Reducing State Anxiety in Older Adults Undergoing MRI: A Controlled Trial of a Multimedia Electronic Book Intervention

Objectives Magnetic resonance imaging (MRI) frequently induces state anxiety in older adults, impairing cooperation and image quality. This study developed and evaluated a multimedia electronic book (e-book) to reduce this anxiety.Methods In a non-randomized controlled pretest–multiple-posttest design, 87 older adults aged 60–80 years (M = 68.87, SD = 6.26) at a regional Thai hospital were allocated equally (n = 29) to an ADDIE-based multimedia e-book, pamphlets, or standard verbal instruction. State anxiety (STAI Form Y-I), blood pressure, respiratory rate, and heart rate were measured before and after the intervention and after MRI, and analyzed using paired-sample t-tests and one-way ANOVA with Scheffé’s post hoc test.Results State anxiety decreased in the e-book and pamphlet groups (p < .001) but increased in the control group (p = .013). After the intervention, the e-book group had lower anxiety than both comparators (p < .001); after MRI, it remained lower than the pamphlet group (p = .025). Physiological differences were largely non-significant.Conclusions The multimedia e-book reduced MRI-related state anxiety in older adults more than pamphlets or standard verbal instruction.Clinical implications This low-cost, easily disseminated tool merits integration into anxiety-management protocols for older patients undergoing MRI.