Amelioration of Claustrophobia and Disruptive Patient Motion in MR Imaging

MR 成像中改善幽闭恐惧症和破坏性患者运动

• 批准号: 8199300
• 负责人: ELVIRA Valentina LANG-ANDERSON
• 金额: $ 26.75万
• 依托单位: HYPNALGESICS, LLC
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8199300
• 关键词: Academic Medical Centers; Affect; Area; Behavior; Behavior Therapy; Boston; Cessation of life; Claustrophobias; Clinical; Communities; Critiques; Development; Devices; Diagnosis; Diagnostic; Economics; Educational Intervention; Educational process of instructing; Educational workshop; Electronics; Evaluation; Event; Feedback; Glosso-Sterandryl; Goals; Health Professional; Healthcare; Human Resources; Hypnosis; Image; Internet; Intervention; Language; Licensing; Life; MRI Scans; Magnetic Resonance Imaging; Marketing; Medical center; Metric; Motion; Multimedia; Nurses; Ohio; Online Systems; Outcome; Participant; Patient Schedules; Patients; Performance; Pharmaceutical Preparations; Phase; Physicians; Preparation; Radiology Specialty; Relaxation Techniques; Risk; Sample Size; Schedule; Sedation procedure; Site; Societies; Structure; System; Techniques; Testing; Time; Trainers Training; Training; Training Support; Visit; Work; base; design; hypnotic; instrument; meetings; operation; portability; prevent; prototype; research clinical testing; satisfaction; skills

DESCRIPTION (provided by applicant): Claustrophobia and disruptive patient motion are common impediments to MRI examination, but they may be prevented or ameliorated with a non-pharmacologic behavioral intervention administered by trained staff. The potential benefits of such an intervention are highly significant, considering that the alternatives are to cancel the study or administer sedation. Inability to complete their MRI scans adversely affects an estimated 700,000 patients every year in the US. These patients are either deprived of a diagnosis, subject to diagnostic delays, or are exposed to risks of pharmacologic sedation, including death. The imaging facilities in turn, typically cannot fill the suddenly vacated examination slots in time before the next scheduled patient and thus incur considerable lost revenue and efficiency. The long-term goal is to provide a validated, clinically feasible means for non-pharmacologic amelioration of claustrophobia and disruptive patient motion, achieved by training MRI staff to use advanced rapport skills and comforting language to help patients. Phase I will design and perform a formative evaluation of a Comfort TalkTM Training intervention so that definitive testing of the hypothesized benefits for the intervention can be accomplished in Phase II. In Specific Aim 1 the Comfort TalkTM intervention sequence will be designed to include training in advanced rapport skills, using basic comforting language and avoiding negative language for all facility staff (including receptionists, technologists, nurses, and physicians). A core of licensed healthcare professionals will be taught how to guide patients in self-hypnotic relaxation techniques, using scripts, found to be safe and effective in the radiology department. Techniques are designed to easily integrate into the normal workflow without adding time. Training will include 2x8 hrs live at three test sites. Acceptance, observation of staff behavior, qualitative feedback, and rates of noncompletion will be used to assess efficacy of training, guide prototype development, and develop train-the-trainer materials. Using in-market piloting techniques, niche applications with their metrics will be explored to develop situation-specific supplemental materials. In Aim 2 an interactive web-based electronic platform will be developed to supplement training and provide post- training support. It will provide scenarios and practice applications, guided dialogue options, functions for online live interactive classes, and interface with Smartphones. The prototype will be beta-tested with 20 experts in hypnosis and refined through user input from the test sites. Aim 3 is to conduct a formative evaluation of the entire Comfort TalkTM intervention. Effects will be evaluated in 3-months intervals and compared to baseline performance. Criteria will include acceptance, qualitative feedback, content mastery, staff behavior, rates of noncompletion, patient recall and satisfaction. Additional metrics identified through in- market exploration will be analyzed for their potential as economic drivers and evaluation instruments. PUBLIC HEALTH RELEVANCE: Annually, an estimated 700,000 patients do not complete their scheduled MRI scans because of claustrophobia or inability to hold still. Training staff working in MRI facilities to provide Comfort TalkTM promises to enable patients to complete and obtain high quality imaging without medication, which will increase comfort and reduce sedation risks for the patients, and increase efficiency and reduce loss of revenue for the facilities.

描述（由申请人提供）：幽闭恐惧症和破坏性患者运动是 MRI 检查的常见障碍，但可以通过训练有素的工作人员进行的非药物行为干预来预防或改善。考虑到替代方案是取消研究或给予镇静剂，这种干预的潜在好处非常显着。在美国，每年约有 700,000 名患者因无法完成 MRI 扫描而受到不利影响。这些患者要么被剥夺诊断权，要么延误诊断，要么面临药物镇静的风险，包括死亡。反过来，成像设施通常无法在下一个安排的患者之前及时填补突然空出的检查时段，从而造成相当大的收入和效率损失。长期目标是提供一种经过验证的、临床上可行的方法，用于非药物改善幽闭恐惧症和破坏性患者运动，通过培训 MRI 工作人员使用先进的融洽技巧和安慰性语言来帮助患者来实现。第一阶段将设计并执行 Comfort TalkTM 培训干预的形成性评估，以便在第二阶段完成对干预假设效益的明确测试。在具体目标 1 中，Comfort TalkTM 干预序列将被设计为包括对所有机构工作人员（包括接待员、技术人员、护士和医生）进行高级融洽技巧培训、使用基本的安慰性语言并避免负面语言。一批持有执照的医疗保健专业人员将学习如何使用放射科安全有效的脚本指导患者进行自我催眠放松技巧。技术旨在轻松集成到正常工作流程中，而无需增加时间。培训将包括在三个测试地点进行 2x8 小时的现场培训。接受度、员工行为观察、定性反馈和未完成率将用于评估培训效果、指导原型开发和开发培训师培训材料。使用市场试点技术，探索利基应用及其指标，以开发针对具体情况的补充材料。目标 2 将开发一个基于网络的交互式电子平台，以补充培训并提供培训后支持。它将提供场景和练习应用、引导对话选项、在线直播互动课程功能以及与智能手机的接口。该原型将由 20 名催眠专家进行 Beta 测试，并根据测试站点的用户输入进行完善。目标 3 是对整个 Comfort TalkTM 干预进行形成性评估。将每隔 3 个月评估一次效果，并与基线表现进行比较。标准将包括接受度、定性反馈、内容掌握、员工行为、未完成率、患者回忆和满意度。将分析通过市场探索确定的其他指标作为经济驱动因素和评估工具的潜力。 公共卫生相关性：每年，估计有 700,000 名患者由于幽闭恐惧症或无法保持静止而无法完成预定的 MRI 扫描。对 MRI 设施中的工作人员进行培训以提供 Comfort TalkTM 承诺使患者无需药物即可完成并获得高质量成像，这将提高患者的舒适度并降低患者的镇静风险，并提高设施的效率并减少收入损失。