. To complete the MRI examination without affecting clinical practice, all patients who preferred the patient-friendly AV system were assigned to the preferring AV group. Patients who indicated that either system was acceptable were randomly assigned to the no preference but allocated AV group or control (using the standard system) groups. In both groups, state anxiety using the State-Trait Anxiety Inventory (STAI) was assessed before and after the MRI examination (A-State-before and A-State-after MRI, respectively). The changes in A-State-before and A-State-after MRI were categorized as follows: relieved high-state anxiety, no change in high-state anxiety, stable easiness, and intensified anxiety. RESULTS Among the 61 included patients, 19 were assigned to the preferring AV group, 20 to the no preference but allocated AV group, and 22 to the control group. There were no significant differences between the group. However, in patients with high-state anxiety before MRI, the preferring AV group and the no preference but allocated AV group, which used the patient-friendly AV system, relieved high-state anxiety by 63.6% (7 of 11 patients) and 81.8% (9 of 11 patients), respectively. In contrast, the control group using the standard system relieved high-level anxiety by only 42.9% (three out of seven patients). CONCLUSION The patient-friendly AV system may reduce anxiety in patients undergoing MRI examinations. IMPLICATIONS FOR PRACTICE The patient-friendly AV system may reduce anxiety in patients undergoing MRI examination by providing a more patient-centered MRI examination environment. These findings may help ameliorate negative perceptions associated with MRI examination.
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Affiliation(s)
- K Shimokawa
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8677, Japan.
| | - K Matsumoto
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8677, Japan.
| | - H Yokota
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan.
| | - E Kobayashi
- Department of Neurosurgery, National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakihara, Chuo-ku, Chiba-shi, Chiba 260-8606, Japan.
| | - Y Hirano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-0856, Japan.
| | - Y Masuda
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8677, Japan.
| | - T Uno
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan.
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Komber H, Little D, Cade S, Graham R, Redman S. Comparing the patient experience between a novel 360° gamma camera (VERITON-CT) and a conventional dual head gamma camera. J Nucl Med Technol 2021; 50:jnmt.121.262627. [PMID: 34750232 PMCID: PMC9168651 DOI: 10.2967/jnmt.121.262627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/25/2021] [Accepted: 09/25/2021] [Indexed: 11/16/2022] Open
Abstract
Aims: To explore whether the novel 360° gamma camera design of VERITON-CT adversely affects the rate of scan non-completion due to claustrophobia or other patient experience factors, when compared to a standard dual-headed gamma camera. Methods: Single centre prospective study of all nuclear medicine studies on either of two gamma cameras; the VERITON-CT (Spectrum Dynamics Medical) and Discovery NM/CT 670 (GE Healthcare). It was recorded whether the patient had completed the scan as protocoled or, due to claustrophobia, had a shortened scan or no scan. The patients were also offered a patient experience questionnaire, with domains of comfort, scan time, scan noise and claustrophobia assessed using a five-point Likert scale. Results: Over a four-month period, there were 296 patients scanned on the Discovery scanner and 274 patients scanned on the VERITON-CT scanner. There was a scan non-completion rate, due to claustrophobia, of 1.35 % for the Discovery and 1.46 % for the VERITON-CT scanner. 354/570 (62%) of all patients involved returned their questionnaires. There was no statistical difference between the responses for comfort, scan time, scan noise and feelings of claustrophobia. Conclusion: The study provides evidence that the novel 360° gamma camera design of VERITON-CT does not lead to a significantly increased scan failure rate due to claustrophobia and there is no change in the subjective experience for patients.
