Solution-focused brief therapy combined with mindfulness-based stress reduction to alleviate claustrophobia during MR imaging

Abstract

Background: This study evaluates the influence of solution-focused approaches combined with mindfulness-based stress reduction (MBSR) on claustrophobia in a high-risk cohort undergoing magnetic resonance (MR) imaging.

Methods: In the prospective observational 2-group study, a total of 77 patients (55% male, mean age 50.1 ± 11.9) underwent solution-focused brief therapy (SFBT) and MBSR before MR examination. The control group (146 patients, 48% male, mean age 48.7 ± 12.9) received the same MR examination condition and only received routine psychological intervention. Before the intervention, after MR examination, all patients were required to complete the Claustrophobia questionnaire, hospital anxiety and depression scale, and the Connor-Davidson resilience scale questionnaire. Additionally, the occurrence of claustrophobic events, image quality, patient satisfaction, average completion time, and 1-time pass rate were recorded. Claustrophobia events included premature termination, sedation, and non-sedation coping actions. The Shapiro-Wilk test was employed to assess the normality of the data, while either an independent samples t test or Mann-Whitney U test was utilized to analyze differences in quantitative information between the 2 groups. χ2 test was employed to validate the qualitative data.

Results: The prevalence of claustrophobia was significantly reduced in the intervention group compared with the control group (18%, 14/77 vs 46%, 67/146; P < .05), while the need for sedation (3%, 2/77 vs 10%, 15/146; P < .05) and non-sedation coping actions (12%, 9/77 vs 23%, 33/146; P < .05) was also significantly reduced in patients who received SFBT & MBSR interventions. Patients who received the SFBT & MBSR intervention had lower mean examination completion time (17.28 ± 3.36 vs 19.75 ± 4.23; P < .05), and hospital anxiety and depression scale score (from 9.03 ± 0.9 to 6.30 ± 0.8; 6.30 ± 0.8 vs 9.08 ± 1.0; P < .05), higher 1-time pass rate (82% vs 61%; P < .05), image quality (P < .05), examination satisfaction (P < .05), and Connor-Davidson resilience scale score (from 57.73 ± 4.5 to 66.08 ± 4.7; 66.08 ± 4.7 vs 57.78 ± 4.6; P < .05). However, there was no statistically significant change observed in the Claustrophobia questionnaire for either the intervention or control group.

Conclusion: The intervention model combining SFBT with MBSR may substantially reduce the incidence of claustrophobia in high-risk patients during MR examinations and may reduce the need for sedation and non-sedation coping actions.

Keywords: anxiety; magnetic resonance imaging; mindfulness-based stress reduction; phobic disorders; solution-focused approach.