Does a Photo Diary Decrease Stress and Anxiety in Children Undergoing Magnetic Resonance Imaging? A Randomized, Controlled Study j Jane H. Hartman, MSN, RN, CPNP; James Bena, MS; Shannon McIntyre, MS; and Nancy M. Albert, PhD, MSN, RN, CCNS, CCRN, NE-BC ABSTRACT: Using a randomized trial methodology with two groups, we surveyed 52 school-aged children and their parents to determine if photo-diary education pre-magnetic resonance imaging (MRI) scan decreased prescan stress and anxiety in children. We also examined anxiety and satisfaction with pre-MRI scan education in parents. At baseline, there were no differences in stress and anxiety total or subscale scores by group; total score p Z .84 and .46, respectively. Posteducation, there were no differences in total stress or anxiety scores by group (p Z .88 and .16, respectively); however, education group children had higher general anxiety (p Z .04), that was reflected in greater likelihood to ‘‘worry about things,’’ p Z .01. In parents in the educa- tion group, there was a trend for perceptions of greater satisfaction with education, less anxiety in their child, and more questions asked by their child (all p Z .18); however, parent anxiety was similar between groups. We discuss results, especially the increase in anxiety and provide implications for nursing related to future research and clinical practice. (J Radiol Nurs 2009;28:122-128.) KEYWORDS: School-age children; Magnetic resonance imaging; Pre-procedure education; Anxiety; Stress. INTRODUCTION Children undergoing magnetic resonance imaging (MRI) are often frightened and anxious before and during the procedure. The MRI scanner’s long narrow bore, loud noise, and the length of time required to complete the scan can be very intimidating for children. The need for children to lie completely still combined with fear and anxiety that children are feeling makes it difficult for them to fully cooperate (Pressdee, May, Eastman, & Grier, 1997). Many children are unable to complete a MRI without procedural sedation. Chil- dren younger than 5 years are rarely able to complete a MRI without sedation because of their developmen- tal level of understanding. Children older than 5 years may require sedation, but may be more likely to cope with a MRI scan when preprocedural education is de- livered, especially if age appropriate and includes seeing the unit in action (Pressdee et al., 1997). Children undergoing MRI at our health care center receive no prior education when having a MRI scan. Many children exhibit stress and anxiety, displayed as Jane H. Hartman, MSN, RN, CPNP, is the Pediatric Nurse Practitioner in Cleveland Clinic at Cleveland, Ohio; James Bena, MS, is the Statistician in Quantitative Health Sciences, Cleveland Clinic at Cleveland, OH; Shannon McIntyre, MS, is the Statistical Programmer in Quantitative Health Sciences, Cleveland Clinic at Cleveland, OH; Nancy M. Albert, PhD, MSN, RN, CCNS, CCRN, NE-BC, is the Director of Nursing Research and Innovation, Cleveland Clinic at Cleveland, Ohio. Corresponding author: Jane H. Hartman, Cleveland Clinic, 9500 Euclid Avenue, Mail code P34, Cleveland, Ohio 44195. E-mail: hartmaj2@ccf.org 1546-0843/$36.00 Copyright Ó 2009 by the Association for Radiologic & Imaging Nursing. doi: 10.1016/j.jradnu.2009.08.002 122 DECEMBER 2009 www.radiologynursing.org