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Affiliation(s)
- Hend Komber
- Royal United Hospitals Bath NHS Trust, United Kingdom
| | - David Little
- Royal United Hospitals Bath NHS Trust, United Kingdom
| | - Sarah Cade
- Royal United Hospitals Bath NHS Trust, United Kingdom
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Jerjen F, Zaidi T, Chan S, Sharma A, Mudliar R, Soomro K, Jimenez Y, Reed W. Magnetic Resonance Imaging for the diagnosis and management of acute colonic diverticulitis: a review of current and future use. J Med Radiat Sci 2021; 68:310-319. [PMID: 33607699 PMCID: PMC8424307 DOI: 10.1002/jmrs.458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 12/14/2022] Open
Abstract
Diverticular disease is one of the most common causes of outpatient visits and hospitalisations across Australia, North America and Europe. According to the Gastroenterological Society of Australia (GESA, 2010), approximately 33% of Australians over 45 years of age and 66% over 85 years of age have some form of colonic diverticulosis. Patients with colonic diverticulosis are known to develop subsequent complications such as acute colonic diverticulitis (ACD), and when more than one attack of diverticulitis occurs, there is a 70-90% chance that the individual will experience ongoing problems and recurring infections throughout their lifetime. Medical imaging is fundamental in the diagnosis, treatment and ongoing management of ACD and its complications, with Computed Tomography (CT) identified as the prevailing gold standard in the last few decades. Cross-database searching highlighted a large gap in the literature regarding the effectiveness of Magnetic Resonance Imaging (MRI) as a non-ionising radiation alternative imaging tool for ACD imaging after the mid-2000s, despite ongoing technological advancements in this modality. This narrative review identified 13 key publications (11 primary prospective cohort studies, 1 systematic review and 1 meta-analysis) that evaluate MRI for ACD imaging, of which five were published within the last decade. Several existing MRI protocols are deemed suitable for ACD imaging, and it is recommended they be re-evaluated in larger cohorts. Future studies should consider the rapidly growing technological improvements of MRI, its cost efficiency and its applicability in modern day healthcare settings when addressing ACD management. This is especially important considering the gradual rise in radiation dose among the Australian population attributable to increased CT referrals, alongside increased reporting of ACD cases in younger individuals.
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Affiliation(s)
- Franziska Jerjen
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Tooba Zaidi
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Shannon Chan
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Ajay Sharma
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Reuel Mudliar
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Khadija Soomro
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Yobelli Jimenez
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
| | - Warren Reed
- Medical Imaging Optimisation and Perception Group (MIOPeG)Discipline of Medical Imaging ScienceSydney School of Health SciencesFaculty of Medicine and HealthFranziska Jerjen and Tooba Zaidi are joint first authorsThe University of SydneySydneyNSWAustralia
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King S, Woodley J, Walsh N. A systematic review of non-pharmacologic interventions to reduce anxiety in adults in advance of diagnostic imaging procedures. Radiography (Lond) 2020; 27:688-697. [PMID: 33028496 DOI: 10.1016/j.radi.2020.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Anticipation of a diagnostic imaging (DI) procedure, particularly one involving advanced technology, can provoke feelings of anxiety in patients. Anxiolytics (anxiety reducing drugs) can be used to reduce pre-procedural anxiety in patients, however there are several known disadvantages to this approach. The aim of this systematic review was to identify and evaluate any preparatory non-pharmacological interventions used to reduce patient anxiety in advance of DI procedures. KEY FINDINGS Database searches revealed twelve studies met the eligibility criteria and were included in the review. A narrative synthesis identified three intervention categories: patient information/education, cognitive strategies (i.e. guided imagery, breathing techniques, imaginative visualisation) and music therapy. CONCLUSION The current review demonstrates that despite the existence of a number of studies providing some evidence for the effectiveness of a range of anxiety reducing interventions for patients prior to DI, the small number and overall low quality of studies identified makes it difficult to draw firm conclusions regarding the application of a specific intervention in clinical practice. IMPLICATIONS FOR PRACTICE The majority of interventions included in this review were shown to be practical for inclusion in the clinical setting and did have some positive effect on patient anxiety levels. As a result those professionals working with adults undergoing advanced technology DI procedures may consider implementing some of the strategies that have been discussed within their practice.
