Chapter Introduction
This chapter will give an overview of how and why this book was written. It also includes a short history of MRI, introduce and explain the reasoning behind the idea of MRI psychology. The causes, prevalence and demographics of who may suffer from anxiety during their MRI will be talk about discussed. Lastly, the financial impact MRI anxiety and prematurely terminated and canceled MRI exams has on patients, technologist, medical imaging departments and radiologist will be explored in detail.
Exceptional patient care has always been the pillar of my 28-year medical imaging career, with MRI patient care becoming a passion. Now, as a seasoned MRI technologist with 12 plus years of experience and specializing in patient care, I have worked with anxious MRI patients on a daily basis. This passion led me to study this topic extensively during graduate school and is the reason for writing this book. The writing of this book has been a nearly 10-year journey that began in a creative problem solving class I took at Portland Community College after completing my MRI training in their first graduating class. We were given an assignment to find a creative solution to a problem we were having at work. As a new MRI technologist, I saw an overwhelming number of patients who had a difficult time completing their exams due to anxiety. My first thoughts were, “What the heck is going on with these people?” It was clear the topic of my paper was going to be MRI anxiety. My professor for this class was both intrigued and impressed with my paper’s topic; she suggested I go to graduate school to study it further and offered to write a letter of recommendation. Long story short, I was admitted into graduate school and my journey began.
During the early stages of my studies, I soon realized there are a variety of reasons why patients become anxious. I also learned psychology not only plays a major role in MRI anxiety but that the MRI environment itself also influences a patient’s psyche. Hence, the idea of studying MRI psychology was born. With this realization, it became apparent there was room for improvement in patient care in the MRI environment. During my research, I quickly discovered a gap in information available on anxiety in the MRI environment not only for technologists, but for patients and other medical professionals as well1. This gap left room for innovation and an opportunity to conduct additional research, and to approach this phenomenon from an evidence-based perspective. It is my hope that this book will make a significant contribution to taking MRI technologists’ skill set and patient care to a higher level.
Anxiety in the MRI environment has been a major issue from the beginning. This substantial prevalence warrants finding more information about the potential causes along with finding additional ways of dealing with it through training opportunities for MRI technologists2. During my own personal experience in a formal training program, there was very little attention given to MRI anxiety considering the significance of the problem. The majority of content covered in this formal training focused on the science and technical aspects of the imaging modality with little attention given to patient care. The insignificant amount of available information that existed on patient care consisted of a few short paragraphs within the MRI safety chapter, which stated the possibility of patients becoming anxious and offered few solutions for the problem. Other than claustrophobia, there was no mention about why MRI patients become anxious. A large gap exists in the training of technologists beyond the technical aspects of performing MRI examinations and care for anxious patients. The vast majority of MRI technologists in the United States are trained on the job. Therefore, when it comes to MRI patient care, this aspect of skill development has come from more senior technologists. While there is value in experience and the majority of this information useful, it may also be antidotal and not based on facts. One of the aims of this book is to reduce that gap and refocus attention on educating technologists using evidence-based answers as to why patients may become anxious.
This knowledge will enable technologists to recognize the different types of anxiety disorders MRI patients may experience along with other potential causes and, more importantly, improve MRI patient care. In turn, it will make our job as technologists easier; if we know the why, then we can more easily figure out the how. That is how to help anxious patients stay calm and complete their exam so they can get better sooner. Compassion through understanding is another positive reason to learn MRI psychology. Unfortunately, I’ve witnessed technologists become frustrated or even angry with anxious patients who needed extra attention. I’ve heard technologist tell patients to put on their big girl or boy pants. Not only is that unprofessional, but it is a ridiculous and ignorant response as they may not realize the disruptive anxiety symptoms these patients are having are mostly involuntary3–5. This is why, in addition to learning about different anxiety-producing disorders an MRI patient may have, you must also learn about the physiology of anxiety. Knowledge is power and I want to give technologists the power to become not just a good technologist, but great one!