Claustrophobia is a psychological disease, a type of terror neurosis, and a fear of closed space. Claustrophobia refers to severe autonomic nervous symptoms such as abnormal fear, shortness of breath, rapid heartbeat, sweating, a near-death feeling, and even syncope caused by patients entering narrow and dark spaces (1–3). Among various types of phobias, claustrophobia is more common than other phobias. This type of phobia is an unreasonable fear that occurs in enclosed spaces such as elevators, tunnels, and computed tomography and magnetic resonance imaging (MRI) equipment (3). According to a report (4), approximately 12.5% of the population has this fear, and most of them are women. It is estimated to occur in 2.1 to 14.3% of all MRI examinations (4–7). In the consensus of experts on magnetic resonance examination technology, claustrophobia is listed as a relative contraindication (8). A previous study (9) pointed out the specific diagnostic criteria of claustrophobia patients: fear of the imbalance between emotion and situation; cannot be eliminated by explanation; uncontrollable; and an avoidance response occurs when patients are in a fearful environment.

With the popularization and promotion of MRI examinations in recent years, the number of patients undergoing the examination is gradually increasing. Claustrophobia caused by MRI examinations has attracted increasing attention (10). Since 2015, the Joint Committee has also put forward new diagnostic imaging requirements for MRI safety, including claustrophobia (5). At present, the solutions for MRI examinations for claustrophobic patients at home and abroad are as follows: Sedation is used in MRI examinations, but this method has certain risks (11), and some foreign scholars have pointed out that reducing noise and increasing space in the scanner can hopefully reduce the incidence of claustrophobia (12). However, the new scanner is expensive, and most existing magnets cannot reduce noise and improve space. Desensitization technology was supplied for treating other virtual reality phobias in MRI patients (11). MRI is a costly imaging method. Optimized contact can improve nursing quality, patient satisfaction, and the magnetic resonance utilization rate (13). Psychological intervention may become a coping strategy for claustrophobia (14).

In recent years, mindfulness, as a psychological intervention method, has been increasingly applied to treat patients with mental disorders and physical diseases. Mindfulness refers to a specific, non-judgmental focus on the present situation. Mindfulness-based stress reduction was proposed by Jon Kabat-Zinn in 1979, and its main theoretical basis comes from the combination of Buddhism and modern psychology (15). It includes mindfulness breathing, mindfulness meditation, mindfulness movement, and body scanning. Through mindfulness-based stress reduction, patients can improve their mindfulness level, relieve anxiety, depression, and other negative emotions, and eventually improve their quality of life (16, 17). Many studies have shown that mindfulness decompression is an effective means to treat and reduce fear and anxiety (18–22). However, there is a rare report on the application of mindfulness-based stress reduction therapy in the magnetic resonance examinations of patients with claustrophobia to date. Therefore, to explore the effectiveness of mindfulness decompression therapy in the magnetic resonance examinations of patients with claustrophobia, researchers tried to use the therapy to provide psychological intervention to claustrophobic patients in MRI examinations.

There were 44 participants, comprising 21 men and 23 women. Their ages ranged from 22 to 65 years, with a mean age of 44.09 ± 11.5 years. In the control group, there were 42 participants, of whom 20 were men and 22 were women. The age range for this group was 19 to 68 years, with an average age of 46.40 ± 13.1 years.

After the mindfulness breathing intervention, the SAS score of the observation group decreased from a mild anxiety state (average 53) to a no-anxiety state (average 44), while the anxiety of the general psychological intervention group did not improve significantly and was still in a mild anxiety state (before 52/after 51). There was no significant difference in the anxiety state between the two groups before the intervention (p = 0.376), and there was a significant difference between the two groups after the intervention (p = 0.000032) (Figure 1).

The scores of the simplified POMS-R scale of the two groups showed that the total score of emotional disorder (TMD) and the score of negative emotion of the patients in the observation group decreased with the practice of mindfulness breathing, while the positive emotion increased due to the practice, and the difference was statistically significant (p = 3.5305e⁻⁸) (Figure 2).

After the mindfulness breathing intervention, the completion rate of magnetic resonance examination in the patients with claustrophobia in the observation group was 90.90%, which was statistically higher than 26.19% of the general psychological intervention (χ² = 6.857, p = 0.0004) (Figure 3).

The satisfaction of the patients in the observation group with nurses’ psychological intervention technology was 97.72%, which was higher than 77.29% in the control group. The difference was statistically significant (p = 0.0028) (Figure 4).

The patients in the observation group had less severe autonomic nervous symptoms than those in the control group during the examination (p < 0.05) (Figure 5).

Our study elucidated the potential benefits of mindfulness respiratory decompression therapy for claustrophobic patients undergoing MRI examinations. Within our cohort of 86 patients requiring MRI between January 2018 and December 2020, those who received mindfulness breathing techniques in addition to routine psychological care demonstrated a markedly enhanced intervention effect with a total effectiveness rate of 90.90%. This was considerably higher than the rate of the control group, which was 26.19%. Furthermore, severe autonomic nervous symptoms were significantly reduced in the observation group compared with the control group. Post-intervention assessments also revealed noteworthy reductions in both SAS and POMS-R scores in the observation group, underscoring the potential efficacy of the mindfulness-based approach. In essence, our findings suggest that mindfulness respiratory decompression therapy offers a promising avenue for enhancing the MRI experience of claustrophobic patients.