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Affiliation(s)
- S King
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
| | - J Woodley
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - N Walsh
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
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Bolejko A, Hagell P. Effects of an information booklet on patient anxiety and satisfaction with information in magnetic resonance imaging: A randomized, single-blind, placebo-controlled trial. Radiography (Lond) 2020; 27:162-167. [PMID: 32753258 DOI: 10.1016/j.radi.2020.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Magnetic resonance imaging (MRI) is an important modality in diagnostics and treatment follow-up. However, MRI can be perceived as unpleasant even though the examination is non-invasive. Patients' knowledge of the MRI procedure is usually scarce, which may enhance patient anxiety at examination. We investigated the effects on anxiety and satisfaction with an information booklet on MRI compared to a placebo booklet delivered to adult patients prior to their first MRI examination. METHODS This randomized, single-blind, placebo-controlled trial included 197 patients. The intervention group (n = 95) received a booklet about MRI prior to the examination, whereas the control group (n = 102) received a placebo booklet of the same size and layout but containing general information. The State Trait Anxiety Inventory with supplementary questions from the Quality from the Patient's Perspective questionnaire were used as patient-reported outcome measures. RESULTS Anxiety did not differ between the groups, either prior to MRI or during the examination, but those who received the placebo booklet were at higher risk of experiencing high anxiety prior to the MRI examination (odds ratio 2.64; P = 0.029). The intervention group was more satisfied with the information received (P = 0.044), and a majority of participants in both groups (≥87%) considered it important to obtain information on the MRI procedure. CONCLUSION Written MRI information decreases the risk of high anxiety levels before MRI and improves patient satisfaction with the information. Further research is needed to investigate whether written information prior to MRI is beneficial not only from the perspective of the patient but may also be cost-effective. IMPLICATIONS FOR PRACTICE Written MRI information prior to the examination is recommended in radiography care.
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Affiliation(s)
- A Bolejko
- Department of Translational Medicine, Department of Medical Imaging and Physiology, Lund University, Skåne University Hospital, Carl Bertil Laurells gata 9, 205 02, Malmö, Sweden.
| | - P Hagell
- The PRO-CARE Group, Faculty of Health Sciences, Kristianstad University, Elmetorpsvägen 15, 291 88, Kristianstad, Sweden.
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Grilo AM, Vieira L, Carolino E, Costa M, Galaio S, Melo I, Geão A, Santos A, Colarinha P. Cancer Patient Experience in a Nuclear Medicine Department: Comparison Between Bone Scintigraphy and 18F-FDG PET/CT. J Nucl Med Technol 2020; 48:254-262. [PMID: 32518119 DOI: 10.2967/jnmt.119.239285] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/16/2020] [Indexed: 12/23/2022] Open
Abstract
Our objective was to assess the anxiety level in cancer patients undergoing nuclear medicine exams and to identify how professionals can improve patient experience. Methods: In total, 94 patients undergoing 99mTc-hydroxymethylene diphosphonate (99mTc-HDP) bone scintigraphy (BS) or 18F-FDG PET/CT completed 2 scan-experience questionnaires and the Spielberger State Anxiety Inventory (STAI-S) before the scan and after image acquisition. Results: Before the exam, the mean anxiety levels were higher for the 99mTc-HDP BS group than for the 18F-FDG PET/CT group. After the exam, the opposite was true. Both groups experienced a reduction in anxiety after the scan (prescan score, 51.75 for 99mTc-HDP BS and 44.67 for 18F-FDG PET/CT; postscan score, 36.70 for 99mTc-HDP BS and 38.82 for 18F-FDG PET/CT). The greatest anxiety factor for the 99mTc-HDP BS group was the duration of the exam (mean ± SD, 5.34 ± 2.08), whereas for the 18F-FDG PET/CT group it was the result (5.40 ± 1.80). Conclusion: Patients undergoing nuclear medicine exams in an oncologic context had significant anxiety levels before and after their scans. However, 99mTc-HDP BS and 18F-FDG PET/CT had different triggers. It is of extreme importance that health-care professionals be aware of these peculiarities and adjust their procedures accordingly.
