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Drozdova A, Polokova K, Jiravsky O, Jiravska Godula B, Chovancik J, Ranic I, Jiravsky F, Hecko J, Sknouril L. Comparing Conventional Physician-Led Education with VR Education for Pacemaker Implantation: A Randomized Study. Healthcare (Basel) 2024; 12:976. [PMID: 38786387 PMCID: PMC11121498 DOI: 10.3390/healthcare12100976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/26/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Education of patients prior to an invasive procedure is pivotal for good cooperation and knowledge retention. Virtual reality (VR) is a fast-developing technology that helps educate both medical professionals and patients. OBJECTIVE To prove non-inferiority of VR education compared to conventional education in patients prior to the implantation of a permanent pacemaker (PPM). METHODS 150 participants scheduled for an elective implantation of a PPM were enrolled in this prospective study and randomized into two groups: the VR group (n = 75) watched a 360° video about the procedure using the VR headset Oculus Meta Quest 2, while the conventional group (n = 75) was educated by a physician. Both groups filled out a questionnaire to assess the quality of education pre- and in-hospital, their knowledge of the procedure, and their subjective satisfaction. RESULTS There was no significant difference in the quality of education. There was a non-significant trend towards higher educational scores in the VR group. The subgroup with worse scores was older than the groups with higher scores (82 vs. 76 years, p = 0.025). Anxiety was reduced in 92% of participants. CONCLUSION VR proved to be non-inferior to conventional education. It helped to reduce anxiety and showed no adverse effects.
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Affiliation(s)
- Adela Drozdova
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
| | - Karin Polokova
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
| | - Otakar Jiravsky
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
- Faculty of Medicine, Masaryk University, 601 77 Brno, Czech Republic
| | - Bogna Jiravska Godula
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
- Faculty of Medicine, Palacky University, 779 00 Olomouc, Czech Republic
| | - Jan Chovancik
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
| | - Ivan Ranic
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
- Faculty of Medicine, University of Ostrava, 701 03 Ostrava, Czech Republic
| | - Filip Jiravsky
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
- Philosophical Faculty, Masaryk University, 601 77 Brno, Czech Republic
| | - Jan Hecko
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
- Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, 708 00 Ostrava, Czech Republic
| | - Libor Sknouril
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
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Bashir ZS, Misquith C, Has P, Bukhari SM. The Effectiveness of Virtual Reality on Anxiety and Pain Management in Patients Undergoing Cardiac Procedures: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e57557. [PMID: 38707015 PMCID: PMC11068510 DOI: 10.7759/cureus.57557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
Cardiac procedure-related anxiety and pain can adversely affect outcomes and lead to patient dissatisfaction. Virtual reality (VR) offers a promising alternative to traditional therapies for improving patient experience. Our objective is to synthesize evidence and assess the effectiveness of VR in reducing cardiac procedure-related anxiety and pain compared to standard of care. We conducted a comprehensive search across various online databases, including MEDLINE, EMBASE, CINAHL, Web of Sciences, and COCHRANE, to identify relevant randomized controlled trials (RCTs) focusing on VR, cardiac procedures, anxiety, and pain. We utilized a random-effect model to generate effect estimates reported as standardized mean differences (SMD) with a 95% confidence interval. Our review comprised 10 studies with a total of 621 participants (intervention arm: 301, control arm: 320). Overall, among the seven studies evaluating anxiety outcomes, no significant difference in anxiety reduction was observed between the intervention and control groups (standardized mean difference (SMD) -0.62, 95% CI -1.61, 0.37, p=0.22). However, studies using the same anxiety assessment tool demonstrated a significant improvement in the VR arm (SMD -1.01, 95% CI -1.98, -0.04, p=0.04). Conversely, the narrative synthesis of four studies examining pain revealed mixed results. Our findings suggest no significant difference in anxiety reduction between the VR and control groups. Future studies should employ standardized tools for assessing and reporting anxiety and pain to better understand the potential of VR in enhancing patient experience during cardiac procedures.
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Affiliation(s)
- Zubair S Bashir
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, USA
| | | | - Phinnara Has
- Lifespan Biostatistics, Epidemiology and Research Design, Rhode Island Hospital, Brown University, Providence, USA
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Ge X, Wu H, Zang Z, Xie J. Application of checklist-based nursing care process in patients undergoing intervention for coronary chronic total occlusions: a quasi-randomized study. BMC Cardiovasc Disord 2023; 23:591. [PMID: 38036972 PMCID: PMC10688462 DOI: 10.1186/s12872-023-03627-8] [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: 10/08/2022] [Accepted: 11/21/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Coronary chronic total occlusion (CTO) interventions are more complex than general percutaneous coronary intervention (PCI) procedures. However, only a few nursing methods are specifically applied to patients undergoing CTO interventions. And the conventional nursing effect is not ideal, urgent need to explore more effective nursing methods. The checklist is a simple and effective tool for error management and performance improvement that has been widely used in many fields. But there have been no reports of the checklist being used to improve care for CTO patients. OBJECTIVE This study aimed to investigate the effectiveness of a checklist-based nursing care process in patients undergoing Coronary chronic total occlusion (CTO) interventions, including duration of care, patient anxiety, improved patient satisfaction, and occurrence of adverse events. METHODS A total of 120 CTO patients undergoing percutaneous coronary intervention (PCI) were selected at our hospital and divided into an intervention group (n = 60, adopted the checklist-based nursing care process for patient care) and a control group (n = 60, adopted nursing care according to the existing workflow) according to different nursing interventions. After surgery, the nurse in charge of the patient completed the nursing according to the "List of postoperative care for CTO patients" filled in by the patient within 24 h after surgery, conducted a doctor satisfaction survey, recorded adverse events, and completed the postoperative Self-Rating Anxiety Scale (SAS) score and patient satisfaction survey before the patient was discharged. Subsequently, the Qc team checks the completion of the patient's checklist for safety and the completion of the questionnaire. Finally, the differences between the two groups in preoperative nursing time, incidence of adverse events caused by nurses' omission or inadequate guidance, patient anxiety, and doctor and patient satisfaction were compared. RESULTS The intervention grouphad significantly shorter preoperative nursing care time and significantly lower the total number of adverse events than the control group (P < 0.05).The postoperative Self-Rating Anxiety Scale (SAS) score of the intervention group was significantly lower than that of the control group (P < 0.05).The satisfaction of doctors and patients in the intervention groupwas significantly higher than that in the control group (P < 0.05). CONCLUSION The application of the checklist-based nursing care process in patients with CTO intervention can significantly reduce the preoperative nursing care time, reduce patient anxiety, improve patients' and doctors' satisfaction with nursing care, and effectively reduce the occurrence of adverse events caused by nurses' omissions or inadequate instructions. TRIAL REGISTRATION The protocol of the trial was registered retrospectively of Chinese Clinical Trial Registry (registration number ChiCTR2200056804, reg date17/02/2022).
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Affiliation(s)
- Xia Ge
- Cardiovascular ward, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China
| | - Haiyang Wu
- Cardiovascular ward, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China
| | - Zhe Zang
- Cardiovascular ward, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China
| | - Jiayi Xie
- Cardiovascular ward, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China.
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Bashir Z, Misquith C, Has P, Bukhari S. Effectiveness of virtual reality on anxiety and pain management in patients undergoing cardiac procedures: a protocol for systematic review and meta-analysis. Open Heart 2023; 10:e002305. [PMID: 37399363 DOI: 10.1136/openhrt-2023-002305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/16/2023] [Indexed: 07/05/2023] Open
Abstract
INTRODUCTION Anxiety and pain associated with cardiac procedures can lead to worse outcomes and poor satisfaction. Virtual reality (VR) can offer an innovative approach to a more informative experience that may enhance procedural understanding and reduce anxiety. It may also provide a more enjoyable experience by controlling procedure-related pain and improving satisfaction. Previous studies have shown benefits of VR-related therapies in improving anxiety related to cardiac rehabilitation and different surgical procedures. We aim to evaluate the effectiveness of VR technology in comparison to the standard of care in reducing anxiety and pain related to cardiac procedures. METHODS AND ANALYSIS This systematic review and meta-analysis protocol is structured according to the Preferred Reporting for Systematic Review and Meta-analysis-Protocol (PRISMA-P) guidelines. A comprehensive search strategy will be used to search the online databases for randomised controlled trials (RCTs) on VR, cardiac procedures, anxiety, and pain. Risk of bias will be analysed using revised Cochrane risk of bias tool for RCTs. Effect estimates will be reported as standardised mean differences with a 95% CI. Random effect model will be used to generate effect estimates if heterogeneity is significant (I2>60%), otherwise fixed effect model will be used. A p value of <0.05 will be taken as statistically significant. Publication bias will be reported using Egger's regression test. Statistical analysis will be performed using Stata SE V.17.0 and RevMan5. ETHICS AND DISSEMINATION There will be no direct involvement of the patient or the public in the conception, design, data collection, and analysis of this systematic review and meta-analysis. Results of this systematic review and meta-analysis will be disseminated via journal articles. PROSPERO REGISTRATION NUMBER CRD 42023395395.
