The Value of Psychological Intervention in Paediatric DMSA Scanning.

Aim: The aim of this study was to design and evaluate psychological intervention to lower distress amongst children undergoing DMSA scans, and lower sedation rates without compromising the quality of scans. Method: Research took place in a nuclear medicine department and a children’s outpatient ward in a hospital in South London. Baseline data was collected via medical note search and postal questionnaire. A randomised quasi-controlled intervention study followed. Two psychological interventions were compared with each other and with baseline data. Intervention ‘A’ included environmental manipulation and distraction during procedures. Intervention ‘B’ included these components plus a photo-booklet depicting a child model coping with procedures, plus a letter with advice to parents. Measures of observed, physiological and self-reported children’s distress, maternal state and trait anxiety, radiographer ratings of scan quality, rates of scan failure and sedation, and responses to a service related questionnaire were collected on the day of the scan. Participants in the baseline phase included 58 families who had used the service in the past 6 months. Participants in the intervention phase included a consecutive sample of 40 children aged 3 months to 9 years old and their mothers. Results: Parent ratings of children’s distress, and sedation rates were significantly lower in the intervention group compared to the baseline group in association with fewer failed scans. There was a trend for children whose mothers had received a preparatory photo-book to be less distressed. Also, families who received the photo-book were significantly more likely to arrive for the scan than families who did not. The cost saving of sending the photo-book was approximately £1636. Maternal state anxiety was significantly correlated with children’s distress on arrival and during the scan. Conclusion: Children who received a psychological intervention were less distressed and less likely to be sedated than children who did not. Using psychological intervention did not compromise scan quality and using a photo-booklet resulted in a cost-saving for the service. The association between maternal state anxiety and children’s distress highlights the need to prepare mothers and their children for medical procedures