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Affiliation(s)
- Ana M Grilo
- H&TRC-Health & Technology Research Center, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal .,CICPsi-Research Center for Psychological Science, Faculty of Psychology, University of Lisbon, Portugal
| | - Lina Vieira
- H&TRC-Health & Technology Research Center, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal.,CIMOSM, ISEL-Centro de Investigação em Modelação e Optimização de Sistemas multifuncionais, Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Elisabete Carolino
- H&TRC-Health & Technology Research Center, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Melissa Costa
- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal; and
| | - Salomé Galaio
- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal; and
| | - Inês Melo
- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal; and
| | - Ana Geão
- Serviço de Medicina Nuclear, Hospital CUF Descobertas, Lisbon, Portugal
| | - Andrea Santos
- Serviço de Medicina Nuclear, Hospital CUF Descobertas, Lisbon, Portugal
| | - Paula Colarinha
- Serviço de Medicina Nuclear, Hospital CUF Descobertas, Lisbon, Portugal
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Faggion CM, Diaz KT. Overview authors rarely defined systematic reviews that are included in their overviews. J Clin Epidemiol 2019; 109:70-79. [DOI: 10.1016/j.jclinepi.2019.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/21/2018] [Accepted: 01/15/2019] [Indexed: 01/08/2023]
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Hogan D, DiMartino T, Liu J, Mastro KA, Larson E, Carter E. Video-based Education to Reduce Distress and Improve Understanding among Pediatric MRI Patients: A Randomized Controlled Study. J Pediatr Nurs 2018; 41:48-53. [PMID: 29370960 DOI: 10.1016/j.pedn.2018.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 01/06/2018] [Accepted: 01/06/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Evaluate the effectiveness of an educational video vs. standard of care in improving relaxation and procedural understanding among pediatric patients undergoing a magnetic resonance imaging (MRI) procedure. DESIGN AND METHODS This pilot randomized controlled trial was conducted in a large, urban academic children's hospital. Pediatric patients were randomized to receive either a 7-minute educational video or standard of care. Standardized surveys, which consisted of a 1-10 visual analog scale and open-ended questions were administered to patients to measure their level of relaxation, understanding of the procedure, and perceptions of the MRI education received. Bivariate statistics were used to compare changes in relaxation score and baseline understanding scores between study groups. Open-ended questions were analyzed using content analysis. RESULTS A total of 50 pediatric patients completed the study. Improvements in relaxation scores and baseline procedural understanding scores were significantly higher among children 13-17 years of age who received the intervention compared to those that did not (P < 0.05). No statistically significant differences were noted in relaxation scores and procedural understanding scores among children < 13 years of age between study groups. A total of 26 patients, half from the control group and half from the intervention group responded to open-ended survey questions. Content analysis revealed that nearly all respondents perceived the educational video to increase their understanding of the MRI procedure. CONCLUSIONS Video-based education effectively improved the relaxation and procedural understanding of children 13-17 years of age undergoing a MRI. PRACTICE IMPLICATIONS Nurses may use video-based education to supplement existing MRI education among older children.
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Affiliation(s)
- Daniel Hogan
- New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, United States.
| | - Tina DiMartino
- New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, United States.
| | - Jianfang Liu
- Columbia University School of Nursing, New York, NY, United States.
| | - Kari A Mastro
- New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, United States
| | - Elaine Larson
- New York-Presbyterian Hospital, New York, NY, United States.
| | - Eileen Carter
- Columbia University School of Nursing, New York-Presbyterian Hospital, New York, NY, United States.
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Martinez-Lorca A, Martinez-Lorca M. Letter to the Editor. J Med Imaging Radiat Sci 2018; 49:118. [DOI: 10.1016/j.jmir.2017.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ding S, Meystre NR, Campeanu C, Gullo G. Contrast media extravasations in patients undergoing computerized tomography scanning: a systematic review and meta-analysis of risk factors and interventions. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2018; 16:87-116. [PMID: 29324560 PMCID: PMC5771689 DOI: 10.11124/jbisrir-2017-003348] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To identify risk factors and interventions preventing or reducing contrast medium extravasation. INTRODUCTION Computed tomography (CT) is a radiological examination essential for the diagnosis and monitoring of many diseases. It is often performed with the intravenous (IV) injection of contrast agents. Use of these products can result in a significant complication, extravasation, which is the accidental leakage of IV material into the surrounding tissue. Patients may feel a sharp pain and skin ulceration or necrosis may develop. INCLUSION CRITERIA This review considered studies that included patients (adults and children) undergoing a CT with IV administration of contrast media. The risk factors considered were patient demographics, comorbidities and medication history. This review also investigated any strategies related to: contrast agent, injection per se, material used for injection, apparatus used, healthcare professionals involved, and patient risk assessment performed by the radiology personnel. The comparators were other interventions or usual care. This review investigated randomized controlled trials and non-randomized controlled trials. When neither of these were available, other study designs, such as prospective and retrospective cohort studies, case-control studies and case series, were considered for inclusion. Primary outcomes considered were: extravasation frequency, volume, severity and complications. METHODS The databases PubMed, CINAHL, Embase, the Cochrane Register of Controlled Trials, Web of Science PsycINFO, ProQuest Dissertations and Theses A&I, TRIP Database and ClinicalTrials.gov were searched to find both published and unpublished studies from 1980 to September 2016. Papers were assessed by two independent reviewers for methodological validity using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI). Data were extracted using the standardized data extraction tool from JBI SUMARI. In one case, quantitative data from two cohort studies were pooled in a statistical meta-analysis. However, generally, statistical pooling was not possible due to heterogeneity of the interventions, populations of interest or outcomes. Accordingly, the findings have been presented in narrative form. RESULTS Fifteen articles were selected from a total of 2151 unique studies identified. Two were randomized controlled trials and 13 were quasi-experimental and observational studies. The quality of these studies was judged to be low to moderate. Some patient characteristics, such as female sex and inpatient status, appeared to be risk factors for extravasation. Additionally, injection rate, venous access site and catheter dwelling time could affect the volume extravasated. Preliminary studies seemed to indicate the potential of extravasation detection accessories to identify extravasation and reduce the volume extravasated. The other interventions either did not result in significant reduction in the frequency/volume of extravasation, or the results were mixed across the studies. CONCLUSIONS The majority of the studies included in this review evaluated the outcomes of extravasation frequency and volume. Given the quality of the primary studies, this systematic review identified only potential risk factors and interventions. It further highlighted the research gap in this area and the importance of conducting trials with solid methodological designs.
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Affiliation(s)
- Sandrine Ding
- Department of Technical Medical Radiology, Haute École de Santé Vaud (HESAV), University of Applied Sciences Western Switzerland (HES-SO), Lausanne, Switzerland
- Bureau d’Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a Joanna Briggs Institute Centre of Excellence, Lausanne, Switzerland
| | - Nicole Richli Meystre
- Department of Technical Medical Radiology, Haute École de Santé Vaud (HESAV), University of Applied Sciences Western Switzerland (HES-SO), Lausanne, Switzerland
- Bureau d’Echange des Savoirs pour des praTiques exemplaires de soins (BEST): a Joanna Briggs Institute Centre of Excellence, Lausanne, Switzerland
| | - Cosmin Campeanu
- Department of Technical Medical Radiology, Haute École de Santé Vaud (HESAV), University of Applied Sciences Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Giuseppe Gullo
- Department of Radiology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
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Martinez Lorca A, Aguado Romo R, Martinez Lorca M, Zabala Baños MC. Anxiety reduction and emotional self-care using the U-technique in radiology departments. Br J Radiol 2017; 90:20170173. [PMID: 28749168 PMCID: PMC5853347 DOI: 10.1259/bjr.20170173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/22/2017] [Accepted: 07/19/2017] [Indexed: 01/06/2023] Open
Abstract
Daily clinical practice is an important source of stress and emotional exhaustion. In the health field, patients could experience a significant number of emotional reactions. There are high levels of anxiety in patients referred for medical imaging, and these levels are even higher in patients undergoing complicated diagnostic procedures. All this shows the need to understand that anxiety must be diagnosed and treated. This situation forces radiologist to develop emotional and social skills to resolve difficulties that may arise in the communicative act. In the patient-radiologist interaction, many elements have been analysed, being communication and communicative skills one of the most important elements. The objective is to present an emotional management tool, the U-technique. It consists of four movements: sympathize, empathize, feel the antidote emotion and spread the antidote emotion in order that the health professionals recognize their emotional state in each moment of the relationship with the patient.