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Affiliation(s)
- Zubair Bashir
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Chelsea Misquith
- Public Health and Research Support Library, Brown University, Providence, Rhode Island, USA
| | - Phinnara Has
- Lifespan Biostatistics, Epidemiology and Research Design, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Syed Bukhari
- Department of Medicine, Temple University, Philadelphia, Pennsylvania, USA
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Curtis E, Fernandez R, Khoo J, Weaver J, Lee A, Halcomb L. Clinical predictors and management for radial artery spasm: an Australian cross-sectional study. BMC Cardiovasc Disord 2023; 23:33. [PMID: 36653743 PMCID: PMC9847059 DOI: 10.1186/s12872-023-03042-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/05/2023] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The transradial approach for coronary artery catheterisation has increased in popularity compared to the transfemoral approach for patients undergoing percutaneous coronary interventions. However, radial artery spasm continues to be a major complication of the procedure. Current management strategies vary concerning radial artery spasm and there is limited evidence of practice in the Australian context. AIM To identify the predictors of radial artery spasm and the medications used for its prevention and management. METHODS A descriptive cross-sectional study was carried out over a three-month period in two tertiary hospitals in NSW, Australia. A self-administered pre-procedural survey was completed by patients undergoing coronary artery catheterisation. This survey collected socio-demographic data and assessed anxiety using the Spielberger State-Trait Anxiety Inventory. Procedural data, including length of procedure, equipment used, occurrence of radial artery spasm, and medications given, were collected post-procedure by the interventionalist. RESULTS Of the 169 participants, over half were male (59.8%) and aged 66 years or older (56.8%). Radial artery spasm was reported in 24 (14.2%) participants. Rates of spasm were significantly higher among females (66.6%, p = 0.004), those aged under 65 years (62.5%, p = 0.001) and those who reported a medical history of anxiety (33.3%, p = 0.0004). There were no significant differences in State and Trait anxiety scores among those who had RAS and those who did not. Logistic regression identified younger age as the only statistically significant predictor of RAS (OR 0.536; 95% CI 0.171-1.684; p = 0.005). To prevent radial artery spasm most patients received midazolam (n = 158; 93.5%), nitrates (n = 133; 78.7%) and/or fentanyl (n = 124; 73.4%) prophylactically. Nitrates were the most frequently administered medication to treat radial artery spasm (78.7%). CONCLUSION This study highlights that there is a need to develop a clearer understanding of the predictors of RAS, as identifying patients at risk can ensure prophylactic measures are implemented. This study identified nitrates as the preferred vasodilator as a preventative measure along with the use of sedation.
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Affiliation(s)
- Elizabeth Curtis
- Faculty of Science, Medicine and Health, University of Wollongong, Building 41 Office 220, Northfields Ave, Keiraville, NSW, 2500, Australia.
| | - Ritin Fernandez
- grid.1007.60000 0004 0486 528XFaculty of Science, Medicine and Health, University of Wollongong, Building 41 Office 220, Northfields Ave, Keiraville, NSW 2500 Australia ,grid.416398.10000 0004 0417 5393Centre for Research in Nursing and Health, St George Hospital, 28 Gray Street, Kogarah, NSW 2217 Australia
| | - John Khoo
- grid.416398.10000 0004 0417 5393Cardiology Department, St George Hospital, Grey Street, Kogarah, NSW 2217 Australia
| | - James Weaver
- grid.416398.10000 0004 0417 5393Cardiology Department, St George Hospital, Grey Street, Kogarah, NSW 2217 Australia
| | - Astin Lee
- grid.1007.60000 0004 0486 528XFaculty of Science, Medicine and Health, University of Wollongong, Building 41 Office 220, Northfields Ave, Keiraville, NSW 2500 Australia ,grid.417154.20000 0000 9781 7439Cardiology Department, The Wollongong Hospital, Crown Street, Wollongong, NSW 2500 Australia
| | - Liz Halcomb
- grid.1007.60000 0004 0486 528XFaculty of Science, Medicine and Health, University of Wollongong, Building 41 Office 220, Northfields Ave, Keiraville, NSW 2500 Australia
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Yang XL, Xie WY, Cai YM, Tang HY, Tao MY, Shen ZM, Chen HJ. Investigation of the Negative Emotions Exhibited in Patients with Coronary Heart Disease After PCI and Any Influencing Factors. Psychol Res Behav Manag 2022; 15:3027-3037. [PMID: 36281272 PMCID: PMC9587531 DOI: 10.2147/prbm.s379422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose To understand existing negative emotions in patients with coronary heart disease after percutaneous coronary stent implantation (PCI) and analyse its influencing factors. Methods Patients with coronary heart disease after PCI in three tertiary hospitals in Changsha City from April to September 2018 were selected as the research subjects. The self-designed general information questionnaire assessed irritability, depression and anxiety (IDA) on a self-rating scale. It was used to examine patients’ existing negative emotions with coronary heart disease after PCI and analyse the influencing factors. Results 203 questionnaires were distributed, and 202 valid questionnaires were recovered, with an effective recovery rate of 99.5%. The IDA score of patients with coronary heart disease after PCI was 17.01±7.60 points, the incidence of negative emotions was 63.8%, and the incidences of depression, anxiety and irritability were 39.6%, 8.4% and 15.8%, respectively. Negative emotion was taken as the dependent variable and a patient’s general data, such as lifestyle and disease, as the independent variables. A univariate analysis was conducted to obtain gender, age, educational level, marital status, work status, per capita monthly household income, sleep status, etc. Seven factors were identified as the influencing factors of negative emotions in patients with coronary heart disease after PCI, and the difference was statistically significant (P<0.05). Conclusion Most patients with coronary heart disease after PCI tend to exhibit negative emotions such as anxiety and depression. Medical staff should attach great importance to evaluating any negative feelings in this group and take timely targeted intervention measures to prevent and mitigate the occurrence and development of these adverse emotions in patients with coronary heart disease after PCI.
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Affiliation(s)
- Xiao-Li Yang
- Department of Liver Surgery, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, 410005, People’s Republic of China
| | - Wen-Yao Xie
- Interventional Operating Room, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, 410005, People’s Republic of China
| | - Yi-Min Cai
- Department of Nursing, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, 410005, People’s Republic of China,Correspondence: Yi-Min Cai, Nursing department, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), No. 61, Jiefang West Road, Changsha, 410005, People’s Republic of China, Tel +86 13787129085, Fax +0731-83928047, Email
| | - Hong-Ying Tang
- Department of Liver Surgery, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, 410005, People’s Republic of China
| | - Mei-Yi Tao
- Department of Nursing, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, 410005, People’s Republic of China
| | - Zhou-Min Shen
- Department of Nursing, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, 410005, People’s Republic of China
| | - Hong-Jiao Chen
- Medical College of Hunan Normal University, Changsha, 410013, People’s Republic of China
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Palandacic AK, Radez J, Ucman S, Lainscak M, Sarotar BN. Evaluating anxiety in elective coronary angiography study: rationale, design, and study methodology. J Cardiovasc Med (Hagerstown) 2022; 23:678-684. [PMID: 36099075 DOI: 10.2459/jcm.0000000000001355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIMS Prevalence of anxiety disorder in coronary artery disease reaches up to 15% and about half of patients with coronary artery disease have anxiety or depression comorbidity. Prevalence of anxiety in patients undergoing percutaneous coronary intervention ranges 24-72%. Depression can often overlap with anxiety symptoms and the evaluation of anxiety in elective coronary angiography study (ANGST) aims to determine the prevalence of anxiety by excluding patients with comorbid depressive symptoms. ANGST also aims to determine how anxiety correlates with psychological parameters (personality traits, coping strategies) and with outcome of elective coronary angiography (ECA). METHODS We will conduct a prospective single-center cross-section study in patients undergoing ECA. Anxiety will be evaluated at four time points using self-rating questionnaires: 14 days prior to ECA; 2-4 h before ECA; 24 h after ECA, but prior to discharge; and 4-6 weeks after discharge. The primary outcome of ANGST is the burden of anxiety experienced by patients without depressive symptoms and a correlation of anxiety with ECA outcome. CONCLUSION Our study aims to provide evidence on which personality traits and coping strategies affect the levels of anxiety. We will also determine psychometric properties of the two questionnaires used in our study. The results will have implications for improvement of interventions designed to recognize anxiety and will offer future research of psychological and/or pharmacological interventions to reduce the burden of anxiety.
