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[预防磁共振成像所致心理困扰的尝试:心理干预的有效性]

[An attempt to prevent psychological distress induced by magnetic resonance imaging: effectiveness of psychological interventions].

作者信息

Mita T, Nakai T, Murakami M, Kitamura N, Nishino N

机构信息

Department of Psychiatry, Saiseikai Nakatsu Hospital, Osaka.

出版信息

Seishin Shinkeigaku Zasshi. 1995;97(1):64-72.

PMID:7732150
Abstract

A magnetic resonance imaging (MRI) examination has reportedly produced psychological distress such as discomfort, anxiety and fear in a certain number of patients. In an attempt to prevent such distress during an MRI, the authors took the following psychological measures: 1) improved psychological support for patients by MRI technicians; 2) providing sufficient information to patients about the imager and the nature of the examination; 3) reassurance of the safety, with the patient free to terminate the examination at any time; 4) environmental modification to induce relaxation, including recorded music, paintings and live plants in the examination room. We then evaluated the effectiveness of these combined psychological support factors for all MRI patients. A questionnaire on psychological distress experienced during an MRI was filled out by 143 patients (mean age, 49.4 years) and 105 patients (mean age, 48.4 years) prior to and after our psychological measures, respectively, after MRI test in Saiseikai Nakatsu hospital, and comparisons made between these two groups (chi 2 test, p < 0.05). The number of patients experiencing psychological distress during an MRI was significantly decreased (50.5%) after the measures were implemented as compared to the number (64.3%) beforehand. In particular, female, 60 or older patients and patients examined for the first time showed significant decreases in experiencing psychological distress after the measures were implemented. The number of patients who reported distress, tended to decrease. Patients who developed certain symptoms, such as palpitation, also tended to decrease. Patients who reported the "long examination time" as a distress factor and those who developed palpitation during the examination significantly decreased. Our results indicate that these combined psychological measures are efficacious in reducing psychological distress during an MRI, mainly by curtailing the patient's subjective sense of examination time. In addition to an MRI examination, our psychological measures should be applied to other medical examinations which tend to generate undue psychological distress.

摘要

据报道,磁共振成像(MRI)检查在一定数量的患者中产生了心理困扰,如不适、焦虑和恐惧。为了在MRI检查期间预防此类困扰,作者采取了以下心理措施:1)MRI技术人员加强对患者的心理支持;2)向患者提供有关成像仪和检查性质的充分信息;3)保证安全性,患者可随时自由终止检查;4)进行环境改造以促进放松,包括在检查室播放录制音乐、展示画作和摆放绿植。然后,我们评估了这些综合心理支持因素对所有MRI患者的有效性。在西日本中津医院进行MRI检查后,分别有143名患者(平均年龄49.4岁)和105名患者(平均年龄48.4岁)在采取心理措施前后填写了关于MRI检查期间经历的心理困扰的问卷,并对这两组进行了比较(卡方检验,p<0.05)。与之前(64.3%)相比,采取措施后在MRI检查期间经历心理困扰的患者数量显著减少(50.5%)。特别是女性、60岁及以上患者和首次接受检查的患者在采取措施后经历心理困扰的情况显著减少。报告有困扰的患者数量有减少趋势。出现某些症状(如心悸)的患者数量也有减少趋势。将“检查时间长”作为困扰因素报告的患者以及在检查期间出现心悸的患者数量显著减少。我们的结果表明,这些综合心理措施在减少MRI检查期间的心理困扰方面是有效的,主要是通过缩短患者的主观检查时间感。除了MRI检查外,我们的心理措施还应应用于其他容易产生过度心理困扰的医学检查。

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