With the transformation of modern medical models into biological, psychological, and social medical models, increasing attention has been given to the influence of psychological factors on diseases (25). Mindfulness-based decompression therapy is an effective psychotherapy method that is safe, simple, and low in cost. It is neither subjected to technical limitations such as instruments nor restricted by the venue. Nurses have subjective operability (26).

In this study, mindfulness respiratory decompression therapy was used in the magnetic resonance examinations of claustrophobic patients. The results showed that the SAS scores of the patients in the observation group after the intervention by mindfulness respiratory decompression therapy were significantly lower than those in the control group. The anxiety of the patients in the observation group was reduced from mild anxiety to no anxiety, while the anxiety of the patients in the control group was still slight before and after the intervention. There was no obvious change. It is suggested that mindfulness respiratory decompression therapy can improve the anxiety of claustrophobic patients. This is similar to the research results by Reich et al. (27). Mindfulness decompression therapy can effectively improve pressure, anxiety, and depression in patients.

In addition to the assessment of anxiety, we also compared the various emotions of patients by evaluating the POMS-R. In this study, patients with claustrophobia were evaluated by POMS-R before and after the intervention. The results showed that there was no significant difference in the POMS-R scores between the two groups before the intervention, but the TMD value, tension, anger, fatigue, depression, panic, and other negative emotions in the observation group were significantly lower than those in the control group after the intervention. Meanwhile, positive emotions such as self-esteem and energy were significantly higher than those in the control group, and the difference was statistically significant. The TMD values of three claustrophobic patients before the intervention were 136.75, 128.59, and 130.78, respectively, and decreased to 88.63, 82.47, and 78.63, respectively, after the intervention. The TMD values of other patients decreased to different degrees. It is suggested that practicing mindfulness breathing and improving mindfulness levels can obviously improve the emotional state of claustrophobic patients, reduce negative emotions, and increase positive emotions.

The results showed that the completion rate of MRI examinations in the patients with claustrophobia in the observation group was 90.90% after the intervention, which was higher than that in the control group (26.19%). Patients’ satisfaction with nurses’ psychological intervention technique in the observation group was 97.72%, which was higher than that in the control group (77.29%). There were fewer patients with severe autonomic nervous symptoms in the observation group than in the control group. Mindfulness respiratory decompression therapy can reduce sympathetic nerve activity in claustrophobic patients, which is beneficial to the smooth completion of MRI examinations. Nurses pay attention to patients’ psychology accurately, which increases patients’ satisfaction. How does mindfulness respiratory decompression therapy accomplish this? Mindfulness emphasizes continuous attention and uncritical acceptance of internal and external stimuli in the moment. In this process, the individual’s perceptual sensitivity, attention, memory ability, emotional state, and emotional adjustment ability change significantly (20). The study confirmed that short-term mindfulness exercises can cause changes in brain information processing patterns (21). Regarding the influence mechanism of mindfulness, mindfulness mainly affects the lateral frontal lobe and basal ganglia. Some studies have found that mindfulness is related to the nerve remodeling of cortical-marginal circuits responsible for stress response and emotion regulation, and the decrease in gray matter volume in the hippocampus and caudate nucleus is related to idiosyncratic mindfulness. The stress-induced enhancement of the amygdala-anterior cingulate function can be reversed by mindfulness meditation practice. At the same time, for the implementation of mindfulness respiratory decompression therapy, we only need to prepare a relatively independent space to guide the patients to practice or watch the practice video and then let the patients practice by themselves. This method consumes a little time of staff and is easy for patients to accept, practice, master, and achieve good results.

This study had limitations. First, this was a single-center study, and the number of cases was relatively small. The indications, the adaptation population, and the maintenance time of the intervention through mindfulness respiratory decompression therapy need to be further studied. Considering the different stressors and stress levels faced by patients in different departments, research can be carried out for patients in different departments in future.

In conclusion, mindfulness respiratory decompression therapy is an economical, safe, effective, and comprehensive decompression method that plays the best role in nursing departments with medical imaging. It can improve patients’ satisfaction with nursing services, effectively help claustrophobic patients complete magnetic resonance examinations, improve patients’ satisfaction with nurses’ psychological intervention techniques, reduce the occurrence of severe autonomic nervous symptoms, reduce anxiety, and stabilize the mood state. At the same time, it can also provide timely and effective imaging diagnosis data for clinicians. Therefore, it is of great significance to both clinicians and the treatment of patients. After the intervention of mindfulness breathing technology, the number of patients with claustrophobia with severe autonomic nervous symptoms decreased significantly during magnetic resonance imaging.

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding authors.

This study was approved by the Ethics Committee of Liuzhou People’s Hospital.

YZ: Data curation, Formal analysis, Writing – review & editing. YC: Data curation, Writing – review & editing. SX: Data curation, Writing – review & editing. SL: Data curation, Writing – review & editing. YL: Data curation, Writing – review & editing. WZ: Formal analysis, Writing – original draft, Writing – review & editing. YX: Conceptualization, Writing – review & editing.