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Affiliation(s)
| | | | - Sasa Ucman
- University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia
| | - Mitja Lainscak
- General Hospital Murska Sobota, Murska Sobota, Slovenia.,Faculty of Medicine, University of Ljubljana, Slovenia
| | - Brigita Novak Sarotar
- University Psychiatric Clinic Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Slovenia
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Shi Y, Zhu C, Jiang R, Zhang M, Cai H, Hu Z, Sun H, Liu Y, Ye Y, Ma Y, Cao X, von Känel R, Li J. Job burnout is associated with slow improvement of quality of life in the employees after a first episode of acute coronary syndrome: A hospital-based longitudinal study in China. J Psychosom Res 2021; 152:110690. [PMID: 34896702 DOI: 10.1016/j.jpsychores.2021.110690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 11/23/2021] [Accepted: 11/27/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study investigated the association between job burnout and quality of life (QoL) after acute coronary syndrome (ACS) in a Chinese sample. METHODS This was a one-year longitudinal study. Participants included patients with a first episode of ACS who were still employed. The Copenhagen Burnout Inventory (CBI) assessed job burnout before discharge, and QoL was assessed using the Medical Outcome Study 8-Items Short Form Health Survey (SF-8) and the Seattle Angina Questionnaire (SAQ) before discharge (baseline), at one month, six months and 12 months after discharge. Generalized estimating equations determined the association between job burnout and longitudinal changes of QoL. RESULTS All participants were assigned to either a "low job burnout" group (n = 70) or a "high job burnout" group (n = 50), based on the upper quartile of job burnout scores. Longitudinally over 1-year follow-up period, the scores of the SF-8 and SAQ among patients with a high level of burnout were lower than those in the low job burnout group. Job burnout was significantly associated with lower physical and mental health (SF-8), as well as greater physical limitation and lower treatment satisfaction (SAQ) over time. CONCLUSION Job burnout at baseline predicted slow improvement of QoL after ACS in a Chinese working sample.
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Affiliation(s)
- Yunke Shi
- Cardiology Department, The 1st Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China.
| | - Caifeng Zhu
- Cardiology Department, The People's Hospital of Chuxiong Yi Autonomous Prefecture, Chuxiong, Yunnan 675000, China
| | - Ruxin Jiang
- Cardiology Department, Baoshan People's Hospital, Baoshan, Yunnan 678000, China
| | - Min Zhang
- Cardiology Department, The 1st Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China.
| | - Hongyan Cai
- Cardiology Department, The 1st Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China.
| | - Zhao Hu
- Cardiology Department, The 1st Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China.
| | - Huang Sun
- Cardiology Department, The 1st Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China.
| | - Yixi Liu
- Cardiology Department, The 1st Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China.
| | - Yujia Ye
- Cardiology Department, The 1st Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China.
| | - Yiming Ma
- Cardiology Department, The 1st Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China.
| | - Xingyu Cao
- Cardiology Department, The 1st Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China.
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles 90095, CA, USA.
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Choi H, Kim J. Effects of multimedia-based information on anxiety, discomfort and satisfaction with care among patients undergoing cerebral angiography: A quasi-experimental study. J Clin Nurs 2021; 31:949-957. [PMID: 34231279 DOI: 10.1111/jocn.15949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/25/2021] [Accepted: 06/04/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES This study investigated the effects of multimedia-based information on anxiety, discomfort and satisfaction with care among patients undergoing cerebral angiography. BACKGROUND Cerebral angiography is the gold standard for diagnosing cerebrovascular conditions; however, patients might experience related anxiety and discomfort. For such patients, reductions in anxiety related to informational interventions have been inconsistent, and the effects on patient discomfort and satisfaction with nurses were not confirmed. DESIGN This quasi-experimental study with a non-equivalent, control group, non-synchronised design was conducted using the TREND checklist. METHODS Fifty-five patients who underwent cerebral angiography at a neurosurgery ward were enrolled in this study. Twenty-seven patients in the experimental group were provided multimedia-based information on cerebral angiography, including actual on-site photographs and videos, an explanation of the benefits of cerebral angiography and introduction to medical staff. Twenty-eight in the control group were provided a printed explanation. The collected data were analysed using the χ²-test, Fisher's exact test, independent t test, paired t test or ANCOVA. RESULTS In the experimental group, anxiety was significantly decreased post-intervention, and there was a significant difference in state anxiety between the experimental and control groups. Discomfort and satisfaction with care also showed significant differences between these two groups. CONCLUSION This study confirmed that multimedia-based information decreases patient anxiety and discomfort while increasing satisfaction with care among those undergoing cerebral angiography compared with a printed explanation only. RELEVANCE TO CLINICAL PRACTICE The anxiety and discomfort of patients undergoing cerebral angiography should be considered a major nursing problem. This study evaluated the effects of multimedia-based information on anxiety, discomfort and satisfaction with care among patients undergoing cerebral angiography and showed it to be an effective nursing intervention.
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Affiliation(s)
- Hyunjung Choi
- Department of Nursing, Dongeui University, Busan, Republic of Korea
| | - Jiyoung Kim
- Department of Nursing, Sangmyung University, Cheonan-si, Republic of Korea
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Preprocedural Anxiety in the Transradial Cardiac Catheterization Era. J Cardiovasc Nurs 2021; 36:E20-E28. [PMID: 33938537 DOI: 10.1097/jcn.0000000000000812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Transradial cardiac catheterization is increasingly being used for the management of coronary artery disease given the low risk of procedural discomfort and complications with this approach. However, the evidence relating to preprocedural anxiety levels in these patients is scarce. OBJECTIVE The aim of this study was to evaluate the anxiety levels and the predictors of anxiety in patients undergoing transradial cardiac catheterization procedures. METHODS Data were collected using a self-administered survey. Anxiety was measured using the Spielberg's State-Trait Anxiety Inventory questionnaire. Multiple regression analysis was used to identify whether gender, age, family history of heart disease, smoking status, history of depression, and trait anxiety scores were predictors of preprocedural anxiety. RESULTS A total of 198 patients participated in this study. More than half of the patients (53.5%) were classified as having a high state anxiety level. The mean (SD) preprocedural trait and state anxiety scores were 35.34 (9.8) and 36.43 (11.4), respectively. Female patients, those younger than 65 years, current smokers, and those with a family history of heart disease, a history of depression, and a history of anxiety had significantly higher anxiety scores. Having high trait anxiety scores was the only predictor of preprocedural anxiety. CONCLUSION Although the transradial approach has a low procedural risk and causes less discomfort to the patient, anxiety persists in more than 50% of patients, with trait anxiety being the best predictor. Nurses should therefore try to decrease anxiety levels in the preprocedural phase to minimize postprocedural adverse outcomes in this group of patients.
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Bruyninx G, Grenier J, Greenman PS, Tassé V, Abdulnour J, Chomienne MH. Prevalence of Symptoms of Anxiety Disorders and Depression in Cardiac Rehabilitation Patients in an Academic Hospital: a Case Study. Psychiatr Q 2021; 92:273-287. [PMID: 32621076 DOI: 10.1007/s11126-020-09791-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The relationship between body and mind is increasingly recognized in the occurrence and prognosis of cardiac disease. Based on reports detailing the potential (and the influence of certain risk factors) of developing depression and anxiety following cardiovascular disease, or a cardiac event, most notably acute coronary syndrome (ACS), we investigated whether such symptoms also existed in patient cases found at the cardiac rehabilitation unit of an academic hospital of Eastern Ontario. We examined data from charts during a 6-year period (2012-2017). The Hospital Anxiety and Depression Scale cumulated data within a retrospective cross-sectional study, was used to estimate the prevalence of anxious and depressive symptoms that might reflect the presence of psychological distress. Overall, our sample included 1178 patient files, 81.3% of which were diagnosed with ACS and 69.6% were male. 63.1% of the patients were between 60 and 79 years old at the time of diagnosis. Most patients were Caucasian (81.1%), married (60.3%), and living with their family (74.3%), and 49.7% were recorded as overweight or obese. We found that 29.3% of patients reported symptoms of psychological distress. Regression analyses revealed strong negative correlations between the proportion of symptoms of psychological distress and factors like age and functional capacity as measured by metabolic equivalents. Significant associations were also established between symptoms of psychological distress and factors such as obesity, sedentary lifestyle, smoking, and sex (female). This study was undertaken as part of a business case to implement a new cardiac rehabilitation programme in an academic hospital of Eastern Ontario and illustrate to the managers and decision-makers, the important factors to consider and to target when developing a stepped-care program for patients in cardiac rehabilitation in order to prevent psychological distress and how such a program was relevant to their institution.
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Affiliation(s)
- Gladys Bruyninx
- Institut du Savoir Montfort, 745a chemin Montréal, Ottawa, Ontario, K1K 0T2, Canada.
