Evaluation of audiovisual and auditory interventions on exam anxiety during whole-body magnetic resonance imaging in cancer patients: a quasi-experimental study.

Abstract

Background: WB-MRI is a radiation-free imaging technique widely used in oncology. Despite clinical advantages, WB-MRI can cause significant patient anxiety and claustrophobia, affecting scan completion and patient adherence. Non-invasive interventions to reduce MRI-related distress are still limited in clinical practice. This study evaluates the use of audiovisual and auditory entertainment for reducing anxiety during WB-MRI.

Methods: In this prospective, quasi-experimental trial, 213 cancer patients (median age: 52.0[44-60]; female 70%) undergoing WB-MRI were equally assigned to Video (nature landscapes and sounds), Music (relaxing instrumental), or Standard (no distraction) groups. Anxiety was assessed using the State Trait Anxiety Inventory (STAI) before and after the exam. Additional measures included the Distress Thermometer, WB-MRI acceptance questionnaire, and claustrophobia ratings. Data analysis compared anxiety changes, interactions between baseline anxiety and claustrophobia, and logistic regression for anxiety reduction likelihood.

Results: Baseline anxiety was comparable across groups. Anxiety reduction was greater in the Video (mean STAI = -5.57) and Music (-2.48) groups compared to the Standard (0.33) group, with the Video group significantly outperforming the Music group (p = 0.006). Logistic regression showed patients in Video (95%CI:3.77-68.22, p < 0.001) and Music (95%CI:1.47-29.8, p = 0.02) groups were significantly more likely to reduce anxiety than controls. Patients with severe claustrophobia and high baseline STAI exhibited pronounced improvements, particularly with Video (β = - 0.38, p < 0.001). The alluvial plot shows that the Video and Music groups experienced a marked reduction in the proportion of patients with severe anxiety, while this proportion slightly increased in the standard condition after the exam.

Conclusion: Audiovisual and auditory entertainment significantly reduced anxiety during WB-MRI, with audiovisual showing the greatest benefit. The simultaneous involvement of multisensory distraction enhances tolerance to procedures, especially in highly anxious and claustrophobic patients. These findings advocate for the adoption of a patient-centered audiovisual system as a non-invasive, practical strategy to enhance patient experience and increase the likelihood of successful scan completion in WB-MRI practice. The results hold significant implications for optimizing patient compliance, offering tangible clinical and economic benefits, including reduced sedation requirements, prevention of long-term phobic responses, minimized motion artifacts, and improved image quality.

Trial registration: Retrospectively registered on ClinicalTrials.gov NCT06332001 [first posted March 26, 2024].