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Paalimäki-Paakki K, Virtanen M, Henner A, Vähänikkilä H, Nieminen MT, Schroderus-Salo T, Kääriäinen M. Effects of a 360° virtual counselling environment on patient anxiety and CCTA process time: A randomised controlled trial. Radiography (Lond) 2023; 29 Suppl 1:S13-S23. [PMID: 36280541 DOI: 10.1016/j.radi.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION This study investigated whether a 360° virtual counselling environment (360°VCE) was more effective at decreasing patients' anxiety than routine standard of care counselling for patients undergoing coronary computed tomography angiography (CCTA), and if there was any difference in the process times for both of these groups. METHODS A total of 86 patients underwent CCTA in this randomised controlled trial. Patients were randomly assigned to intervention and control groups. The 360°VCE was developed using spherical panoramic images and non-immersive 360° technology. The primary outcome, anxiety, was measured using the State-Trait Anxiety Inventory (STAI). The secondary outcome, CCTA process time, was measured from the time of arrival in the department until end of examination. RESULTS Pre-scan anxiety was lower among patients in the 360°VCE group immediately before CCTA in comparison to patients in the control group (p = 0.015). Women demonstrated higher levels of anxiety than men in both groups. No between-group differences were discerned in CCTA process time. CONCLUSION Access to 360°VCE can reduce patients' pre-CCTA anxiety levels. IMPLICATIONS FOR PRACTICE The presented results can be used to improve patient counselling and care, reduce anxiety among patients undergoing CCTA, and optimise the CCTA examination procedure.
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Affiliation(s)
- Karoliina Paalimäki-Paakki
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Degree Programme of Radiography and Radiation Therapy, Oulu University of Applied Sciences, Oulu, Finland.
| | - Mari Virtanen
- School of Rehabilitation and Examination, Helsinki Metropolia University of Applied Sciences, Helsinki, Finland
| | - Anja Henner
- Degree Programme of Radiography and Radiation Therapy, Oulu University of Applied Sciences, Oulu, Finland
| | - Hannu Vähänikkilä
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Miika T Nieminen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Tanja Schroderus-Salo
- Degree Programme of Radiography and Radiation Therapy, Oulu University of Applied Sciences, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Oulu University Hospital, Oulu, Finland
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Whole-body magnetic resonance imaging and FDG-PET/CT for lymphoma staging: Assessment of patient experience. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2017. [DOI: 10.1016/j.ejrnm.2017.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Williams MC, Hunter A, Shah A, Assi V, Lewis S, Mangion K, Berry C, Boon NA, Clark E, Flather M, Forbes J, McLean S, Roditi G, van Beek EJ, Timmis AD, Newby DE. Symptoms and quality of life in patients with suspected angina undergoing CT coronary angiography: a randomised controlled trial. Heart 2017; 103:995-1001. [PMID: 28246175 PMCID: PMC5529983 DOI: 10.1136/heartjnl-2016-310129] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/01/2016] [Accepted: 08/15/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In patients with suspected angina pectoris, CT coronary angiography (CTCA) clarifies the diagnosis, directs appropriate investigations and therapies, and reduces clinical events. The effect on patient symptoms is currently unknown. METHODS In a prospective open-label parallel group multicentre randomised controlled trial, 4146 patients with suspected angina due to coronary heart disease were randomised 1:1 to receive standard care or standard care plus CTCA. Symptoms and quality of life were assessed over 6 months using the Seattle Angina Questionnaire and Short Form 12. RESULTS Baseline scores indicated mild physical limitation (74±0.4), moderate angina stability (44±0.4), modest angina frequency (68±0.4), excellent treatment satisfaction (92±0.2) and moderate impairment of quality of life (55±0.3). Compared with standard care alone, CTCA was associated with less marked improvements in physical limitation (difference -1.74 (95% CIs, -3.34 to -0.14), p=0.0329), angina frequency (difference -1.55 (-2.85 to -0.25), p=0.0198) and quality of life (difference -3.48 (-4.95 to -2.01), p<0.0001) at 6 months. For patients undergoing CTCA, improvements in symptoms were greatest in those diagnosed with normal coronary arteries or who had their preventative therapy discontinued, and least in those with moderate non-obstructive disease or had a new prescription of preventative therapy (p<0.001 for all). CONCLUSIONS While improving diagnosis, treatment and outcome, CTCA is associated with a small attenuation of the improvements in symptoms and quality of life due to the detection of moderate non-obstructive coronary artery disease. TRIAL REGISTRATION NUMBER NCT01149590.
