What is the best way to help patients relieve their anxiety and claustrophobia when facing an MRI scan? Combining aromatherapy and breathing techniques may be just the cure to quell the jitters of sliding into that magnet bore.
Selena Glenn, CEO of Konxja Consulting. Photo courtesy of RSNA.By easing the tension of skittish patients, imaging facilities could see fewer cancelled exams and cost savings from repeat scans, while MRI technologists have another tool to comfort patients.
"Most importantly, it keeps the patient on the table so they can get their exam done the first time and without delay of their treatment," said Selena Glenn, CEO of Konxja Consulting of Portland, OR. She presented results from a pilot study at RSNA 2015 in Chicago.
Glenn has been a radiologic technologist for 22 years, six of which were as an MRI technologist. She still works as an MRI technologist part time and spends her other time teaching the aromatherapy and breathing exercises that she developed to fellow MRI technologists and patients to enhance the scanning experience.
Reflections on MRI
"I still remember the first time I saw an MRI clinical image; I was enamored and awestruck by such a beautiful picture the human body could produce," Glenn told RSNA attendees. "When I became an MRI technologist, I came to realize that no one enjoyed getting an MRI. I thought to myself, 'What's going on with these people?' "
She made patient anxiety and claustrophobia research part of her graduate studies and came to discover that these conditions are global issues for patients, technologists, and businesses alike.
"The adverse effects include delayed treatment, patient fears, frustration for technologists, and financial losses," Glenn said.
In her talk, Glenn cited previous studies that found 40% of patients experience anxiety, 25% to 37% are afflicted with moderate to severe anxiety, and between 2% and 20% of MRI scans are cancelled due to anxiety and claustrophobia. In 2011, a study estimated that approximately 2 million MRI scans were cancelled worldwide, which resulted in $1.3 billion of lost revenue for imaging centers.
"Although there have been many interventions used to ease patients' anxieties, technologists still experience problems and more interventions are needed," she said.
So, Glenn hypothesized that complementary alternative medicine modalities would help alleviate patient fears, and she took that concept one step further by combining aromatherapy and breathing techniques to change the patients' cognition and negative thoughts during an MRI scan.
"The humanistic approach focuses on creating a trustworthy relationship between the patient and the technologist," Glenn added.
This pilot study included 38 claustrophobic patients, who were divided into an experimental group and a control group. In the experimental group, five patients were on antianxiety medication and 13 people were not medicated. The control group consisted of eight patients with antianxiety medication and 12 individuals who were not medicated.
Subjects within the experimental group performed breathing exercises and were exposed to aromatherapy of their choice prior to the MRI scan, while the control group was provided with standard care that included MRI information and fake aromatherapy.
All MRI scans, except one, were performed on a 1.5-tesla, wide short-bore scanner, with imaging of the hip region and above.
Lower anxiety levels
Based on physiological results, which included heart rate data, patients' anxiety levels decreased by a statistically significant rate of 76% in the experimental group after the intervention tools were utilized (p = 0.01) and at midscan (p = 0.02) among both medicated and nonmedicated participants.
In contrast, the control group experienced a statistically insignificant reduction of 67% in anxiety levels after their standard intervention (p = 0.12) and at midscan (p = 0.69).
A decrease in heart rate was evident among patients who experienced a reduction in anxiety levels in the experimental group, while the mean heart rate in the control group was higher.
In addition, 56% of the individuals in the experimental group thought the combination of aromatherapy and breathing techniques were helpful in reducing anxiety. Furthermore, 39% of the group thought the breathing exercises were effective, while 5% believed that aromatherapy only was beneficial.
Among the control group, 47% of patients said neither the MRI information nor the sham aromatherapy reduced their anxiety, compared with 29% of subjects who felt both approaches were helpful, and 24% who believed that the information sheet only was effective. No patients credited the fake aromatherapy for being useful.
When Glenn analyzed responses from an open-ended patient questionnaire about their reactions and MRI scanning experience, 33% of patients in the experimental group said their anxiety levels decreased, compared with 22% of the participants in the control group.
"Although a 10% difference is not statistically significant, we believe the reason is because of the very small sample size," Glenn said.
Positive comments
Glenn provided an example of a few positive reviews of the aromatherapy and breathing exercising. Patients' comments included the following:
- "Made me think of pleasant things and not doing an MRI. It helped me relax."
- "Felt like I was at a spa than an MRI."
- "Focusing on breathing kept my mind from racing. Helped with the panic."
- "Procedures followed by the MRI technician made me feel relaxed. She made me feel relaxed physically and emotionally."
Given the encouraging results from the pilot study, Glenn concluded the use of aromatherapy and breathing techniques could lead to fewer cancelled MRI exams, produce cost savings for imaging centers, and offer another interventional tool for MRI technologists.
For patients, being able to complete their MRI scan helps to avoid delays in necessary treatment, she added.