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, Ontario, K1H 8M5, Canada.
| | - Jean Grenier
- Institut du Savoir Montfort, 745a chemin Montréal, Ottawa, Ontario, K1K 0T2, Canada
| | - Paul S Greenman
- Institut du Savoir Montfort, 745a chemin Montréal, Ottawa, Ontario, K1K 0T2, Canada
- Université du Québec en Outaouais, 283, boul. Alexandre-Taché, Gatineau, Québec, J8X 3X7, Canada
| | - Vanessa Tassé
- Institut du Savoir Montfort, 745a chemin Montréal, Ottawa, Ontario, K1K 0T2, Canada
| | - Joseph Abdulnour
- Institut du Savoir Montfort, 745a chemin Montréal, Ottawa, Ontario, K1K 0T2, Canada
| | - Marie Hélène Chomienne
- Institut du Savoir Montfort, 745a chemin Montréal, Ottawa, Ontario, K1K 0T2, Canada
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, Ontario, K1H 8M5, Canada
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12
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The relationship between coronary artery disease and depression and anxiety scores. North Clin Istanb 2020; 7:523-526. [PMID: 33163893 PMCID: PMC7603855 DOI: 10.14744/nci.2020.72602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/24/2020] [Indexed: 02/07/2023] Open
Abstract
Coronary artery disease (CAD) is one of the severe diseases that may cause significant moral and financial burden on society today. There are many studies in the literature on whether psychiatric disorders may cause CAD or an increase in prevalence after CAD. Although many studies have emphasized the importance of early diagnosis and treatment of depression in CAD patients, clinicians do not attach much attention to depression in daily practice. Several scales have been developed that are comfortable to use to describe anxiety and depression in CAD patients. High depression and anxiety scores predicted by psychological symptom scales following CAD treatment are closely related to treatment success and prognosis of the CAD. We believe that patients with CAD should be followed carefully for the diagnosis of depression and anxiety disorders; since the treatment of them may improve the prognosis of CAD.
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13
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Hu J, Ren J, Zheng J, Li Z, Xiao X. A quasi-experimental study examining QR code-based video education program on anxiety, adherence, and satisfaction in coronary angiography patients. Contemp Nurse 2020; 56:428-440. [PMID: 32814500 DOI: 10.1080/10376178.2020.1813043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: QR (quick response) codes are a promising tool for health education, however effects of QR code application in providing peri-procedure education to patients with coronary angiography is unclear.Aim/Objective: This study investigated the effect of a QR code-based video education program on anxiety, adherence, and satisfaction in Chinese coronary angiography patients.Material and Methods: This prospective controlled clinical trial included 335 patients undergoing coronary angiography, including 166 patients in the experimental group and 169 patients in the control group. On the day before coronary angiography, patients in the experimental group had access to and could watch an educational video on their smartphones by scanning a QR code for multiple times, while patients in the control group watched the same video on a tablet once only. The primary outcome was anxiety assessed using the Chinese State Anxiety Inventory (C-SAI). Adherence to instructions and patient satisfaction with the information delivery method were also evaluated.Results: The C-SAI scores improved in the experimental group compared to the control group (F = 9.8, P < 0.001) over time. There is a significant difference in the changes of anxiety scores from baseline to pre-procedure (P < 0.001) and post-procedure (P < 0.01) between the two groups. Individuals in the experimental group showed better adherence to instructions on removing dentures and jewelry, and taking medicines before the procedure (P < 0.05), and limb activity, water consumption, and diet after the procedure (P < 0.001).Conclusion: Patient education programs on smartphone that can be accessed multiple times by scanning a QR code can be an effective and convenient approach to reducing anxiety and enhancing adherence to instructions among Chinese coronary angiography patients. Hospitals and clinicians should consider more investments in developing such patient education programs and also help improve ehealth literacy.
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Affiliation(s)
- Jingwen Hu
- Department of Cardiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Jie Ren
- Department of Cardiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Jie Zheng
- Clinical Research Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Zhijian Li
- Department of Cardiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xianghua Xiao
- Eye Institute, Xi'an City First Hospital, Xi'an, People's Republic of China.,Shaanxi Key Laboratory of Ophthalmology, Shaanxi Institute of Ophthalmology, Xi'an, People's Republic of China.,Eye Institute, the First Affiliated Hospital of Northwest University, Xi'an, People's Republic of China
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14
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Abstract
BACKGROUND Cardiac catheterisations for CHD produce anxiety for patients and families. Current strategies to mitigate anxiety and explain complex anatomy include pre-procedure meetings and educational tools (cardiac diagrams, echocardiograms, imaging, and angiography). More recently, three-dimensionally printed patient-specific models can be added to the armamentarium. The purpose of this study was to evaluate the efficacy of pre-procedure meetings and of different educational tools to reduce patient and parent anxiety before a catheterisation. METHODS Prospective study of patients ≥18 and parents of patients <18 scheduled for clinically indicated catheterisations. Patients completed online surveys before and after meeting with the interventional cardiologist, who was blinded to study participation. Both the pre- and post-meeting surveys measured anxiety using the State-Trait Anxiety Inventory. In addition, the post-meeting survey evaluated the subjective value (from 1 to 4) of individual educational tools: physician discussion, cardiac diagrams, echocardiograms, prior imaging, angiograms and three-dimensionally printed cardiac models. Data were compared using paired t-tests. RESULTS Twenty-three patients consented to participate, 16 had complete data for evaluation. Mean State-Trait Anxiety Inventory scores were abnormally elevated at baseline and decreased into the normal range after the pre-procedure meeting (39.8 versus 31, p = 0.008). Physician discussion, angiograms, and three-dimensional models were reported to be most effective at increasing understanding and reducing anxiety. CONCLUSION In this pilot study, we have found that pre-catheterisation meetings produce a measurable decrease in patient and family anxiety before a procedure. Discussions of the procedure, angiograms, and three-dimensionally printed cardiac models were the most effective educational tools.
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Increased Heart Rate Variability following Elective Percutaneous Coronary Intervention in Patients with Stable Coronary Artery Disease and Preprocedural Anxiety. Cardiol Res Pract 2020; 2019:3696825. [PMID: 32089874 PMCID: PMC7024083 DOI: 10.1155/2019/3696825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/07/2019] [Accepted: 11/29/2019] [Indexed: 11/29/2022] Open
Abstract
Background There is a strong association between chronic ischemia and autonomic imbalance. Percutaneous coronary intervention (PCI) may restore autonomic balance in patients with stable coronary artery disease (SCAD), which is characterized by increased heart rate variability (HRV). Anxiety is often found in patients who are going to undergo invasive procedures and has been identified to induce autonomic imbalance. The aim of our study is to identify the impact of preprocedural anxiety on increased HRV following an elective PCI. Methods Our study was a pretest and post-test correlation study involving 44 SCAD patients who underwent elective PCI at Cipto Mangunkusumo National Hospital. The HRV was measured before and after PCI. Anxiety symptoms were evaluated using Hospital Anxiety Depression Score (HADS) questionnaires. Results We found a higher increase on HRV parameter following the PCI of subjects in the nonanxiety group compared with the anxiety group (median = 9.11 vs. 2.83; U = 154.00; p=0.043). Conclusions Preprocedural anxiety may inhibit HRV increase following PCI procedure.
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16
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Ahmad M, Ayasrah SM. Periprocedural anxiety associated with cardiac catheterisation and the monitored physiological measures. J Perioper Pract 2019; 30:130-134. [PMID: 31246160 DOI: 10.1177/1750458919857658] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To describe, compare and examine self-reported anxiety levels and associated physiological responses of blood pressure, heart rate and respiratory rate of patients undergoing cardiac catheterisation (CATH). METHODS Repeated measure design was used to assess a sample of 100 patients who had undergone cardiac catheterisation (CATH) in a major specialised heart institute in Jordan. RESULTS Patients' anxiety levels differed significantly across the three time periods (baseline, prior to and post CATH). The mean anxiety levels prior to CATH scored with State Anxiety Inventory (M = 52.14, SD = 6.0) was significantly higher than that at baseline (M = 48.35, SD = 5.6) and post CATH (M = 36.27, SD = 9.7). CONCLUSION Most patients experienced anxiety when scheduled for a CATH. The highest level of anxiety was within two hours prior to the procedure and the lowest was post procedure.