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Affiliation(s)
- Michelle C Williams
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Amanda Hunter
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Anoop Shah
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Valentina Assi
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Stephanie Lewis
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Kenneth Mangion
- Institute for Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Colin Berry
- Institute for Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Nicholas A Boon
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Elizabeth Clark
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | | | | | | | - Giles Roditi
- Institute for Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Edwin Jr van Beek
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Adam D Timmis
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - David E Newby
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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Cademartiri F, Nistri S, Tarantini G, Maffei E. Management of coronary artery disease with cardiac CT beyond gatekeeping. Heart 2017; 103:975-976. [PMID: 28446549 DOI: 10.1136/heartjnl-2016-310473] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 09/09/2016] [Indexed: 12/19/2022] Open
Affiliation(s)
- Filippo Cademartiri
- Department of Radiology & Research Center, Montreal Heart Institute/Universitè de Montreal, Montreal, Quebec, Canada.,Department of Radiology, Erasmus Medical Center University, Rotterdam, The Netherlands
| | - Stefano Nistri
- Cardiology Service, CMSR- Veneto Medica, Altavilla Vicentina, Italy
| | | | - Erica Maffei
- Department of Radiology & Research Center, Montreal Heart Institute/Universitè de Montreal, Montreal, Quebec, Canada
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La Grutta L, Toia P, Maffei E, Cademartiri F, Lagalla R, Midiri M. Infarct characterization using CT. Cardiovasc Diagn Ther 2017; 7:171-188. [PMID: 28540212 DOI: 10.21037/cdt.2017.03.18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Myocardial infarction (MI) is a major cause of death and disability worldwide. The incidence is not expected to diminish, despite better prevention, diagnosis and treatment, because of the ageing population in industrialized countries and unhealthy lifestyles in developing countries. Nowadays it is highly requested an imaging tool able to evaluate MI and viability. Technology improvements determined an expansion of clinical indications from coronary plaque evaluation to functional applications (perfusion, ischemia and viability after MI) integrating additional phases and information in the mainstream examination. Cardiac computed tomography (CCT) and cardiac MR (CMR) employ different contrast media, but may characterize MI with overlapping imaging findings due to the similar kinetics and tissue distribution of gadolinium and iodinated contrast media. CCT may detect first-pass perfusion defects, dynamic perfusion after pharmacological stress, and delayed enhancement (DE) of non-viable territories.
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Affiliation(s)
| | - Patrizia Toia
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Erica Maffei
- Department of Radiology, Montreal Heart Institute/Universitè de Montreal, Montreal, Canada
| | - Filippo Cademartiri
- Department of Radiology, Montreal Heart Institute/Universitè de Montreal, Montreal, Canada.,Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Roberto Lagalla
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
| | - Massimo Midiri
- Department of Radiology, DIBIMED, University of Palermo, Palermo, Italy
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Integrated non-invasive approach to atherosclerosis with cardiac CT and carotid ultrasound in patients with suspected coronary artery disease. LA RADIOLOGIA MEDICA 2016; 122:16-21. [DOI: 10.1007/s11547-016-0692-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022]
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Relationship between anxiety level and radiological investigation. Comparison among different diagnostic imaging exams in a prospective single-center study. LA RADIOLOGIA MEDICA 2016; 121:763-8. [DOI: 10.1007/s11547-016-0664-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 06/01/2016] [Indexed: 11/27/2022]
