Skip to main content

Advertisement

SpringerLink
Log in

Easing anxiety in preparation for pediatric magnetic resonance imaging: a pilot study using animal-assisted therapy

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

Children undergoing magnetic resonance imaging (MRI) can experience negative emotions both before and during their scan, causing them to move and often necessitating the use of procedural sedation. Several strategies to improve patient compliance have been attempted.

Objective

This study was designed to evaluate the effectiveness of a non-pharmacological intervention to reduce anxiety in pediatric patients preparing for MRI using animal-assisted therapy.

Materials and methods

An animal intervention pilot study was performed in patients who agreed in advance to interact with a dog. Patients and caregivers filled out questionnaires, including questions designed to capture changes in patient emotion before and after the intervention. MRI diagnostic quality was compared to age- and gender-matched control groups with and without general anesthesia.

Results

The intervention in 21 patients comparing pre- and post-scan surveys demonstrated a statistically significant improvement in patient anxiety levels (P<0.01). Diagnostic MRI scans were achieved in 19/21 (90%), with no significant difference in exam quality or times compared against control groups. The majority of caregivers and staff members agreed strongly that patients benefited from the therapy dog’s presence.

Conclusion

The use of animal-assisted therapy in a pilot group in our MRI division resulted in a beneficial effect on patients’ emotional status, easing anxiety in preparation for scheduled scans, without impacting MRI quality or duration. Further randomized studies will be needed to demonstrate its significance in reducing sedation rates in children undergoing MRI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Viggiano M, Giganti F, Rossi A et al (2015) Impact of psychological interventions on reducing anxiety, fear and the need for sedation in children undergoing magnetic resonance imaging. Pediatr Rep 7:5682

    Article  PubMed  PubMed Central  Google Scholar 

  2. Kaplan RF, Cravero JP, Yaster M, Cote CJ (2012) Sedation for diagnostic and therapeutic procedures outside the operating room. In: Cote C, Lerman J, Anderson B (eds) A practice of anesthesia for infants and children, 5th edn. Saunders, Philadelphia

    Google Scholar 

  3. Arlachov Y, Ganatra R (2012) Sedation/anaesthesia in paediatric radiology. Br J Radiol 85:e1018–e1031

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Jaimes C, Murcia DJ, Miguel K et al (2018) Identification of quality improvement areas in pediatric MRI from analysis of patient safety reports. Pediatr Radiol 48:66–73

    Article  PubMed  Google Scholar 

  5. Robertson RL, Silk S, Ecklund K et al (2018) Imaging optimization in children. J Am Coll Radiol 15:440–443

    Article  PubMed  Google Scholar 

  6. Malviya S, Voepel-Lewis T, Eldevik OP et al (2000) Sedation and general anaesthesia in children undergoing MRI and CT: adverse events and outcomes. Br J Anaesth 84:743–748

    Article  CAS  PubMed  Google Scholar 

  7. Vanderby S, Babyn PS, Carter MW et al (2010) Effect of anesthesia and sedation on pediatric MR imaging patient flow. Radiology 256:229–237

    Article  PubMed  Google Scholar 

  8. Carter AJ, Greer ML, Gray SE, Ware RS (2010) Mock MRI: reducing the need for anaesthesia in children. Pediatr Radiol 40:1368–1374

    Article  PubMed  Google Scholar 

  9. Herned RK 2nd, Strain JD (2001) MRI-compatible audio/visual system: impact on pediatric sedation. Pediatr Radiol 32:247–250

    Article  Google Scholar 

  10. Tornqvist E, Masson A, Hallstrom I (2014) Children having magnetic resonance imaging: a preparatory storybook and audio/visual media are preferable to anesthesia or deep sedation. J Child Health Care 19:359–369

    Article  PubMed  Google Scholar 

  11. Lemaire C, Moran GR, Swan H (2009) Impact of audio/visual systems on pediatric sedation in magnetic resonance imaging. J Magn Reson Imaging 30:649–655

    Article  PubMed  Google Scholar 

  12. McGuirt D (2016) Alternatives to sedation and general anesthesia in pediatric magnetic resonance imaging: a literature review. Radiol Technol 88:18–26

    PubMed  Google Scholar 

  13. Windram J, Grosse-Wortmann L, Shariat M et al (2002) Cardiovascular MRI without sedation or general anesthesia using a feed-and-sleep technique in neonates and infants. Pediatr Radiol 42:183–187

    Article  Google Scholar 

  14. Durand DJ, Young M, Nagy P et al (2015) Mandatory child life consultation and its impact on pediatric MRI workflow in an academic medical center. J Am Coll Radiol 12:594–598

    Article  PubMed  Google Scholar 

  15. McGee K (2003) The role of a child life specialist in a pediatric radiology department. Pediatr Radiol 33:467–474

    Article  PubMed  Google Scholar 

  16. Jaimes C, Gee MS (2016) Strategies to minimize sedation in pediatric body magnetic resonance imaging. Pediatr Radiol 46:916–927

    Article  PubMed  Google Scholar 

  17. Food and Drug Administration (2016) Drug Safety Communication: FDA review results in new warnings about using general anesthetics and sedation drugs in young children and pregnant women. Available at https://www.fda.gov/Drugs/DrugSafety/ucm554634.htm. Accessed 4 Sept 2017

