The Impact of Scripted Self-Hypnotic Relaxation on the Periprocedural Experience and Anesthesiologist Sedation Use in the Pediatric Cardiac Catheterization Suite: A Prospective Randomized Controlled Trial.

Purpose: To assess the impact on children of self-hypnotic relaxation scripts read by trained staff prior to the induction of anesthesia and/or extubation on the periprocedural experience.

Patients And Methods: A total of 160 children aged 7-18 years undergoing a cardiac catheterization intervention under general anesthesia were randomized into 4 groups: (1) a pre-procedure (PP-script) read prior to entering the procedural room, (2) a script read prior to extubation (PX-Script), (3) both PP- and PX-Scripts read and (4) no script read. Anxiety and pain were rated on self-reported 0-10 scales.

Does Patient Satisfaction Drive Volumes in Outpatient Magnetic Resonance Imaging?

Objective: To help quantify the potential microeconomic impact of patient satisfaction in radiology, we tested the hypothesis that patient volume trends reflect patient satisfaction trends in outpatient magnetic resonance imaging (MRI).

Methods: Patient visits (N = 39,595) at distinct outpatient MRI sites within a university-affiliated hospital system during a 1-year period were retrospectively analyzed. Individual sites were grouped as having "decreasing," "stable," or "increasing" volume using an average quarterly volume change threshold of 5%.

The dosimetric benefit of in-advance respiratory training for deep inspiration breath holding is realized during daily treatment in left breast radiotherapy: A comparative retrospective study of serial surface motion tracking.

Introduction: A novel approach of in-advance preparatory respiratory training and practice for deep inspiration breath holding (DIBH) has been shown to further reduce cardiac dose in breast cancer radiotherapy patients, enabled by deeper (extended) DIBH. Here we investigated the consistency and stability of such training-induced extended DIBH after training completion and throughout the daily radiotherapy course.

Methods: Daily chestwall motion from real-time surface tracking transponder data was analysed in 67 left breast radiotherapy patients treated in DIBH.

Efficacy of a Self-Hypnotic Relaxation App on Pain and Anxiety in a Randomized Clinical Trial: Results and Considerations on the Design of Active and Control Apps.

Despite an explosion of mobile app offerings for management of pain and anxiety, the evidence for effectiveness is scarce. Placebo-controlled trials are the most desirable but designing inactive placebo apps can be challenging. For a prospective randomized clinical trial with 72 patients in a craniofacial pain center, we created an app with self-hypnotic relaxation (SHR) for use with iOS and Android systems.

Communication and Team Interactions to Improve Patient Experiences, Quality of Care, and Throughput in MRI.

Patients undergoing MRI may experience fear, claustrophobia, or other anxiety manifestations due to the typically lengthy, spatially constrictive, and noisy MRI acquisition process and in some cases are not able to tolerate completion of the study. This article discusses several patient-centered aspects of radiology practice that emphasize interpersonal interactions. Patient education and prescan communication represent 1 way to increase patients' awareness of what to expect during MRI and therefore mitigate anticipatory anxiety.

Prevalence and Financial Impact of Claustrophobia, Anxiety, Patient Motion, and Other Patient Events in Magnetic Resonance Imaging.

Claustrophobia, other anxiety reactions, excessive motion, and other unanticipated patient events in magnetic resonance imaging (MRI) not only delay or preclude diagnostic-quality imaging but can also negatively affect the patient experience. In addition, by impeding MRI workflow, they may affect the finances of an imaging practice. This review article offers an overview of the various types of patient-related unanticipated events that occur in MRI, along with estimates of their frequency of occurrence as documented in the available literature.

Helping Children Cope with Medical Tests and Interventions.

Medical procedures and tests become a challenge when anxiety and pain make it difficult for the patient to cooperate or remain still when needed. Fortunately a short intervention with hypnoidal language at the onset of a procedure induces a positive and sustained change in the way pain and anxiety are processed. While anesthesia may appear to be a simple solution to eliminate pain, the adverse effects of pre-anesthesia anxiety on postoperative behavior and recovery are often not fully appreciated.

