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: 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
• 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

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）：幽闭恐怖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。这种干预的潜在获益非常显著，因为目前的替代做法是取消研究或给予镇静。无法完成MRI扫描对美国每年约70万例患者造成不良影响，这些患者要么被剥夺诊断，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。成像设施，反过来，通常不能填满 突然空出的扫描槽，并冒着相当大的收入和效率损失的风险。由此产生的负面患者体验进一步降低了患者满意度评级。长期目标是通过培训机构工作人员，通过先进的融洽技巧和安慰性语言帮助患者，提供一种经验证的临床可行方法，用于非药物改善MR成像中的幽闭恐惧症和破坏性患者运动。第一阶段的成果包括设计了一个Comfort Talk（R）培训原型和一个特定于设施现场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。其结果是：根据国家基准，大大减少了取消，提高了效率，提高了患者满意度。第二阶段的目标是实现对广泛商业化的假设效益的扩展和确定性测试。具体目标1采用“翻转课堂”原则，致力于开发一个可扩展的培训员培训和认证原型：从基于网络的预备课程开始，在现场培训期间最大限度地增加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，这将逐步在线移动到虚拟环境中，在虚拟环境中，候选培训师的化身与虚拟环境交互。 患者化身应选择适当的Comfort Talk（R）策略。在目标2中，将通过开发内部Trainer-Champions来实现机构内计划的采用;为无法参加现场培训的核心员工和不在高焦虑和疼痛易发区域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，以实现患者水平的垂直整合。需要 在工作人员的词汇使用和行为模式方面， 将通过捕获和分析网站条目进行整合，以便针对特定患者人群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。在俄亥俄州和杜克大学医学中心的12个MRI卫星的前瞻性随机设计中，将评估对患者满意度、经济结局和投资回报的影响。