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Affiliation(s)
| | | | - Manuela Martinez Lorca
- Department of Psychology, Faculty of Occupational Therapy, Speech therapy and Nursing, University of Castilla-La Mancha, Talavera de la Reina (Toledo), Spain
| | - Maria Carmen Zabala Baños
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Occupational Therapy, Speech therapy and Nursing, University of Castilla-La Mancha, Ciudad Real, Spain
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Munn Z, Pearson A, Jordan Z, Murphy F, Pilkington D, Anderson A. Addressing the Patient Experience in a Magnetic Resonance Imaging Department: Final Results from an Action Research Study. J Med Imaging Radiat Sci 2016; 47:329-336. [PMID: 31047258 DOI: 10.1016/j.jmir.2016.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 03/24/2016] [Accepted: 04/06/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Patients undergoing magnetic resonance imaging (MRI) can experience anxiety and claustrophobia. A multimethod action research study was conducted to determine how patient care was currently being delivered in an MRI department and to determine whether this could be improved. METHODS This action research study used both quantitative and qualitative methods. Changes were introduced into the department after baseline data collection to address areas for improvement. A survey was conducted of patients to establish their level of satisfaction and/or anxiety and to determine whether this improved during the course of the project. Staff practice was qualitatively observed over the course of the project and observations recorded in a field diary. Finally, focus groups were held with staff. RESULTS The project resulted in improved satisfaction and lower anxiety for patients, and increased the amount of patients receiving information compared with the results of a baseline survey. However, these findings were not statistically significant. Among staff, qualitative observations portrayed a renewed focus on the patient in MRI including changes in their actions such as increased use of touch, improved communication, and focused efforts to maintain privacy. CONCLUSIONS This study was able to achieve a change in practice through an action research cycle in a MRI department. Over the course of the project, improvements were made to the department, and radiographers changed the way they acted and interacted with patients.
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Affiliation(s)
- Zachary Munn
- Joanna Briggs Institute, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Alan Pearson
- Joanna Briggs Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Zoe Jordan
- Joanna Briggs Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Fred Murphy
- Directorate of Radiography, University of Salford, Manchester, UK
| | | | - Amanda Anderson
- MRI Unit, Royal Adelaide Hospital, Adeliade, South Australia
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Martínez-Lorca A, Martínez-Lorca M. Dar información más allá del consentimiento informado. RADIOLOGIA 2015; 57:451. [DOI: 10.1016/j.rx.2015.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 02/05/2015] [Accepted: 02/11/2015] [Indexed: 10/23/2022]
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Munn Z, Pearson A, Jordan Z, Murphy F, Pilkington D, Anderson A. Patient Anxiety and Satisfaction in a Magnetic Resonance Imaging Department: Initial Results from an Action Research Study. J Med Imaging Radiat Sci 2014; 46:23-29. [PMID: 31052060 DOI: 10.1016/j.jmir.2014.07.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 07/01/2014] [Accepted: 07/07/2014] [Indexed: 12/01/2022]
Abstract
PURPOSE The way patients experience health care is largely dependent on the attitudes and actions of the health care professionals they encounter. In medical imaging, the radiographer is often the biggest provider of patient care. Patients undergoing magnetic resonance imaging (MRI) can experience anxiety and claustrophobia. The aim of this study was to determine current levels of anxiety and satisfaction within an MRI unit. METHODS An action research study was conducted in an MRI unit in a large metropolitan hospital. The focus of this study was on improving patient care within the department. The initial phase of this study focused on determining current levels of anxiety and satisfaction within the department. To achieve this, a survey was conducted of patients attending the department for imaging. RESULTS Surveys were returned from 120 patients. Overall, the mean anxiety was 2.617 on a 10-point scale (0 = no anxiety, 10 = maximum anxiety; 95% confidence interval, 2.075-3.159; standard deviation, 3). Overall, the mean satisfaction was 8.86 (95% confidence interval, 8.459-9.254; standard deviation, 2.15). There was a statistically significant difference between anxiety for patients who received information and those who did not (information = 2.29, no information = 4.0, P = .045). CONCLUSIONS Although the vast majority of patients are satisfied with the care they receive during MRI, anxiety is still an issue. The provision of information has been linked to lower levels of anxiety with these patients. The findings from this survey provide insight as to how patients perceive the MRI department and can be used as a benchmark for future surveys to determine if any changes can be made to further improve satisfaction and anxiety during MRI.
