How is patient anxiety affecting your equation in MR

Leadership Matters Article 4 Minute Read GE Healthcare Global

Visiting the doctor is often stressful for patients. Many patients in the United States only make appointments when they aren’t feeling well, causing them to associate going to the doctor with being sick. Patients who have to go for scans are often even more anxious for a variety of reasons including increased wait time, not knowing what to expect and being uncomfortably positioned on the scanner. This anxiety could be diminished some by different techniques and tools for technologists, such as music or videos, aromatherapy, reassurance or accommodation.

Causes of patient anxiety when getting an MRI scan

The fact that some people have issues with claustrophobia in an MRI scan is no secret. There are plenty of lists online providing tips for people who know they may have issues. A small portion (2.3%) of people actually feel claustrophobia while inside the scanner, though many others experience anxiety.

Some patients, especially women, experience anxiety as they are in the waiting room.1 The anxiety level of some of them will increase as their wait time increases. If the facility is running behind, it can cause their anxiety level to increase.

Another thing that can cause anxiety for patients is the fear of the unknown.2 Some people fear the unknown, because they don’t want to leave their comfort zone. If they do not know what to expect during an MRI scan, they are less likely to feel comfortable while they are being scanned. This can build on any anxiety they feel about being in the doctor’s office or worrying what the test may show.

Some websites that address anxiety and claustrophobia about an MRI scan state that the patient may be uncomfortable during the scan due to how they are positioned. However, many departments try to prevent this, because being uncomfortable often causes movement during the scan. Movement can increase the initial scan time or can result in rescanning.

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Preventing patient anxiety

Patients can sometimes benefit from talking to the staff about what to expect and how long a scan should take.3 This can help to combat anxiety caused by fear of the unknown, because it keeps patients informed about their scan. Many departments and facilities may be unable to speak with every patient due to time constraints. However, providing a video link or explanatory website may help patients in a broader sense and reduce over-the-phone questions. If a patient still has questions after viewing the video or reading the website, they may need to call the facility for further answers. If facilities provide links for their patients, they may help patients find accurate information.

Some MR facilities provide headphones for their patients to listen to music.4,5 The patient is sometimes asked to bring their own music, or the department may ask them what station they would like to listen to. Other facilities allow patients to watch videos during their scan through the use of specially designed goggles or screens that are compatible with the scanner. Patients should consider whether the music or video will have a calming affect or make them want to dance, laugh, or otherwise move. Each patient should know if they can sit still while listening to music and may each require different genres of music and videos.

A human’s sense of smell often links to their memories. Because of this, different smells could help calm patients down. This can be done through aromatherapy. Some patients may find it helpful to have aromatherapy to reduce anxiety and claustrophobia.6,7 Aromatherapy uses materials and aromatic oils for different reasons. Certain smells are designed to calm a patient, while others may be useful for things like reducing nausea or sleeping. One study used lavender-sandalwood and orange-peppermint and reduced patient anxiety by 63%.6 It is important, however, to remember that not all patients can handle strong scents. Smells can cause headaches, allergies, or other adverse effects for different patients, especially those who have migraines with smell sensitivity. The facility should check with the patient about whether or not they want to use aromatherapy.

The last way to alleviate patient anxiety depends on the scanner and the array coils in the patient platform. Some scanners allow a patient to be put into the machine feet-first instead of head-first. This can help ease anxiety in some claustrophobic or anxious patients due to their ability to see whether the scanner affects their lower extremities before putting the upper body through. Depending on the area being imaged, their head may not even enter the scanner. When the patient is able to choose between head- or feet-first, they may find that they feel more in control of their scan.

Patients may find that one or more of the techniques listed above help alleviate their anxiety and claustrophobia in the MR suite. These methods could be through providing different sounds or scents throughout the scan or through equipping them with knowledge and decisions about their scans, allowing them to feel more in control. Different methods can help combat the waiting room anxiety, fear of the unknown and positioning issues to reduce their overall anxiety levels.

References

1. Hlaing (Sue) Thu, et al. “Factors Associated With Increased Anxiety in the MRI Waiting Room.” Journal of Radiology Nursing. September 2015; 34(3): 170-174. Web. 4 March 2019. <https://www.sciencedirect.com/science/article/pii/S1546084315000735>.

2. Darla Dernovsek. “Helping MRI patients overcome their top 10 fears.” The-Alliance.org. 21 June 2018. Web. 4 March 2019. <https://www.the-alliance.org/blog/helping-mri-patients-overcome-their-top-10-fears>.

3. J.R. Tugwell, N. Goulden and P. Mullins. “Alleviating anxiety in patients prior to MRI: A pilot single-centre single-blinded randomized controlled trial with a radiographer versus routine intervention.” Radiography. 31 October 2017; 24(2018): 122-129. Web. 4 March 2019. <https://www.sor.org/system/files/article/201805/113_j_tugwell_radiography_24_2018_122-129.pdf>.

4. “6 ways to keep calm during your MRI scan.” NuffieldHealth.com. 15 January 2016. Web. 4 March 2019. <https://www.nuffieldhealth.com/article/6-ways-to-keep-calm-during-your-mri-scan>.

5. Julie Revelant. “10 ways to get through an MRI or CAT scan if you’re claustrophobic.” FoxNews.com. 24 October 2015. Web. 4 March 2019. <https://www.foxnews.com/health/10-ways-to-get-through-an-mri-or-cat-scan-if-youre-claustrophobic>.

6. “Aromatherapy Tabs Reduce MRI Anxiety.” Itnonline.com. 9 August 2011. Web. 4 March 2019. <https://www.itnonline.com/content/aromatherapy-tabs-reduce-mri-anxiety>.

7. Mike Bassett. “Aromatherapy, Breathing Techniques, Aid MRI Anxiety.” RNSA.org. 1 December 2015. Web. 4 March 2019. <https://rsna2015.rsna.org/dailybulletin/index.cfm?pg=15tue11>.