Effects of Patients' Affect on Adverse Procedural Events during Image-Guided Interventions.

Purpose: To assess how a patient's affect on presentation relates to the likelihood of adverse events during their subsequent interventional image-guided procedures.

Materials And Methods: A secondary analysis was performed of an existing dataset from a clinical trial with 230 patients who underwent percutaneous peripheral vascular and renal interventions and who had completed the positive affect (PA) negative affect (NA) schedule (PANAS) before their procedures. Summary PANAS scores were split over the median and used to classify the participants into those with high vs low PA and high vs low NA.

Effects of Interpersonal Skills Training on MRI Operations in a Saturated Market: A Randomized Trial.

Purpose: The aim of this study was to assess the effects of team training on operational efficiency during outpatient MRI.

Methods: In this institutional review board-approved, HIPAA-compliant study, six MRI outpatient sites of a midwestern hospital system were randomized to serve as controls or have their teams trained in advanced communication skills. The fourth quarter of fiscal year 2015 was the trial baseline.

Analyzing acute procedural pain in clinical trials.

Because acute procedural pain tends to increase with procedure time, assessments of pain management strategies must take that time relationship into account. Statistical time-course analyses are, however, complex and require large patient numbers to detect differences. The current study evaluated the abilities of various single and simple composite measures such as averaged pain or individual patient pain slopes to detect treatment effects.

Understanding patient satisfaction ratings for radiology services.

Objective: Under the Hospital Value-Based Purchasing Program of the Centers for Medicare & Medicaid Services, patient satisfaction accounts for 30% of the measures of and payments for quality of care. Understanding what drives patient satisfaction data and how the data are obtained, converted into scores, and formulated into rankings is increasingly critical for imaging departments. The objectives of this article are to describe the potential impact of patient satisfaction ratings on institutions and individuals, explain how patient satisfaction is rated and ranked, identify drivers that affect the ratings and rankings, and probe the resulting challenges unique to radiology departments.

A Better Patient Experience Through Better Communication.

The transformation of healthcare from a seller's market to a consumer's market has pushed the element of patient satisfaction into the forefront of various medical facility evaluation tools, including those used by Medicare when weighing reimbursement to hospitals for patient care. Research has identified good communication skills to be a key factor in ensuring better patient outcomes, and nurturing patient satisfaction. Because of the growing amount of money at stake for patients' satisfaction with a facility, the communication skills of individual healthcare providers are bound to impact their employees' reimbursement, bonuses, and promotion options.

Managing distress, discomfort, and anxiety in imaging.

Positive patient interactions and experiences not only help the customer but also directly affect the bottom line. Waste of overhead can be limited by simply changing the way staff talks with patients. It is important to include rapid rapport skills and ways to positively shape the patients' experience right from the start instead of waiting and possibly having a procedure or scan disrupted.

Distress in the radiology waiting room.

Purpose: To assess the level of distress in women awaiting radiologic procedures.

Materials And Methods: In this institutional review board-approved and HIPAA-compliant study, 214 women between 18 and 86 (mean, 47.9) years of age completed the State Trait Anxiety Inventory (STAI), Impact of Events Scale (IES), Center for Epidemiologic Studies Depression Scale (CES-D), and Perceived Stress Scale (PSS) immediately prior to their procedures.

Effect of team training on patients' ability to complete MRI examinations.

Rationale And Objectives: Assess whether staff training in advanced rapport skills and self-hypnotic relaxation techniques reduces noncompletion rates during magnetic resonance imaging (MRI).

Methods And Materials: All staff of a free-standing MRI facility was invited to 3 hours of preparatory communication lectures. Half of the practice was then engaged in intensive training.

In vitro analysis of downstream particulates with mechanical thrombectomy devices: comparison of 20-kHz sonothrombolytic and rotating dispersion wire systems.

Purpose: To assess the potential of macroembolization, the authors compared the downstream particulate profile generated with use of two thrombectomy devices, a 20-kHz ultrasound-based sonothrombolytic (ST) device and a rotating dispersion wire (RDW).

