Abstract
ObjectivesTo evaluate the influence of audio-guided self-hypnosis on claustrophobia in a high-risk cohort undergoing magnetic resonance (MR) imaging.MethodsIn this prospective observational 2-group study, 55 patients (69% female, mean age 53.6 ± 13.9) used self-hypnosis directly before imaging. Claustrophobia included premature termination, sedation, and coping actions. The claustrophobia questionnaire (CLQ) was completed before self-hypnosis and after MR imaging. Results were compared to a control cohort of 89 patients examined on the same open MR scanner using logistic regression for multivariate analysis. Furthermore, patients were asked about their preferences for future imaging.ResultsThere was significantly fewer claustrophobia in the self-hypnosis group (16%; 9/55), compared with the control group (43%; 38/89; odds ratio .14; p = .001). Self-hypnosis patients also needed less sedation (2% vs 16%; 1/55 vs 14/89; odds ratio .1; p = .008) and non-sedation coping actions (13% vs 28%; 7/55 vs 25/89; odds ratio .3; p = .02). Self-hypnosis did not influence the CLQ results measured before and after MR imaging (p = .79). Self-hypnosis reduced the frequency of claustrophobia in the subgroup of patients above an established CLQ cut-off of .33 from 47% (37/78) to 18% (9/49; p = .002). In the subgroup below the CLQ cut-off of 0.33, there were no significant differences (0% vs 9%, 0/6 vs 1/11; p = 1.0). Most patients (67%; 35/52) preferred self-hypnosis for future MR examinations.ConclusionsSelf-hypnosis reduced claustrophobia in high-risk patients undergoing imaging in an open MR scanner and might reduce the need for sedation and non-sedation coping actions.Key Points• Forty percent of the patients at high risk for claustrophobia may also experience a claustrophobic event in an open MR scanner.• Self-hypnosis while listening to an audio in the waiting room before the examination may reduce claustrophobic events in over 50% of patients with high risk for claustrophobia.• Self-hypnosis may also reduce the need for sedation and other time-consuming non-sedation coping actions and is preferred by high-risk patients for future examinations.
Highlights
Up to 10% of patients cannot undergo magnetic resonance (MR) imaging due to severe claustrophobia triggered by the small diameter of the MR tube or loud noises [1, 2]
Among the patients with repeated examinations, there was a 52-year-old woman with a relatively high claustrophobia questionnaire (CLQ) who completed the first examination without need for sedation or non-sedation coping actions using selfhypnosis
Our results show that selfhypnosis reduces the need for conscious sedation and non-sedation coping actions, which require extra staff and room time, medication and further patient care items as described by Bluemke et al [26]
Summary
Up to 10% of patients cannot undergo magnetic resonance (MR) imaging due to severe claustrophobia triggered by the small diameter of the MR tube or loud noises [1, 2]. In view of recent studies indicating that, with appropriate precautions, pacemakers and implantable cardioverter-defibrillators (ICD) no longer preclude MR examinations [3, 4], severe claustrophobia is the main remaining relative contraindication to MR imaging. Patients may experience anxiety when encountering MR imaging or being inside the MR tube during the examination [5], especially if the procedure is unknown to them and they lack information about what to expect [6]. Dealing with claustrophobic patients is a challenge for medical staff [8, 9]. There are many factors that influence claustrophobia in general and during MR imaging in particular [11]
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