医学影像检查诱发患者焦虑的多维机制及精准护理干预体系构建研究

Research on the Multidimensional Mechanisms of Patient Anxiety Induced by Medical Imaging Examinations and the Development of a Personalized Nursing Intervention System

摘要: 目的：医学影像检查(如MRI、CT、PET-CT等)因其封闭空间、高噪音、辐射风险及潜在的疾病确诊压力，常引发患者焦虑情绪，影响检查的顺利进行及患者的身心健康。本研究旨在探讨医学影像检查过程中患者焦虑的诱发机制，分析个性化护理干预的效果，并构建一套针对不同患者群体的护理干预体系，以提高影像检查的依从性和患者舒适度，优化医疗体验。方法：本研究采用混合研究方法，包括问卷调查、焦虑评估量表(SAS)、访谈分析及护理干预实验。选取在我院接受MRI、CT或PET-CT检查的患者360例，按照随机分组原则分为实验组(180例)和对照组(180例)。对照组接受常规护理，包括检查前常规告知及基本安慰。实验组实施个性化护理干预，具体包括：(1) 心理疏导：通过医护人员详细讲解检查流程，提供正面情绪支持；(2) 环境优化：降低检查室噪音，提供舒适的候诊环境；(3) 音乐疗法：允许患者佩戴耳机播放舒缓音乐，以降低紧张感；(4) 认知行为干预：向患者提供放松训练方法，如深呼吸训练及渐进性肌肉放松训练。数据采用SPSS 26.0软件进行统计分析，通过t检验、方差分析评估干预效果。结果：研究结果显示，医学影像检查前，360例患者中约74.2%(267例)表现出不同程度的焦虑情绪，主要表现为心率加快(63.9%)、手心出汗(57.8%)、紧张不安(70.5%)等。焦虑程度与患者年龄、文化水平、过往检查经验及疾病严重程度呈正相关(P < 0.05)。护理干预后，实验组患者的SAS评分由(57.85 ± 4.21)显著下降至(37.92 ± 3.68)，而对照组患者的SAS评分仅从(57.65 ± 4.08)下降至(51.82 ± 3.57)，两组间差异具有统计学意义(P < 0.01)。此外，实验组患者的影像检查依从率由原来的84.6%提升至95.7%，而对照组的依从率仅提高至87.3%。在主观体验方面，实验组患者对护理服务的满意度(91.8%)显著高于对照组(77.9%)。结论：医学影像检查可诱发较高比例的患者焦虑，影响检查质量及患者依从性。基于个性化护理干预体系的实施，包括心理疏导、环境优化、音乐疗法及认知行为干预，可有效降低患者焦虑水平，提高检查顺利率及患者满意度。本研究证实，针对不同患者群体采用综合性护理措施，能够优化影像医学服务质量，为临床护理实践提供科学依据，具有重要的临床推广价值。

Abstract: Objective: Medical imaging examinations (such as MRI, CT, PET-CT) often induce patient anxiety due to confined spaces, high noise levels, radiation risks, and potential diagnostic pressures, which may hinder the smooth progress of examinations and adversely affect patients’ physical and mental health. This study aimed to explore the mechanisms underlying anxiety during medical imaging examinations, analyze the effects of personalized nursing interventions, and construct a targeted intervention system for different patient groups to improve compliance with imaging examinations, enhance patient comfort, and optimize the healthcare experience. Methods：This study adopted a mixed-methods approach, including questionnaires, the Self-Rating Anxiety Scale (SAS), interview analysis, and nursing intervention experiments. A total of 360 patients undergoing MRI, CT, or PET-CT examinations at our hospital were randomly divided into an experimental group (180 cases) and a control group (180 cases). The control group received routine care, including pre-examination explanations and basic reassurance. The experimental group received personalized nursing interventions: (1) Psychological counseling: Detailed explanations of the examination process by healthcare providers and positive emotional encouragement; (2) Environmental optimization: Noise reduction in examination rooms and provision of a comfortable waiting environment; (3) Music therapy: Permission for patients to wear headphones and listen to soothing music to alleviate tension; (4) Cognitive-behavioral interventions: Instruction in relaxation techniques, such as deep breathing and progressive muscle relaxation. Data were statistically analyzed using SPSS 26.0 software, with t-tests and ANOVA to evaluate intervention effects. Results: The results revealed that approximately 74.2% (267/360) of patients exhibited varying degrees of anxiety before imaging examinations, primarily manifested as increased heart rate (63.9%), sweaty palms (57.8%), and restlessness (70.5%). Anxiety levels were positively correlated with patient age, education level, prior examination experience, and disease severity (P < 0.05). After the intervention, the SAS scores of the experimental group significantly decreased from 57.85 ± 4.21 to 37.92 ± 3.68, while the control group’s scores decreased only slightly from 57.65 ± 4.08 to 51.82 ± 3.57, with a statistically significant intergroup difference (P < 0.01). Additionally, the compliance rate for imaging examinations in the experimental group increased from 84.6% to 95.7%, whereas the control group’s compliance rate improved to only 87.3%. Regarding subjective experiences, patient satisfaction with nursing services was significantly higher in the experimental group (91.8%) than in the control group (77.9%). Conclusion: Medical imaging examinations can induce a high proportion of patient anxiety, adversely affecting examination quality and compliance. The implementation of a personalized nursing intervention system-including Psychological counseling, environmental optimization, music therapy, and cognitive-behavioral interventions-effectively reduces anxiety levels, improves examination success rates, and enhances patient satisfaction. This study confirms that comprehensive nursing measures tailored to different patient populations can optimize the quality of imaging medical services, providing scientific evidence for clinical nursing practice and holding significant value for clinical promotion.