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Affiliation(s)
- Muayyad Ahmad
- Clinical Nursing Department, School of Nursing, University of Jordan, Amman, Jordan
| | - Shahnaz M Ayasrah
- Department of Applied Science/Nursing, Al-Balqa' Applied University (Ajloun University College), Al-Salt, Jordan
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17
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Lu Y, Jiang Y, Gu L. Using path analysis to investigate the relationships between depression, anxiety, and health-related quality of life among patients with coronary artery disease. Qual Life Res 2019; 28:2695-2704. [PMID: 31098799 DOI: 10.1007/s11136-019-02207-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2019] [Indexed: 01/11/2023]
Abstract
PURPOSE Demographic and clinical indicators usually influence depression, anxiety, and health-related quality of life (HRQoL) in patients with coronary artery disease (CAD). The aim of this study was to assess the direct and indirect association that existed among the identified variables, psychosocial status, and HRQoL in CAD patients. METHODS CAD patients with at least one of the main coronary artery and/or branch stenosis over 50% were eligible for inclusion. HRQoL, depression, and anxiety were tested by questionnaires within 3 days after angiography. Mono-factor and multiple linear regression models were used to examine the independent associations of depression, anxiety, and HRQoL. A path analysis was conducted to examine the association among demographic/clinical indicators, depression, anxiety, and HRQoL. RESULTS The sample consisted of 414 subject, patients with depression accounted for 40.82%, and patients with anxiety accounted for 25.12%. The direct effects of SAS scores on HRQoL (B = - 0.26, β = - 0.16), of SDS scores on HRQoL (B = - 0.70, β = - 0.47), of gender on HRQoL (B = 4.05, β = 0.17), and of NYHA classification on HRQoL (B = - 3.46, β = - 0.18) were significant (p < 0.001). The indirect effects of gender on HRQoL (B = 2.16, β = 0.09) and of Gensini scores on HRQoL (B = - 0.06, β = - 0.08) were also statistically significant (p < 0.001). CONCLUSIONS Depression and anxiety were common CAD patients and played an important role in HRQoL. Gender differences were found in determinants of HRQoL and the state of depression and anxiety directly, and women's anxiety, depression, and quality of life were worse than men's. NYHA classification and Gensini scores also played direct and indirect role in HRQoL, respectively.
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Affiliation(s)
- Yihua Lu
- Department of Epidemiology and Health Statistics, School of Public Health, Nantong University, Nantong, 226019, Jiangsu, People's Republic of China.
| | - Yun Jiang
- Department of Cardio Thoracic, Nantong Rich Hospital, Nantong, 226010, People's Republic of China
| | - Liang Gu
- Department of Cardiovascular Surgery, Nantong Rich Hospital, Nantong, 226010, People's Republic of China
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18
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Koh Y, Rashid H, Khaw S, Nasis A. Artificial FLOwering plants in Reducing Anxiety and depressive symptoms following Acute Coronary Syndromes (A-FLORA-ACS): a randomised controlled trial. Heart Vessels 2018; 34:888-897. [PMID: 30539231 DOI: 10.1007/s00380-018-1314-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 11/30/2018] [Indexed: 11/30/2022]
Abstract
Patients often experience emotional distress after acute coronary syndrome (ACS). These may lead to symptoms of depression or anxiety and greater morbidity/mortality. We sought to determine whether flowering plants in the coronary care ward reduced depressive and anxiety symptoms in these patients. Patients with ACS were randomly allocated to flowering plants (intervention) or no plants (control) in their room during index hospitalisation. Baseline data were collected. The primary outcome was the Hospital Anxiety and Depression Scale (HADS) depressive and anxiety symptom scores at discharge. Secondary outcomes were HADS depression and anxiety scores at 3 months. Both modified intention-to-treat (mITT) and per-protocol (PP) analysis were performed. 122 patients were included in the analysis after case exclusion, with all completing the HADS questionnaire at discharge and 89/122 (73%) patients completing the 3-month post-discharge HADS. At discharge, mean depressive symptom scores were lower in the intervention group, but only significantly so in the PP analysis (mITT 3.6/21 vs 4.6/21, p = 0.11; PP 3.5/21 vs 4.9/21, p = 0.04). There were no significant changes in between-group anxiety symptom scores (mITT 6.4/21 vs 6.1/21, p = 0.51; PP 3.3/21 vs 3.6/21, p = 0.67). The mean increase in depressive symptom scores at 3 months was smaller in the intervention group in both analyses (mITT 0.6 ± 3.6 vs 2.2 ± 2.6, p = 0.02; PP 0.8 ± 3.6 vs 2.4 ± 2.7, p = 0.03). Mean increase in anxiety symptom scores was not significantly different between groups (mITT 2.8/21 vs 2.5/21, p = 0.86; PP 3.3/21 vs 3.6/21, p = 0.67). Flowering plants during index hospitalisation for ACS reduced depressive symptoms in a per-protocol analysis but did not have a significant impact on anxiety symptoms. Increases in depression symptom scores were significantly smaller at 3 months post exposure to flowers compared to anxiety symptom scores.
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Affiliation(s)
- Youlin Koh
- MonashHeart, Monash Medical Centre, 246 Clayton Road, Clayton, VIC, 3168, Australia.
| | - Hashrul Rashid
- MonashHeart, Monash Medical Centre, 246 Clayton Road, Clayton, VIC, 3168, Australia.,Monash Cardiovascular Research Centre, Monash University, Melbourne, Australia
| | - Stephanie Khaw
- Monash Cardiovascular Research Centre, Monash University, Melbourne, Australia
| | - Arthur Nasis
- MonashHeart, Monash Medical Centre, 246 Clayton Road, Clayton, VIC, 3168, Australia.,Monash Cardiovascular Research Centre, Monash University, Melbourne, Australia
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19
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Salari A, Rouhi Balasi L, Ashouri A, Moaddab F, Zaersabet F, Nourisaeed A. Medication Adherence and its Related Factors in Patients Undergoing Coronary Artery Angioplasty. J Caring Sci 2018; 7:213-218. [PMID: 30607362 PMCID: PMC6311628 DOI: 10.15171/jcs.2018.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 07/25/2018] [Indexed: 11/30/2022] Open
Abstract
Introduction: Percutaneous Coronary Intervention (PCI) has
no effect on coronary artery atherosclerosis, thus the modification of physiological risk
factors seems essential to prevent coronary artery disease (CAD). Then PCI patients have
to receive multiple drug therapies in an attempt to prevent the recurrence of cardiac
events. In spite of the evidence based on medication adherence to prevent post-PCI CAD
development, medication adherence is the main concern for health care system. Accordingly,
this study aims to determine the medication adherence and its related factors among these
patients. Methods: In this cross-sectional study, the statistical
community was the patients undergoing PCI at medical educational hospital of Dr. Heshmat
in Rasht, Iran. 269 patients were selected by convenient sampling method. The data were
collected by a questionnaire consisting of 4 parts, namely the socio-individual factors,
Morisky medication adherence scale, hospital anxiety and depression scale and cardiac
patient’s self-efficacy scale. Data analysis was done by descriptive statistics and the
significance variables in univariate analysis were examined in a multi logistic regression
model through considering co-linearity. Results: The results showed that 75 patients (28%) didn’t
adhere to the medication. In addition, the majority of them were reported to have clinical
anxiety (44.2%) and mild depression (55.8%). Also, based on the results derived from
multiple logistic regressions, only the spouse's educational level and family history of
coronary artery disease were significant predictors of medication adherence. Conclusion: The current study findings display lack of
complete post-PCI medication adherence, which underscores the importance of the existence
of cardiac rehabilitation systems in the society. Therefore, it is recommended that
cardiac rehabilitation centers be built in the society.
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Affiliation(s)
- Arsalan Salari
- Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Leila Rouhi Balasi
- Department of Nursing, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Asieh Ashouri
- Department of Health Education and Promotion, Health and Environment Research Center, Faculty of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Fatemeh Moaddab
- Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Fatemeh Zaersabet
- Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Azam Nourisaeed
- Department of Psychology, Islamic Azad University of Guilan, Rasht, Iran
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20
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Barker AL, Peeters G, Morello RT, Norman R, Ayton D, Lefkovits J, Brennan A, Evans SM, Zalcberg J, Reid C, Ahern S, Soh SE, Stoelwinder J, McNeil JJ. Symptoms and feelings valued by patients after a percutaneous coronary intervention: a discrete-choice experiment to inform development of a new patient-reported outcome. BMJ Open 2018; 8:e023141. [PMID: 30341131 PMCID: PMC6196865 DOI: 10.1136/bmjopen-2018-023141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To inform the development of a patient-reported outcome measure, the aim of this study was to identify which symptoms and feelings following percutaneous coronary intervention (PCI) are most important to patients. DESIGN Discrete-choice experiment consisting of two hypothetical scenarios of 10 symptoms and feelings (pain or discomfort; shortness of breath; concern/worry about heart problems; tiredness; confidence to do usual activities; ability to do usual activities; happiness; sleep disturbance; dizziness or light-headedness and bruising) experienced after PCI, described by three levels (never, some of the time, most of the time). Preference weights were estimated using a conditional logit model. SETTING Four Australian public hospitals that contribute to the Victorian Cardiac Outcomes Registry (VCOR) and a private insurer's claim database. PARTICIPANTS 138 people aged >18 years who had undergone a PCI in the previous 6 months. MAIN OUTCOME MEASURES Patient preferences via trade-offs between 10 feelings and symptoms. RESULTS Of the 138 individuals recruited, 129 (93%) completed all 16 choice sets. Conditional logit parameter estimates were mostly monotonic (eg, moving to worse levels for each individual symptom and feeling made the option less attractive). When comparing the magnitude of the coefficients (based on the coefficient of the worst level relative to best level in each item), feeling unhappy was the symptom or feeling that most influenced perception of a least-preferred PCI outcome (OR 0.42, 95% CI 0.34 to 0.51, p<0.0001) and the least influential was bruising (OR 0.81, 95% CI 0.67 to 0.99, p=0.04). CONCLUSION This study provides new insights into how patients value symptoms and feelings they experience following a PCI.
