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Development and validation of a questionnaire evaluating patient anxiety during Magnetic Resonance Imaging: the Magnetic Resonance Imaging-Anxiety Questionnaire (MRI-AQ)
Ryhov County Hospital, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Linnaeus University, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
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2016 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 6, 1368-1380 p.Article in journal (Refereed) Published
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Text
Abstract [en]

Aim. To develop and validate a new instrument measuring patient anxiety during Magnetic Resonance Imaging examinations, Magnetic Resonance Imaging-Anxiety Questionnaire. Background. Questionnaires measuring patients anxiety during Magnetic Resonance Imaging examinations have been the same as used in a wide range of conditions. To learn about patients experience during examination and to evaluate interventions, a specific questionnaire measuring patient anxiety during Magnetic Resonance Imaging is needed. Design. Psychometric cross-sectional study with test-retest design. Methods. A new questionnaire, Magnetic Resonance Imaging-Anxiety Questionnaire, was designed from patient expressions of anxiety in Magnetic Resonance Imaging-scanners. The sample was recruited between October 2012-October 2014. Factor structure was evaluated with exploratory factor analysis and internal consistency with Cronbachs alpha. Criterion-related validity, known-group validity and test-retest was calculated. Results. Patients referred for Magnetic Resonance Imaging of either the spine or the heart, were invited to participate. The development and validation of Magnetic Resonance Imaging-Anxiety Questionnaire resulted in 15 items consisting of two factors. Cronbachs alpha was found to be high. Magnetic Resonance Imaging-Anxiety Questionnaire correlated higher with instruments measuring anxiety than with depression scales. Known-group validity demonstrated a higher level of anxiety for patients undergoing Magnetic Resonance Imaging scan of the heart than for those examining the spine. Test-retest reliability demonstrated acceptable level for the scale. Conclusion. Magnetic Resonance Imaging-Anxiety Questionnaire bridges a gap among existing questionnaires, making it a simple and useful tool for measuring patient anxiety during Magnetic Resonance Imaging examinations.

Place, publisher, year, edition, pages
WILEY-BLACKWELL , 2016. Vol. 72, no 6, 1368-1380 p.
Keyword [en]
anxiety; instrument development; magnetic resonance imaging; nurse; nursing; reliability; validity
National Category
Other Medical Sciences not elsewhere specified
Identifiers
URN: urn:nbn:se:liu:diva-129145DOI: 10.1111/jan.12917ISI: 000376007400014PubMedID: 26893007OAI: oai:DiVA.org:liu-129145DiVA: diva2:936062
Note

Funding Agencies|Swedish Heart and Lung Foundation; Futurum County Council of Jonkoping

Available from: 2016-06-13 Created: 2016-06-13 Last updated: 2017-11-28
In thesis
1. Magnetic Resonance Imaging of the Heart: Image quality, measurement accuracy and patient experience
Open this publication in new window or tab >>Magnetic Resonance Imaging of the Heart: Image quality, measurement accuracy and patient experience
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Non-invasive diagnostic imaging of atherosclerotic coronary artery disease (CAD) is frequently carried out with cardiovascular magnetic resonance imaging (CMR) or myocardial perfusion single photon emission computed tomography (MPS). CMR is the gold standard for the evaluation of scar after myocardial infarction and MPS the clinical gold standard for ischemia. Magnetic Resonance Imaging (MRI) is at times difficult for patients and may induce anxiety while patient experience of MPS is largely unknown.

Aims: To evaluate image quality in CMR with respect to the sequences employed, the influence of atrial fibrillation, myocardial perfusion and the impact of patient information. Further, to study patient experience in relation to MRI with the goal of improving the care of these patients.

Method: Four study designs have been used. In paper I, experimental cross-over, paper (II) experimental controlled clinical trial, paper (III) psychometric crosssectional study and paper (IV) prospective intervention study. A total of 475 patients ≥ 18 years with primarily cardiac problems (I-IV) except for those referred for MRI of the spine (III) were included in the four studies.

Result: In patients (n=20) with atrial fibrillation, a single shot steady state free precession (SS-SSFP) sequence showed significantly better image quality than the standard segmented inversion recovery fast gradient echo (IR-FGRE) sequence (I). In first-pass perfusion imaging the gradient echo-echo planar imaging sequence (GREEPI) (n=30) had lower signal-to-noise and contrast–to-noise ratios than the steady state free precession sequence (SSFP) (n=30) but displayed a higher correlation with the MPS results, evaluated both qualitatively and quantitatively (II). The MRIAnxiety Questionnaire (MRI-AQ) was validated on patients, referred for MRI of either the spine (n=193) or the heart (n=54). The final instrument had 15 items divided in two factors regarding Anxiety and Relaxation. The instrument was found to have satisfactory psychometric properties (III). Patients who prior CMR viewed an information video scored significantly (lower) better in the factor Relaxation, than those who received standard information. Patients who underwent MPS scored lower on both factors, Anxiety and Relaxation. The extra video information had no effect on CMR image quality (IV).

Conclusion: Single shot imaging in atrial fibrillation produced images with less artefact than a segmented sequence. In first-pass perfusion imaging, the sequence GRE-EPI was superior to SSFP. A questionnaire depicting anxiety during MRI showed that video information prior to imaging helped patients relax but did not result in an improvement in image quality.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2016. 74 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1524
National Category
Radiology, Nuclear Medicine and Medical Imaging Medical Image Processing Cardiac and Cardiovascular Systems Medical Laboratory and Measurements Technologies Family Medicine
Identifiers
urn:nbn:se:liu:diva-130796 (URN)10.3384/diss.diva-130796 (DOI)9789176857427 (ISBN)
Public defence
2016-09-30, Originalet, Qulturum, Hus B4, Länssjukhuset Ryhov, Jönköping, 09:00 (Swedish)
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Available from: 2016-08-24 Created: 2016-08-24 Last updated: 2016-08-29Bibliographically approved

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Årestedt, KristoferEngvall, Jan
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Division of Nursing ScienceFaculty of Medicine and Health SciencesDivision of Cardiovascular MedicineDepartment of Clinical Physiology in LinköpingCenter for Medical Image Science and Visualization (CMIV)
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