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Affiliation(s)
- Zachary Munn
- The Joanna Briggs Institute, School of Translational Health Science, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Alan Pearson
- The Joanna Briggs Institute, School of Translational Health Science, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Zoe Jordan
- The Joanna Briggs Institute, School of Translational Health Science, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Fred Murphy
- Directorate of Radiography, University of Salford, Manchester, Salford, UK
| | - Diana Pilkington
- MRI Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Amanda Anderson
- MRI Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Munn Z, Jordan Z. The Effectiveness of Nonpharmacologic Interventions to Reduce Anxiety and Increase Patient Satisfaction and Comfort during Nuclear Medicine Imaging. J Med Imaging Radiat Sci 2014; 45:47-54. [DOI: 10.1016/j.jmir.2013.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 09/13/2013] [Accepted: 10/11/2013] [Indexed: 10/25/2022]
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Munn Z, Jordan Z. Interventions to Reduce Anxiety, Distress, and the Need for Sedation in Pediatric Patients Undergoing Magnetic Resonance Imaging: A Systematic Review. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.jradnu.2012.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Munn Z, Jordan Z. The effectiveness of interventions to reduce anxiety, claustrophobia, sedation and non-completion rates of patients undergoing high technology medical imaging. ACTA ACUST UNITED AC 2012; 10:1122-1185. [PMID: 27820328 DOI: 10.11124/01938924-201210190-00001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Advanced, high technology medical imaging, such as Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT), have seen significant increases in their use. A number of interventions have been developed with the aim of reducing anxiety, fear and claustrophobia prior to and during imaging. OBJECTIVE To determine the effectiveness of interventions aiming to improve the patient experience of high technology medical imaging. INCLUSION CRITERIA Any patients who have undergone high technology (MRI, CT, PET, Nuclear medicine and SPECT) imaging in a medical imaging department. Interventional scans were not considered for inclusion.Considered interventions were: MRI scanner designs, quieter machines, information, psychological support, anxiety reduction protocols, mock MRI, team training, prone scanning, audiovisual (AV) systems, cognitive behavioural therapies, fragrance administration, guided imagery, patient positioning devices and paediatric preparation booklets.Experimental and observational studies were included in the review.Primary patient outcomes:Secondary patient outcome measures included: SEARCH STRATEGY: A comprehensive, three-step search strategy conducted during August to October 2011 aimed to find both published and unpublished English language studies across 14 major databases. No time restrictions. METHODOLOGICAL QUALITY Retrieved papers were assessed by two independent reviewers prior to inclusion in the review using standardised critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). DATA COLLECTION Data was extracted from papers included in the review using the standardised data extraction tool from JBI-MAStARI. DATA SYNTHESIS Quantitative data was, where possible pooled in statistical meta-analysis using JBI-MAStARI. All results were subject to double data entry. RESULTS Thirty-eight studies met the inclusion criteria and were considered to be of suitable methodological quality. The quality of the studies varied; however, all the studies included had at a minimum a comparison group. Of the final 38 studies, 29 assessed interventions for MRI, 8 Nuclear Medicine procedures, and one in CT. Meta-analysis was performed for two interventions; additional information and an AV system.Significantly fewer children (10-18 years) required sedation prior to a MRI scan when given an audiovisual intervention (n=1785) OR 0.42% (CI 0.25 - 0.70), compared with the control group. Open MRI, newer MRI scanners, quieter machines, information in combination with psychological support or an anxiety reduction protocol, mock MRI, team training, prone scanning, AV systems, cognitive behavioural therapies, fragrance administration, guided imagery, patient positioning devices and paediatric preparation booklets were all found to have some positive effect on at least one outcome, whilst the findings for additional information were mixed. CONCLUSIONS This review identified 38 studies that assessed interventions to reduce anxiety, claustrophobia, sedation and non-completions and improve satisfaction for patients undergoing medical imaging. The majority of the interventions studied had some positive effect on at least one outcome.Healthcare professionals need to be aware of the potential for patients undergoing medical imaging to experience anxiety, fear and claustrophobia during scanning. A number of interventions can be selected and tailored to the patient group.There is still a significant amount of research required to establish the effectiveness for a number of interventions aimed to reduce anxiety, fear and claustrophobia in medical imaging, particularly in CT.
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Affiliation(s)
- Zachary Munn
- 1. The Joanna Briggs Institute, Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia 5005
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Munn Z, Jordan Z. The effectiveness of interventions to reduce anxiety, claustrophobia, sedation and non-completion rates of patients undergoing high technology medical imaging. ACTA ACUST UNITED AC 2012. [DOI: 10.11124/jbisrir-2012-59] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Munn Z, Jordan Z. The effectiveness of interventions to reduce fear, anxiety and claustrophobia of patients undergoing imaging with high technology modalities: a systematic review. JBI LIBRARY OF SYSTEMATIC REVIEWS 2011; 9:1-15. [PMID: 27820109 DOI: 10.11124/01938924-201109481-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Zachary Munn
- 1Joanna Briggs Institute, Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia 5005
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