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Collateral non cardiac findings in clinical routine CT coronary angiography: results from a multi-center registry. Radiol Med 2015; 120:1122-9. [PMID: 25981381 DOI: 10.1007/s11547-015-0551-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 04/30/2015] [Indexed: 12/21/2022]
Abstract
PURPOSE The aim of the study was to evaluate the prevalence of collateral findings detected in computed tomography coronary angiography (CTCA) in a multi-center registry. MATERIALS AND METHODS We performed a retrospective review of 4303 patients (2719 males, mean age 60.3 ± 10.2 years) undergoing 64-slice CTCA for suspected or known coronary artery disease (CAD) at various academic institutions between 01/2006 and 09/2010. Collateral findings were recorded and scored as: non-significant (no signs of relevant pathology, not necessary to be reported), significant (clear signs of pathology, mandatory to be reported), or major (remarkable pathology, mandatory to be reported and further investigated). RESULTS We detected 6886 non-cardiac findings (1.6 non cardiac finding per patient). Considering all centers, only 865/4303 (20.1 %) patients were completely without any additional finding. Overall, 2095 (30.4 %) non-significant, 4486 (65.2 %) significant, and 305 (4.4 %) major findings were detected. Among major findings, primary lung cancer was reported in 21 cases. In every center, most prevalent significant findings were mediastinal lymph nodes >1 cm. In 256 patients, collateral findings were clinically more relevant than coexisting CAD and justified the symptoms of patients. CONCLUSIONS The prevalence of significant and major collateral findings in CTCA is high. Radiologists should carefully evaluate the entire scan volume in each patient.
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McNierney-Moore A, Smith C, Guardiola J, Xu KT, Richman PB. Patient understanding of radiation risk from medical computed tomography-A comparison of Hispanic vs. non-Hispanic emergency department populations. PeerJ 2015; 3:e937. [PMID: 26019999 PMCID: PMC4435503 DOI: 10.7717/peerj.937] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/16/2015] [Indexed: 01/28/2023] Open
Abstract
Background. Cultural differences and language barriers may adversely impact patients with respect to understanding the risks/benefits of medical testing. Objective. We hypothesized that there would be no difference in Hispanic vs. non-Hispanic patients’ knowledge of radiation risk that results from CT of the abdomen/pelvis (CTAP). Methods. We enrolled a convenience sample of adults at an inner-city emergency department (ED). Patients provided written answers to rate agreement on a 10-point scale for two correct statements comparing radiation exposure equality between: CTAP and 5 years of background radiation (question 1); CTAP and 200 chest x-rays (question 3). Patients also rated their agreement that multiple CT scans increase the lifetime cancer risk (question 2). Scores of >8 were considered good knowledge. Multivariate logistic regression analyses were performed to estimate the independent effect of the Hispanic variable. Results. 600 patients in the study group; 63% Hispanic, mean age 39.2 ± 13.9 years. Hispanics and non-Hispanics whites were similar with respect to good knowledge-level answers to question 1 (17.3 vs. 15.1%; OR = 1.2; 95% CI [0.74–2.0]), question 2 (31.2 vs. 39.3%; OR = 0.76; 95% CI [0.54–1.1]), and question 3 (15.2 vs. 16.5%; OR = 1.1; 95% CI [0.66–1.8]). Compared to patients who earned <20,000, patients with income >40,000 were more likely to answer question 2 with good knowledge (OR = 1.96; 95% CI [1.2–3.1]). Conclusion. The study group’s overall knowledge of radiation risk was poor, but we did not find significant differences between Hispanic vs. non-Hispanic patients.
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Affiliation(s)
- Afton McNierney-Moore
- Department of Emergency Medicine, Christus Spohn/Texas A&M School of Medicine , Corpus Christi, TX , USA
| | - Cynthia Smith
- Department of Emergency Medicine, Christus Spohn/Texas A&M School of Medicine , Corpus Christi, TX , USA
| | - Jose Guardiola
- Texas A&M University/Corpus Christi , Corpus Christi, TX , USA
| | - K Tom Xu
- Department of Surgery, Texas Tech University Health Sciences Center , Lubbock, TX , USA
| | - Peter B Richman
- Department of Emergency Medicine, Christus Spohn/Texas A&M School of Medicine , Corpus Christi, TX , USA
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