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Affiliation(s)
- Anna L Barker
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Geeske Peeters
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Global Brain Health Institute, University of California, San Francisco | Trinity College Dublin, Trinity College Institute of Neuroscience, Dublin, Ireland
| | - Renata T Morello
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Richard Norman
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Darshini Ayton
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jeffrey Lefkovits
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Angela Brennan
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sue M Evans
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John Zalcberg
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Christopher Reid
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- NHMRC Centre for Research Excellence in Cardiovascular Outcomes Improvement, Curtin University, Bentley, Western Australia, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sze-Ee Soh
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Johannes Stoelwinder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John J McNeil
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Vlastra W, Delewi R, Rohling WJ, Wagenaar TC, Hirsch A, Meesterman MG, Vis MM, Wykrzykowska JJ, Koch KT, de Winter RJ, Baan J, Piek JJ, Sprangers MAG, Henriques JPS. Premedication to reduce anxiety in patients undergoing coronary angiography and percutaneous coronary intervention. Open Heart 2018; 5:e000833. [PMID: 30275956 PMCID: PMC6157563 DOI: 10.1136/openhrt-2018-000833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/09/2018] [Accepted: 08/22/2018] [Indexed: 11/09/2022] Open
Abstract
Aims In this study, we examined the effects of the routinely administration of benzodiazepines on reducing periprocedural anxiety versus no premedication. Methods In this open label study, we enrolled 1683 patients undergoing diagnostic coronary angiograms (CAG) or percutaneous coronary interventions (PCI). Randomisation was simulated by systematically allocating patients in monthly rotational periods to lorazepam 1 mg/sl, oxazepam 10 mg/po, diazepam 5 mg/po, midazolam 7.5 mg/po or no premedication. Anxiety was measured at four different time points using the one-item Visual Analogue Scale for Anxiety (VAS score) ranging from 0 to 10. The primary outcome was the difference in anxiety reduction (ΔVAS, preprocedure to postprocedure), between the different premedication strategies versus no premedication. Results Anxiety reduction was larger in patients premedicated with lorazepam (ΔVAS=−2.0, SE=1.6, P=0.007) or diazepam (ΔVAS=−2.0, SE=1.5, p=0.003) compared with patients without any premedication (ΔVAS=−1.4, SE=1.2). The use of midazolam or oxazepam did not lead to a significant reduction in anxiety compared with patients who did not receive premedication. Additionally, a high number of patients treated with midazolam (N=39, 19.8%) developed side effects. Conclusions In this study, the use of lorazepam or diazepam was associated with a significant, but modest anxiety reduction in patients undergoing CAG or PCI. This study does not support the standard use of oxazepam or midazolam as premedication to reduce anxiety.
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Affiliation(s)
- Wieneke Vlastra
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Ronak Delewi
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Wim J Rohling
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Tineke C Wagenaar
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Alexander Hirsch
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Martin G Meesterman
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Marije M Vis
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Joanna J Wykrzykowska
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Karel T Koch
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Robbert J de Winter
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Jan Baan
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Jan J Piek
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - José P S Henriques
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
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Sharif F, Najafi Kalyani M, Ahmadi F, Iman MT. In the shadow of perceived threat: The live experience of Iranian patients candidate for undergoing coronary angiography. JOURNAL OF VASCULAR NURSING 2018; 36:140-144. [PMID: 30139451 DOI: 10.1016/j.jvn.2018.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 04/25/2018] [Accepted: 04/26/2018] [Indexed: 10/14/2022]
Abstract
Coronary angiography (CAG) is a stressful event for many patients. This article aimed to explore the Iranian patients' experiences of undergoing CAG. In this qualitative study that is a substudy of a larger study, 15 patients (seven men and eight women) with a mean age of 49.8 ± 11.6 years were recruited from three hospitals in Shiraz, southwest Iran. Data were collected using semistructured, face-to-face interview before undergoing CAG. Interviews were audiotaped and transcribed. Data were analyzed using qualitative content analysis. Perceived threat of patients included two themes: being under pressure and anxiety. Patients undergoing CAG experience psychological problems that can threaten them in catheterization laboratory. Health professionals are required to help and prepare this patient for an invasive CAG. To minimize the psychological problems of patients undergoing CAG, nurses and physicians should perform some supportive interventions in their care plan.
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Affiliation(s)
- Farkhondeh Sharif
- Professor, Community Based Psychiatric Care Research Center, Department of Psychiatric Nursing, School of Nursing & Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Najafi Kalyani
- School of Nursing & Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Fazlollah Ahmadi
- Professor, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Taghi Iman
- Professor, Department of Sociology, Faculty of Social Sciences, Shiraz University, Shiraz, Iran
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Age and pain as predictors of discomfort in patients undergoing transfemoral percutaneous coronary interventions. Heart Lung 2018; 47:576-583. [PMID: 30093164 DOI: 10.1016/j.hrtlng.2018.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 06/14/2018] [Accepted: 07/04/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Transfemoral percutaneous coronary intervention (PCI) requires strict bed rest, causing pain and discomfort in patients. However, no studies have investigated this issue. OBJECTIVES To investigate the predictors of discomfort in transfemoral PCI patients. METHODS A cross-sectional sample of 110 patients from two coronary care units completed questionnaires on demographic and clinical characteristics, visual analogue pain scale, and discomfort. RESULTS Eight factors predicted overall discomfort: physiologic pain, physiological discomfort, psychological discomfort, analgesic use after sheath removal, hemostasis method, and bed rest duration. Psychological discomfort was associated with age, chronic obstructive pulmonary disease, analgesic use after sheath removal, successful hemostasis, and hematoma >5 cm. A hierarchical regression model explained 70.5% of the variance in overall discomfort. CONCLUSIONS Age and physiologic pain are major predictors of overall discomfort, especially in patients aged <60 years having high pain sensitivity. Critical care providers should note patients' physiological and psychological issues throughout the PCI process.
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Su SF, Chang MY, Wu MS, Liao YC. Safety and efficacy of using vascular closure devices for hemostasis on sheath removal after a transfemoral artery percutaneous coronary intervention. Jpn J Nurs Sci 2018; 16:172-183. [PMID: 30044037 DOI: 10.1111/jjns.12221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 04/18/2018] [Accepted: 05/22/2018] [Indexed: 11/26/2022]
Abstract
AIM To determine the efficacy of vascular closure devices (VCDs) for hemostasis following transfemoral percutaneous coronary interventions (PCIs). METHODS This two-group pre-post-test observational study with purposive sampling enrolled 73 patients between January, 2014 and February, 2015. The patients were allocated to either the intervention (vascular closure devices group, n = 34) or the control group (manual compression [MC] group, n = 39). Questionnaires were used to assess their demographic and clinical characteristics, vascular complications, visual analogue scale score for pain, and discomfort levels. Pain and discomfort were measured before and after the PCI. RESULTS Vascular complications were observed in 15 (44.1%) VCD patients and 13 (33.3%) MC patients, with no significant between-group difference. However, the VCD patients had a higher relative risk of bruising, hematomas, and need for further treatment. After the PCI, the pain scores and discomfort levels increased significantly in both groups, but the VCD patients had more successful hemostasis, less pain, and less physical and psychological discomfort (lower-limb numbness, shoulder pain, restlessness, and worrying about walking ability, being unable to lift heavy objects in the future, and taking time off from work). CONCLUSION The VCDs seem to be superior to the MCs, providing more successful hemostasis, less pain and discomfort, and earlier ambulation after a transfemoral PCI. These findings aid clinical nurses in understanding the risk of vascular complications, discomfort, and pain that are associated with VCD use for improving the quality of clinical care and help clinicians in determining the appropriate hemostatic method for patients undergoing a transfemoral PCI, particularly in the Chinese population.
