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）：幽闭恐怖症和破坏性患者运动是MRI检查的常见障碍，但可以通过由经过培训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，这种干预的潜在获益非常显著。在美国，每年约有70万患者无法完成MRI扫描。这些患者要么被剥夺诊断，诊断延迟，或暴露于药物镇静的风险，包括死亡。成像设施又通常不能在下一个预定患者之前及时填充突然空出的检查时隙，从而导致相当大的收入和效率损失。长期目标是通过培训MRI工作人员使用先进的融洽关系技能和安慰性语言帮助患者，为幽闭恐惧症和破坏性患者运动的非药物改善提供一种经过验证的临床可行方法。第I阶段将设计并执行Comfort TalkTM培训干预的形成性评估，以便在第II阶段完成对干预的假设受益的最终测试。在具体目标1中，Comfort TalkTM干预序列将设计为包括高级融洽关系技能培训，使用基本的安慰语言，避免所有机构工作人员（包括接待员、技术人员、护士和医生）的负面语言。一个核心的持牌医疗保健专业人员将被教导如何指导病人在自我催眠放松技术，使用脚本，发现是安全和有效的放射科。这些技术旨在轻松集成到正常的工作流程中，而不会增加时间。培训将包括在三个测试地点进行2x8小时的现场培训。接受、观察员工行为、定性反馈和未完成率将用于评估培训的有效性、指导原型开发和开发培训师培训材料。使用市场试点技术，利基应用程序及其指标将被探索，以开发特定情况的补充材料。在目标2中，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。它将提供场景和实践应用程序，引导对话选项，在线直播互动课程的功能，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，并通过测试网站的用户输入进行改进。目标3是对整个Comfort TalkTM干预进行形成性评估。将每隔3个月评价一次效果，并与基线性能进行比较。标准将包括接受，定性反馈，内容掌握，工作人员的行为，未完成率，病人回忆和满意度。通过市场探索确定的其他指标将分析其作为经济驱动因素和评估工具的潜力。 公共卫生关系：每年，估计有70万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。培训在MRI设施工作的员工提供Comfort TalkTM承诺使患者能够在没有药物的情况下完成并获得高质量的成像，这将增加患者的舒适度并减少镇静风险，并提高效率并减少设施的收入损失。