A person-centered continuity pathway for pediatric contrast-enhanced imaging: sustaining one multisensory context across home, hospital, and scanner transitions.

Abstract

Background: Pediatric contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) require sustained cooperation, procedural immobility, and venous access, creating operational and experiential challenges for children, families, and imaging services. Existing nonpharmacological interventions generally address isolated procedural segments and do not preserve a familiar context across home, hospital, and scanner transitions.

Innovation: Euterpe-Radiology (Euterpe-RAD) is a consent-gated, five-module institutional pathway that sustains one autobiographically anchored multisensory context-family-voice recordings, a personalized therapeutic composition, and child- or family-selected visual content-from home familiarization through hospital preparation, venous access, acquisition, and closure. Continuity is defined by content identity, coverage of four predefined transitions, and stability of the caregiver and therapeutic roles. The added value of continuity over single-segment preparation is a design hypothesis and is not tested here.

Approach: This community case study describes pathway design and initial implementation under institutional quality-improvement governance. The pathway was offered to eight caregivers; six consented and two declined, both citing the organizational burden of the home-based component. Three children entered Module 1. One completed all five modules and underwent contrast-enhanced CT without sedation. Of the other two, one was excluded when photosensitivity was identified during the opening tele-anamnesis, and one completed home familiarization but did not undergo CT because cannulation was not tolerated. In three additional consenting children, the interval between referring-unit authorization and the scheduled examination was shorter than the 5-7-day home-familiarization window. Module 1 therefore could not be delivered; these children received hospital-stage music-therapy support only and underwent CT without sedation. These encounters are classified as partial deliveries rather than five-module completions. No MRI examination was delivered.

Conclusions: One complete CT pathway was delivered without modification of acquisition or contrast protocols. The exclusions, procedural discontinuation, and partial deliveries define implementation boundaries rather than effects. These counts do not establish effectiveness, acceptability, or a sedation-sparing effect; the MRI branch remains a design specification, and prospective comparative evaluation is required.