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的患者运动是MRI检查的常见障碍，但可以通过受过训练的员工管理的非药物行为干预来预防或改善它们。考虑到替代方案是取消研究或管理镇静剂，这种干预的潜在好处非常重要。在美国，无法完成其MRI扫描会对大约700,000名患者产生不利影响。这些患者要么被剥夺了诊断延迟的诊断，要么受到药理镇静的风险，包括死亡。成像设施反过来，通常无法在下一个预定患者之前及时填补突然腾出的检查插槽，因此会导致大量的收入和效率损失。长期的目标是提供经过验证的临床可行手段，用于对幽闭恐惧症的非药物改善和颠覆性患者运动，通过培训MRI员工使用高级融洽的技巧和舒适的语言来帮助患者。第一阶段将对舒适性TalkTM培训干预措施进行设计和进行形成性评估，以便可以在II阶段实现对干预措施的假设收益的确定测试。在特定的目标1中，舒适性TalkTM干预顺序将旨在包括使用基本舒适语言的高级融洽关系培训，并为所有设施人员（包括接待员，技术人员，护士和医生）避免使用负面语言。将教授有执照的医疗保健专业人员的核心，如何使用脚本来指导患者的自我催眠性放松技术，这些脚本在放射学系中是安全有效的。技术旨在轻松地集成到普通工作流程中，而无需增加时间。培训将包括在三个测试地点进行的2x8小时。接受，观察员工行为，定性反馈和非完成率将用于评估培训的功效，指导原型开发和开发培训培训材料。使用市场内试验技术，将探索及其指标的利基应用程序以开发特定情况的补充材料。在AIM 2中，将开发一个基于网络的电子平台来补充培训并提供培训后支持。它将提供场景和练习应用程序，指导对话选项，在线实时交互式类别的功能以及与智能手机的交互。该原型将与20位催眠专家进行Beta测试，并通过测试地点的用户输入进行完善。 AIM 3是对整个舒适TalkTM干预的形成性评估。效果将以3个月的间隔进行评估，并将其与基线性能进行比较。标准将包括接受，定性反馈，内容精通，员工行为，非完成率，患者召回和满意度。通过市场勘探确定的其他指标将被分析，以作为其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，由于幽闭恐惧症或无法保持静止状态，估计有70万名患者未完成预定的MRI扫描。在MRI设施中工作的培训人员提供舒适的TalkTM承诺，使患者能够完成并获得高质量的成像，而无需药物治疗，这将增加舒适性并降低患者的镇静风险，并提高效率并减少设施的收入损失。