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Affiliation(s)
- Shu-Fen Su
- Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Mei-Yu Chang
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Meng-Shan Wu
- Department of Nursing, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Ying-Chin Liao
- Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Fuxing Township, Taiwan
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Haddad NE, Saleh MN, Eshah NF. Effectiveness of nurse-led video interventions on anxiety in patients having percutaneous coronary intervention. Int J Nurs Pract 2018. [DOI: 10.1111/ijn.12645] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ramirez DA, Brodie FL, Rose-Nussbaumer J, Ramanathan S. Anxiety in patients undergoing cataract surgery: a pre- and postoperative comparison. Clin Ophthalmol 2017; 11:1979-1986. [PMID: 29184388 PMCID: PMC5689065 DOI: 10.2147/opth.s146135] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Reducing surgery-related patient anxiety without under-emphasizing surgical risk is challenging for even the most experienced surgeon. The purpose of this study is to identify specific anxieties faced by patients in hopes of better informing the preoperative surgeon-patient dialogue. Setting Comprehensive and specialty ophthalmology clinics at the University of California, San Francisco. Design A prospective, survey-based study in which a pre- and postoperative questionnaire was administered to patients undergoing routine phacoemulsification. The surgeon was masked to patient enrollment and questionnaire responses. Materials and methods A 36-item questionnaire on patient anxiety was developed from existing literature, building on the validated Surgical Fear Questionnaire. Patients were eligible if they were aged >18 years and willing to participate. Patients were excluded if having more than phacoemulsification alone or if unable to respond in English, and were retroactively excluded if there were complications during surgery. The primary outcome was self-reported anxiety on an 11-point Likert scale. Results Sixty-one patients were included for analysis. Preoperatively, patients reported greatest anxiety around the operation itself and becoming blind. Reflecting postoperatively, patients reported the greatest anxiety for the operation itself. Statistically significant decreases were greatest for anxiety about the operation failing (p<0.001) and becoming blind (p<0.001). No decrease was observed for the operation itself (p=0.1). Conclusion More effort must be made to specifically discuss the steps of the operation itself and the expected visual outcomes to alleviate patient anxiety. The authors hope these data can provide insight for surgeons into patient anxiety surrounding cataract surgery and help strengthen the patient-physician relationship.
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Affiliation(s)
- David A Ramirez
- School of Medicine, University of California, San Francisco.,Department of Ophthalmology, University of California, San Francisco
| | - Frank L Brodie
- Department of Ophthalmology, University of California, San Francisco
| | - Jennifer Rose-Nussbaumer
- Department of Ophthalmology, University of California, San Francisco.,Francis I. Proctor Foundation, San Francisco, CA, USA
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Effect of Benson relaxation technique on the preoperative anxiety and hemodynamic status: A single blind randomized clinical trial. Artery Res 2017. [DOI: 10.1016/j.artres.2017.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Anxiety levels of patients undergoing coronary procedures in the catheterization laboratory. Int J Cardiol 2016; 228:926-930. [PMID: 27912201 DOI: 10.1016/j.ijcard.2016.11.043] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/07/2016] [Accepted: 11/05/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND High levels of anxiety are associated with worse outcomes in coronary artery disease patients. Little is known about anxiety levels in patients undergoing coronary procedures. Our objective is to examine the levels of anxiety in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) during the different phases of hospital stay and to evaluate which patient characteristics are associated with increased anxiety. METHODS Patients undergoing CAG or PCI between April 2009 and April 2010 were included in this prospective cohort study. Anxiety levels were measured using the self reported Visual Analogue Scale (VAS) of Anxiety, ranging from 0 to 100. VAS anxiety scores were obtained at hospital intake, pre- and post-procedure, and at hospital discharge. Multivariate linear regression analyses were performed to assess correlations between baseline characteristics and anxiety levels at the different time points. RESULTS In total 2604 patients were included, with 70.4% male participants with a mean age of 65±12years. VAS anxiety scores were highest pre-procedure (44.2±27.0mm). Female patients reported a significantly higher pre procedure VAS anxiety score (50.4±26.5) compared to males (41.5±26.8, p=0.02). Other factors associated with higher levels of anxiety at different time points were age<65years, low level of education and an acute primary PCI. CONCLUSION In the largest cohort to date, we examined anxiety among patients undergoing PCI or CAG was highest immediately around the procedure, particularly in patients aged <65years, of female gender, undergoing primary PCI, or with a lower level of education. Better pre-procedural information or pharmacological strategies may reduce anxiety in these patients.
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Hollander MHJ, Schortinghuis J, Vissink A. Changes in heart rate during third molar surgery. Int J Oral Maxillofac Surg 2016; 45:1652-1657. [PMID: 27575392 DOI: 10.1016/j.ijom.2016.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 06/16/2016] [Accepted: 08/08/2016] [Indexed: 11/16/2022]
Abstract
Anxiety is an undesirable psychological phenomenon. Patients are usually anxious when subjected to third molar surgery, but the pattern of anxiety is unknown. The aim of this study was to assess the intensity and course of anxiety during third molar surgery. This study included 48 consecutive patients (mean age 25±6 years) who had a third molar removed surgically under local anaesthesia. The heart rate was monitored continuously during treatment as a measure of anxiety. Preoperative anxiety was scored with the Modified Dental Anxiety Scale. Each patient's anxiety level was assessed when in the waiting room, sitting down in the dental chair, during the application of local anaesthesia, application of surgical drapes, time-out procedure, incision, alveolotomy, removal of the third molar, and suturing, and at the end of the procedure. The lowest heart rates were recorded in the waiting room, in the dental chair, during anaesthesia, when applying surgical drapes, during suturing, and at the end of the procedure. The highest values were obtained during the time-out procedure, incision, and alveolotomy (P<0.005). In conclusion, the intensity and course of anxiety has a specific pattern during third molar surgery, with the lowest levels of anxiety prior to surgery and directly postoperative and the highest during the time-out procedure and the actual surgery.
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Affiliation(s)
- M H J Hollander
- Department of Oral and Maxillofacial Surgery, Scheper Hospital, Emmen, Netherlands
| | - J Schortinghuis
- Department of Oral and Maxillofacial Surgery, Scheper Hospital, Emmen, Netherlands.
| | - A Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
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Kala P, Hudakova N, Jurajda M, Kasparek T, Ustohal L, Parenica J, Sebo M, Holicka M, Kanovsky J. Depression and Anxiety after Acute Myocardial Infarction Treated by Primary PCI. PLoS One 2016; 11:e0152367. [PMID: 27074002 PMCID: PMC4830576 DOI: 10.1371/journal.pone.0152367] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 03/13/2016] [Indexed: 11/29/2022] Open
Abstract
Aims The main objective of the study was to find out prevalence of depression and anxiety symptoms in the population of patients with AMI with ST-segment elevation (STEMI), treated with primary PCI (pPCI). Secondary target indicators included the incidence of sleep disorders and loss of interest in sex. Methods and results The project enrolled 79 consecutive patients with the first AMI, aged <80 years (median 61 years, 21.5% of women) with a follow-up period of 12 months. Symptoms of depression or anxiety were measured using the Beck Depression Inventory II tests (BDI-II, cut-off value ≥14) and Self-Rating Anxiety Scale (SAS, cut-off ≥ 45) within 24 hours of pPCI, before the discharge, and in 3, 6 and 12 months). Results with the value p<0.05 were considered as statistically significant. The BDI-II positivity was highest within 24 hours after pPCI (21.5%) with a significant decline prior to the discharge (9.2%), but with a gradual increase in 3, 6 and 12 months (10.4%; 15.4%; 13.8% respectively). The incidence of anxiety showed a relatively similar trend: 8.9% after pPCI, and 4.5%, 10.8% and 6.2% in further follow-up. Conclusions Patients with STEMI treated by primary PCI have relatively low overall prevalence of symptoms of depression and anxiety. A significant decrease in mental stress was observed before discharge from the hospital, but in a period of one year after pPCI, prevalence of both symptoms was gradually increasing, which should be given medical attention.
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Affiliation(s)
- Petr Kala
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Nela Hudakova
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Michal Jurajda
- Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tomas Kasparek
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Psychiatry, University Hospital Brno, Brno, Czech Republic
| | - Libor Ustohal
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Psychiatry, University Hospital Brno, Brno, Czech Republic
| | - Jiri Parenica
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marek Sebo
- Centre of Cardiovascular and Transplantation Surgery, Brno, Czech Republic
| | - Maria Holicka
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jan Kanovsky
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- * E-mail:
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Abstract
The study aimed to explore perioperative practitioners' knowledge, awareness and experiences of perioperative vulnerability in clinical practice. A qualitative descriptive design was used; data was obtained by conducting semi-structured interviews with ten perioperative practitioners over a two week period in July 2014. The study found that perioperative practitioners were aware of the concept of perioperative vulnerability and had varied experience of it in practice. Data analysis identified three main themes in relation to vulnerability: labels, recognition and management. We conclude that the concept of perioperative vulnerability exists in practice and that perioperative practitioners manage the concept effectively using strategies that promote positive outcomes.
