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

基本信息

批准号：
8777608
负责人：
ELVIRA Valentina LANG-ANDERSON
金额：
$ 50万
依托单位：
HYPNALGESICS, LLC
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-08-01 至 2016-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8777608
关键词：
Academic Medical Centers Adoption Affect Anxiety Area Behavior Behavior Therapy Behavioral Benchmarking Certification Cessation of life Claustrophobias Client satisfaction Clinical Conscious Cues Data Decision Analysis Development Diagnosis Diagnostic Educational process of instructing Environment Feedback Goals Human Resources Image Institution Intervention Investments Language Life MRI Scans Magnetic Resonance Imaging Measures Modeling Morphologic artifacts Motion Ohio Online Systems Pain Patient Schedules Patients Pattern Pharmaceutical Preparations Phase Play Preparation Randomized Relaxation Risk Role Scanning Schedule Sedation procedure Site Structure Testing Time Trainers Training Training Training Support Vocabulary Work base commercialization cost design economic outcome experience improved instructor patient population preference prevent programs prospective prototype public health relevance repository satisfaction skills virtual virtual reality

项目摘要

DESCRIPTION (provided by applicant): Claustrophobia and disruptive patient motion-longtime common impediments to MRI examination-can be prevented or ameliorated with a non-pharmacologic behavioral intervention administered by trained staff. The potential benefits of such an intervention are highly significant as current practice 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 who are either deprived of a diagnosis, subject to diagnostic delays and interpretation errors due to motion, or are exposed to risks of pharmacologic sedation, including death. The imaging facilities, in turn, typically cannot fill the suddenly vacated scan slots and risk considerable lost revenue and efficiency. The resulting negative patient experiences further lower patient satisfaction ratings. The long-term goal is to provide a validated, clinically feasible means for non-pharmacologic amelioration of claustrophobia and disruptive patient motion in MR imaging, by training facility staff to assist patients through advanced rapport skills and comforting language. Phase I accomplishments include designs of a prototype of Comfort Talk(R) Training and a facility-site-specific customizable online Training Support Platform to support MRI staffs in personalizing their skill development. The results: significantly reduced cancellations, improved efficiency and increased patient satisfaction based on national benchmarks. The goal of Phase II is to enable scaling and definitive testing of the hypothesized benefits for broad-based commercialization. Specific Aim 1 pursues development of a scalable, prototype for trainer training and certification using the "flipped classroom" principle: beginning with preparatory web-based course-work to maximize time for mutual feedback and pedagogical skill practice during live training. Practice and certification will include traditional tests and role-play, which will be progressively moved online into virtual environments within which a Candidate Trainer's avatar interacting with virtual Patient avatars is expected to choose appropriate Comfort Talk(R) strategies. In Aim 2, intra-institutional program adoption will be pursued through developing internal Trainer-Champions; supportive online courses for core staff who cannot participate in live training and for personnel who do not work in high anxiety and pain prone areas; and a customizable Comfort Talk(R) patient app, co-branded with the site to enable vertical integration to the patient level. The need for site-specific individualization with regard to use of vocabulary and behavior patterns of staff will be integrated by capture and analysis of site entries to enable scaling of customized culture-conscious content for specific patient populations and situations and further integration in subsequent training materials. Aim 3 targets unequivocal assessment of the effect of Comfort Talk(R) training, including the newly trained trainers and local champions. In a prospective randomized design at 12 MRI satellites of the Ohio State and Duke University Medical Center effects on patient satisfaction, economic outcomes, and return-on-investment will be assessed.

描述（由申请人提供）：幽闭恐惧症和破坏性患者运动（MRI 检查的长期常见障碍）可以通过由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。这种干预措施的潜在好处非常显着，因为目前的替代做法是取消研究或给予镇静剂。在美国，每年约有 700,000 名患者无法完成 MRI 扫描，这些患者要么无法得到诊断，要么因运动而导致诊断延迟和解释错误，要么面临药物镇静的风险，包括死亡。反过来，成像设施通常无法填补突然腾出扫描槽位，并面临着收入和效率大幅损失的风险。由此产生的负面患者体验进一步降低了患者满意度。长期目标是通过培训设施工作人员通过先进的融洽技巧和舒适的语言来帮助患者，从而提供一种经过验证的、临床上可行的方法，以非药物方式改善 MR 成像中的幽闭恐惧症和破坏性患者运动。第一阶段的成就包括设计 Comfort Talk(R) 培训原型和针对特定设施的可定制在线培训支持平台，以支持 MRI 工作人员个性化他们的技能发展。结果：根据国家基准，显着减少了取消，提高了效率并提高了患者满意度。第二阶段的目标是对广泛商业化的假设效益进行扩展和明确测试。具体目标 1 追求使用“翻转课堂”原则开发可扩展的培训师培训和认证原型：从基于网络的预备课程开始，最大限度地延长现场培训期间相互反馈和教学技能练习的时间。实践和认证将包括传统的测试和角色扮演，这些将逐步在线转移到虚拟环境中，在虚拟环境中，候选人培训师的化身与虚拟互动患者化身应选择适当的 Comfort Talk(R) 策略。在目标 2 中，将通过培养内部培训师冠军来推动机构内计划的采用；为无法参加现场培训的核心员工以及不在高度焦虑和疼痛易发地区工作的人员提供支持性在线课程；以及可定制的 Comfort Talk(R) 患者应用程序，与该网站联合品牌，以实现患者层面的垂直整合。需要针对工作人员的词汇使用和行为模式进行特定地点的个性化将通过捕获和分析站点条目进行整合，以便能够针对特定患者群体和情况扩展定制的文化意识内容，并进一步整合到后续培训材料中。目标 3 旨在明确评估 Comfort Talk(R) 培训的效果，包括新培训的培训师和当地冠军。在俄亥俄州立大学和杜克大学医学中心的 12 颗 MRI 卫星的前瞻性随机设计中，将评估对患者满意度、经济结果和投资回报的影响。