Materials And Methods: An arterial flow model was pressurized to 100 mm Hg and perfused with 1,000 mL/min normal saline. Tubing containing 7-mm x 30-cm bovine thrombus proximal to a 75% stenosis was inserted distal to a nonstenosed bypass.

Large-core breast biopsy: abnormal salivary cortisol profiles associated with uncertainty of diagnosis.

Purpose: To determine whether uncertainty of the diagnosis after large-core breast biopsy (LCBB) adversely affects biochemical stress levels.

Materials And Methods: This study was institutional review board approved and HIPAA compliant, and all patients gave written informed consent. One hundred fifty women aged 18-86 years collected four salivary cortisol samples per day for 5 days after LCBB.

Hemolysis comparison between the OmniSonics OmniWave Endovascular System and the Possis AngioJet in a porcine model.

Purpose: To compare the degree of hemolysis generated during use of the ultrasound-based OmniSonics OmniWave Endovascular System and the Possis AngioJet connected to an Xpeedior-6 catheter.

Materials And Methods: Twelve 64-145-kg Yorkshire pigs were used as the model because their weight, blood volume, and vessel diameters are comparable to that of adult humans. Six pigs were treated with the OmniWave and six with the AngioJet; half of the pigs in each group were treated in the contralateral iliofemoral arteries and half in the ipsilateral iliofemoral veins.

Beneficial effects of hypnosis and adverse effects of empathic attention during percutaneous tumor treatment: when being nice does not suffice.

Purpose: To determine how hypnosis and empathic attention during percutaneous tumor treatments affect pain, anxiety, drug use, and adverse events.

Materials And Methods: For their tumor embolization or radiofrequency ablation, 201 patients were randomized to receive standard care, empathic attention with defined behaviors displayed by an additional provider, or self-hypnotic relaxation including the defined empathic attention behaviors. All had local anesthesia and access to intravenous medication.

Endovenous laser ablation of the saphenous veins: bilateral versus unilateral single-session procedures.

Purpose: To assess the feasibility of bilateral endovenous laser ablation (EVLA) of saphenous veins in a single session with use of diluted lidocaine for tumescent anesthesia.

Materials And Methods: Among 122 consecutive EVLA procedures (112 patients; mean age, 49 years; 75% women) over a 12-month period, there were 75 unilateral procedures (n = 67) and 47 bilateral interventions (n = 45). Tumescent anesthesia consisted of lidocaine diluted to 0.

Hypnosis for acute distress management during medical procedures.

The use of hypnosis during medical procedures has a long-standing tradition but has been struggling for acceptance into the mainstream. In recent years, several randomized-controlled trials with sufficient participant numbers have demonstrated the efficacy of hypnosis in the perioperative domain. With the advancements of minimally invasive high-tech procedures during which the patient remains conscious, hypnotic adjuncts have found many applications.

Fibrin sheath removal from central venous catheters: an internal snare manoeuvre.

Background: Dysfunction of haemodialysis catheters is most commonly due to a narrowing of the catheter lumen and/or formation of a fibrin sheath around the catheter tip. Reported methods for restoring patency of the catheter lumen include passage of a J-tipped guide wire, passage of a biopsy brush through the catheter, or infusion of a thrombolytic agent into the catheter. While these methods are often effective, they suffer from several limitations.

Effects of age on responsiveness to adjunct hypnotic analgesia during invasive medical procedures.

Objectives: To assess the effects of age on responsiveness to self-hypnotic relaxation as an analgesic adjunct in patients undergoing invasive medical procedures.

Material And Methods: Secondary data analysis from a prospective trial with 241 patients randomized to receive hypnosis, attention, and standard care treatment during interventional radiological procedures. Growth curve analyses, hierarchical linear regressions, and logistic regressions using orthogonal contrasts were used for analysis.

Adjunctive self-hypnotic relaxation for outpatient medical procedures: a prospective randomized trial with women undergoing large core breast biopsy.

Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. Two hundred and thirty-six women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n=82), or self-hypnotic relaxation (n=78) during their procedures.