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Ayasrah SM, Ahmad MM. Educational Video Intervention Effects on Periprocedural Anxiety Levels Among Cardiac Catheterization Patients: A Randomized Clinical Trial. Res Theory Nurs Pract 2016; 30:70-84. [DOI: 10.1891/1541-6577.30.1.70] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose: To explore the effectiveness of an educational video intervention in lowering periprocedural anxiety among Jordanian patients hospitalized for cardiac catheterization (CATH). There are many potential reasons of anxiety related to CATH including involvement of the heart and the actual test procedure. Methods: A randomized controlled trial took place in a specialized heart institute in Jordan. The sample size was 186 patients who had undergone CATH procedure. Patients anxiety levels were measured by physiological parameters of anxiety (blood pressure, heart rate, and respiratory rate) and by the Spielberger State Anxiety Inventory (SAI). Results: After video education, there was a significant difference in periprocedural perceived anxiety between the groups: preprocedural anxiety levels (M = 39.03, SD = 5.70) for the experimental group versus (M = 49.34, SD = 6.00) for the control, p < .001, and postprocedural perceived anxiety for the experimental group (M = 29.18, SD = 5.42) versus (M = 41.73, SD = 5.41) for the control. Conclusion: Providing an educational video intervention about CATH may effectively decrease periprocedural anxiety levels.
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Ferreira NDC, Ramalho EDS, Lopes JDL. Non-pharmacological strategies to decrease anxiety in cardiac catheterization: integrative review. Rev Bras Enferm 2015; 68:1093-102. [PMID: 26676432 DOI: 10.1590/0034-7167.2015680614i] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 10/06/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to identify and review the literature on non-pharmacological strategies used for reducing anxiety in patients receiving cardiac catheterization. METHOD this study was an integrative literature review. The research was conducted using the databases LILACS, SciELO, Medline (through BVS and PubMed) and Scopus. Studies were analyzed according to their objective, method, instruments used for evaluating patients' anxiety, and the results obtained. RESULTS the most used strategy for reducing anxiety in patients receiving cardiac catheterization was music therapy. However, no study identifying the most appropriate time for this intervention (before, during and/or after the procedure) was found. Other strategies identified in this review were educational videos, massage, and palm therapy. CONCLUSION the results found suggest that anxiety can be reduced using non-pharmacological strategies.
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Hasankhani H, Gholizadeh L, Mohammadi E, Zamanzadeh V, Allahbakhshian A, Ghaffari S, Allahbakhshian M. The lived experiences of patients post coronary angioplasty: A qualitative study. JOURNAL OF VASCULAR NURSING 2014; 32:144-50. [DOI: 10.1016/j.jvn.2014.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 03/31/2014] [Accepted: 04/01/2014] [Indexed: 10/24/2022]
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Abstract
This study aims to report the analysis of the concept of perioperative vulnerability. Literature searches were conducted in databases CINAHL, Medline, PsychINFO, OVID, InterNurse, as well as a manual library search from article reference lists. Search terms were restricted to 'concept analysis', 'vulnerability', 'perioperative', 'patient' and 'perioperative patient'. Retrieved literature was analysed using the Walker & Advant (2005) concept analysis framework. Based on the concept analysis, vulnerability can be seen as having both physical and psychological elements and can be influenced by personal traits. Vulnerability is affected by previous experiences, perceptions of life, disease and ultimately the level of control an individual has over a given situation. The study concludes that inclusion of the concept of vulnerability within both pre- and post-registration training programmes would facilitate awareness of the issues surrounding perioperative vulnerability and the need to plan individualised care accordingly. It is hoped that this analysis will inspire further research and theoretical underpinning of perioperative practice, facilitating the development of new ways to manage vulnerability that will benefit individual patients, develop practice and promote positive patient outcomes.
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Roohafza H, Sadeghi M, Khani A, Andalib E, Alikhasi H, Rafiei M. Psychological state in patients undergoing coronary artery bypass grafting surgery or percutaneous coronary intervention and their spouses. Int J Nurs Pract 2014; 21:214-20. [PMID: 24750214 DOI: 10.1111/ijn.12234] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Percutaneous coronary intervention (PCI) and the coronary artery bypass grafting surgery (CABG) are well accepted treatments for coronary artery disease. Many patients and their spouses experience increased level of stress, anxiety and depression before and after going under the procedure. One hundred and ninety-six cardiac patients who were candidate for CABG or PCI procedures and their spouses were asked to complete Hospital Anxiety and Depression Scale and General Health Questionnaire-12 before and 1 month after procedures. Anxiety, depression and stress level in patients and their spouses going under the procedures significantly reduced over time. Scores of anxiety, depression and stress in patients and their spouses were correlated. There was no difference in the level of anxiety, depression and stress between CABG and PCI groups before to after procedures. We suggest providing information about the procedures to both patients and their spouses to deal better with their own psychological state.
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Affiliation(s)
- Hamidreza Roohafza
- Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Steinke EE, Jaarsma T, Barnason SA, Byrne M, Doherty S, Dougherty CM, Fridlund B, Kautz DD, Mårtensson J, Mosack V, Moser DK. Sexual counselling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP). Eur Heart J 2013; 34:3217-35. [PMID: 23900695 DOI: 10.1093/eurheartj/eht270] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
After a cardiovascular event, patients and their families often cope with numerous changes in their lives, including dealing with consequences of the disease or its treatment on their daily lives and functioning. Coping poorly with both physical and psychological challenges may lead to impaired quality of life. Sexuality is one aspect of quality of life that is important for many patients and partners that may be adversely affected by a cardiac event. The World Health Organization defines sexual health as '… a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences ….'(1(p4)) The safety and timing of return to sexual activity after a cardiac event have been well addressed in an American Heart Association scientific statement, and decreased sexual activity among cardiac patients is frequently reported.(2) Rates of erectile dysfunction (ED) among men with cardiovascular disease (CVD) are twice as high as those in the general population, with similar rates of sexual dysfunction in females with CVD.(3) ED and vaginal dryness may also be presenting signs of heart disease and may appear 1-3 years before the onset of angina pectoris. Estimates reflect that only a small percentage of those with sexual dysfunction seek medical care;(4) therefore, routine assessment of sexual problems and sexual counselling may be of benefit as part of effective management by physicians, nurses, and other healthcare providers.
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Bunevicius A, Staniute M, Brozaitiene J, Pop VJM, Neverauskas J, Bunevicius R. Screening for anxiety disorders in patients with coronary artery disease. Health Qual Life Outcomes 2013; 11:37. [PMID: 23497087 PMCID: PMC3601013 DOI: 10.1186/1477-7525-11-37] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 03/04/2013] [Indexed: 02/01/2023] Open
Abstract
Background Anxiety disorders are prevalent and associated with poor prognosis in patients with coronary artery disease (CAD). However, studies examining screening of anxiety disorders in CAD patients are lacking. In the present study we evaluated the prevalence of anxiety disorders in patients with CAD and diagnostic utility of self-rating scales for screening of anxiety disorders. Methods Five-hundred and twenty-three CAD patients not receiving psychotropic treatments at initiation of rehabilitation program completed self-rating scales (Hospital Anxiety and Depression Scale or HADS; Spielberger State-Anxiety Inventory or SSAI; and Spielberger Trait-Anxiety Inventory or STAI) and were interviewed for generalized anxiety disorder (GAD), social phobia, panic disorder and agoraphobia (Mini-International Neuropsychiatric Interview or MINI). Results Thirty-eight (7%) patients were diagnosed with anxiety disorder(s), including GAD (5%), social phobia (2%), agoraphobia (1%) and panic disorder (1%). Areas under the ROC curve of the HADS Anxiety subscale (HADS-A), STAI and SSAI for screening of any anxiety disorder were .81, .80 and .72, respectively. Optimal cut-off values for screening of any anxiety disorders were ≥8 for the HADS-A (sensitivity = 82%; specificity = 76%; and positive predictive value (PPV) = 21%); ≥45 for the STAI (sensitivity = 89%; specificity = 56%; and PPV = 14%); and ≥40 for the SSAI (sensitivity = 84%; specificity = 55%; PPV = 13%). In a subgroup of patients (n = 340) scoring below the optimal major depressive disorder screening cut-off value of HADS-Depression subscale (score <5), the HADS-A, STAI and SSAI had moderate-high sensitivity (range from 69% to 89%) and low PPVs (≤22%) for GAD and any anxiety disorders. Conclusions Anxiety disorders are prevalent in CAD patients but can be reliably identified using self-rating scales. Anxiety self-rating scales had comparable sensitivities but the HADS-A had greater specificity and PPV when compared to the STAI and SSAI for screening of anxiety disorders. However, false positive rates were high, suggesting that patients with positive screening results should undergo psychiatric interview prior to initiating treatment for anxiety disorders and that routine use of anxiety self-rating scales for screening purposes can increase healthcare costs. Anxiety screening has incremental value to depression screening for identifying anxiety disorders.
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Affiliation(s)
- Adomas Bunevicius
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
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