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)：幽闭恐惧症和扰乱患者的运动是MRI检查的常见障碍，但由训练有素的工作人员进行非药物行为干预可以预防或改善这些障碍。考虑到替代方案是取消研究或注射镇静剂，这种干预的潜在好处非常显著。无法完成核磁共振扫描对美国每年约70万名患者造成不利影响。这些患者要么被剥夺了诊断的机会，要么受到诊断延误的影响，要么面临着药物镇静的风险，包括死亡。反过来，成像设施通常不能在下一个预定的患者之前及时填满突然空出的检查空位，从而导致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，通过培训核磁共振工作人员使用先进的融洽技能和安慰语言来帮助患者，从而非药物地改善幽闭恐惧症和扰乱患者的运动。第一阶段将设计和执行Comfort TalkTM培训干预措施的形成性评估，以便在第二阶段完成对干预假设益处的最终测试。在具体目标1中，Comfort TalkTM干预序列将设计为包括对所有设施工作人员(包括接待员、技术人员、护士和医生)进行高级融洽技能、使用基本安慰语言和避免负面语言的培训。一个有执照的医疗专业人员的核心将被教授如何使用在放射科被发现是安全和有效的脚本来指导患者自我催眠放松技术。这些技术旨在轻松集成到正常工作流程中，而不会增加时间。培训将包括在三个考点进行2x8小时的现场培训。将使用验收、对员工行为的观察、质量反馈和未完成率来评估培训的效果，指导原型开发，并开发培训人员材料。利用市场上的试点技术，将探索利基应用及其衡量标准，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互动电子平台，以补充培训并提供培训后支助。它将提供场景和练习应用程序、引导式对话选项、在线实时互动课程功能，以及与智能手机的接口。该原型将与20名催眠专家一起进行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。效果将每隔3个月进行一次评估，并与基线绩效进行比较。标准将包括接受度、质量反馈、内容掌握程度、工作人员行为、不完成率、患者召回和满意度。将对通过市场探索确定的其他指标进行分析，以确定其作为经济驱动因素和评估工具的潜力。 与公共卫生相关：每年，估计有70万名患者由于幽闭恐惧症或无法保持不动而无法完成预定的MRI扫描。培训在核磁共振设施工作的工作人员提供舒适TalkTM承诺使患者能够在没有药物治疗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，降低患者的镇静风险，并提高效率和减少设施的收入损失。