The focus of Unit 11 is alleviating patient fear.

„Patients undergoing magnetic resonance imaging (MRI) often experience fear and anxiety prior to and during scanning. This could result in early termination of scan and indirectly affect image quality in terms of motion artefacts. In addition, anxiety is known to increase respiratory rate, peristalsis and fluid flow, all potentially having detrimental effects on image quality. It is reported that up to 37% of patients undergoing an MRI scan experience moderate to high levels of anxiety.”¹

Healthcare professionals play a key role in recognizing these fears and applying strategies to alleviate them. This unit will guide you through understanding common behavioural responses in claustrophobic patients, recognizing the signs of severe anxiety, and exploring effective strategies to address and reduce patient fear.

Learning Objectives:

By the end of this unit, you will be able to:

1. Recognize common behavioural responses in claustrophobic patients.
2. Identify the signs of severe anxiety in patients.
3. Apply effective strategies to address and alleviate patient fears.

Claustrophobia, the fear of being in small or confined spaces, is a common issue in healthcare settings, particularly in diagnostic procedures like MRIs, CT scans or other imaging studies. Patients may exhibit a variety of behavioural responses when faced with potentially claustrophobic situations. These responses may include:

Physical symptoms: Sweating, rapid heartbeat, shortness of breath and dizziness.

Verbal expressions of fear: Complaints of feeling trapped or unable to breathe, or vocalizing fear of being enclosed.

Restlessness: A patient may show signs of agitation, such as shifting positions or fidgeting.

Tense body language: Patients may tense up, avoid eye contact or cross their arms as if to shield themselves.

Severe anxiety can manifest in a variety of ways, particularly in healthcare environments where patients may feel vulnerable. It is essential to recognize the signs early to provide appropriate support. Some common signs of severe anxiety include:

Physical symptoms: Increased heart rate, shallow or rapid breathing, sweating, and trembling.

Verbal signs: Speaking rapidly, repeating phrases, or expressing a fear of dying or losing control.

Behavioural cues: Fidgeting, pacing, avoidance of eye contact or withdrawal from conversation.

Emotional signs: Tearfulness, anger or irritability.

Recognizing these signs early on allows you to intervene appropriately and begin alleviating the patient’s anxiety.

There are several strategies healthcare professionals can use to help alleviate patient fear and anxiety, especially in those with claustrophobia or severe anxiety. Some effective approaches include:

Clear communication: Explain the procedure in simple, reassuring terms. Let the patient know exactly what to expect, including how long the procedure will take and any potential discomfort they might experience.

Creating a calm environment: Ensure the environment is as calming as possible by reducing noise, providing soft lighting and maintaining a peaceful atmosphere. You can also offer distractions, like music or guided imagery.

Breathing exercises: Teach the patient to focus on slow, deep breaths to calm their nervous system. Phrases like “Inhale slowly, hold, and exhale gently” can be helpful.

Offer support: Reassure the patient that they are not alone. Having a healthcare provider or family member present during the procedure can be comforting.

Use of relaxation techniques: Progressive muscle relaxation or visualization techniques can be effective in reducing physical symptoms of anxiety and fear.

Sedation or medication: In cases of extreme anxiety or claustrophobia, mild sedation or anti-anxiety medication can be considered, following appropriate protocols.

Pause for Thought

Consider a situation where a patient experienced severe anxiety or claustrophobia during a procedure. What strategies did you employ to help alleviate their fear? How did these strategies affect the outcome of the procedure?

Key Takeaways

• Patients undergoing MRI scans often experience anxiety and fear.
• Patient fear in MRI can affect scan quality.
• Common claustrophobic behaviours: sweating, rapid heartbeat, restlessness, tense body language.
• Signs of severe anxiety: rapid heart rate, shallow breathing, trembling, tearfulness, anger.
• Effective strategies: clear communication, calm environment, breathing exercises, emotional support, relaxation techniques, sedation or medication if necessary
• Early recognition and intervention are crucial for successful outcomes

Next Steps

• Do the exercises.
• Participate in Role-play Simulation 11.
• Share reflections and key takeaways during debrief.

1. Tugwell J.R., Goulden N., Mullins P., „Alleviating anxiety in patients prior to MRI”, researchgate.net/publication/320763595