  18. Halm MA (2008) The healing power of the human-animal connection. Am J Crit Care 17:373–376

    PubMed  Google Scholar 

  19. Marcus DA (2013) The science behind animal-assisted therapy. Curr Pain Headache Rep 17:322

    Article  PubMed  Google Scholar 

  20. Siewertsen CM, French ED, Teramoto M (2015) Autism spectrum disorder and pet therapy. Adv Mind Body Med 29:22–25

    PubMed  Google Scholar 

  21. Cowling A (2010) The benefits and limitations of pet therapy for people with dementia. In: Oshkosh Scholar, volume 5. University of Wisconsin, Oshkosh

  22. Cherniack EP, Cherniack AR (2014) The benefit of pets and animal-assisted therapy to the health of older individuals. Curr Gerontol Geriatr Res 2014:623203

    Article  PubMed  PubMed Central  Google Scholar 

  23. Wu AS, Niedra R, Pendergast L, McCrindle BW (2002) Acceptability and impact of pet visitation on a pediatric cardiology inpatient unit. J Pediatr Nurs 17:354–362

    Article  PubMed  Google Scholar 

  24. Kaminski M, Pellino T, Wish J (2002) Play and pets: the physical and emotional impact of child-life and pet therapy on hospitalized children. Child Health Care 31:321–335

    Article  Google Scholar 

  25. Sobo EJ, Eng B, Kassity-Krich N (2006) Canine visitation (pet) therapy: pilot data on decreases in child pain perception. J Holist Nurs 24:51–57

    Article  PubMed  Google Scholar 

  26. Chubak J, Hawkes R (2016) Animal-assisted activities: results from a survey of top-ranked pediatric oncology hospitals. J Pediatr Oncol Nurs 33:289–296

    Article  PubMed  Google Scholar 

  27. Gagnon J, Bouchard F, Landry M et al (2004) Implementing a hospital-based animal therapy program for children with cancer: a descriptive study. Can Oncol Nurs J 14:217–222

    Article  PubMed  Google Scholar 

  28. Moody WJ, King R, O’Rourke S (2002) Attitudes of paediatric medical ward staff to a dog visitation programme. J Clin Nurs 11:537–544

    Article  PubMed  Google Scholar 

  29. Calcaterra V, Veggiotti P, Palestrini C et al (2015) Post-operative benefits of animal-assisted therapy in pediatric surgery: a randomised study. PLoS One 10:e0125813

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Vagnoli L, Caprilli S, Vernucci C et al (2015) Can presence of a dog reduce pain and distress in children during venipuncture? Pain Manag Nurs 16:89–95

    Article  PubMed  Google Scholar 

  31. Shellock FG, Woods TO, Crues JV 3rd (2009) MR labeling information for implants and devices: explanation of terminology. Radiology 253:26–30

    Article  PubMed  Google Scholar 

  32. Kain ZN, Mayes LC, Cicchetti DV et al (1997) The Yale preoperative anxiety scale: how does it compare with a "gold standard"? Anesth Analg 85:783–788

    Article  CAS  PubMed  Google Scholar 

  33. Berghmans JM, Poley MJ, van der Ende J et al (2017) A visual analog scale to assess anxiety in children during anesthesia induction (VAS-I): results supporting its validity in a sample of day care surgery patients. Paediatr Anaesth 27:955–961

    Article  PubMed  Google Scholar 

  34. Writing Panel of Working Group, Lefebvre SL, Golab GC et al (2008) Guidelines for animal-assisted interventions in health care facilities. Am J Infect Control 36:78–85

    Article  Google Scholar 

  35. Center for Disease Control and Prevention (2003) Environmental infection control guidelines. Available at https://www.cdc.gov/infectioncontrol/pdf/guidelines/environmental-guidelines.pdf. Accessed 4 Sept 2017

Download references

Acknowledgments

The authors thank Dr. James Robertson, pediatric anesthetist, for contributing to this manuscript regarding anesthesia practices at our institution.

Author information

Authors and Affiliations

  1. Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G 1X8, Canada

    Manuela Perez, Joanne F. Somers, Nicole Simms, Sabia Shaheed, Leah A. Kehoe, Stephanie A. Holowka, Albert A. Aziza, Manohar M. Shroff & Mary-Louise C. Greer

  2. Department of Clinical Medicine, University of Queensland, Brisbane, Australia

    Claire Cuscaden

  3. Department of Medical Imaging, University of Toronto, Toronto, ON, Canada

    Manohar M. Shroff & Mary-Louise C. Greer

Authors
  1. Manuela Perez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Claire Cuscaden
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joanne F. Somers
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nicole Simms
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sabia Shaheed
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Leah A. Kehoe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Stephanie A. Holowka
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Albert A. Aziza
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Manohar M. Shroff
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Mary-Louise C. Greer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mary-Louise C. Greer.

Ethics declarations

Conflicts of interest

None

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(PDF 136 kb)

ESM 2

(PDF 93 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Perez, M., Cuscaden, C., Somers, J.F. et al. Easing anxiety in preparation for pediatric magnetic resonance imaging: a pilot study using animal-assisted therapy. Pediatr Radiol 49, 1000–1009 (2019). https://doi.org/10.1007/s00247-019-04407-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-019-04407-3

Keywords

Search

Navigation