Efficacy of complementary interventions for management of anxiety in patients undergoing coronary angiography: A rapid systematic review

Effect of acupressure in the third eye point (EX-HN 3) on psychological distress, comfort and physiologic parameters among patients undergoing coronary angiography

AIM

The present study aimed to investigate the effect of acupressure on comfort, anxiety, stress, depression, and vital signs in patients undergoing coronary angiography.

METHODS

This randomized clinical trial was conducted on patients who underwent coronary angiography in Tehran, Iran. Seventy patients were randomly assigned to the intervention and control groups. The intervention protocol consisted of 20 min of acupressure applied to the Yintang point, and standard medical care was applied to the control group. Depression, Anxiety, and Stress questionnaire (DASS-21), General Comfort Questionnaire (GCQ) questionnaires, and standard monitoring were used as data collection tools before and after intervention, as well as after angiography. Data were analyzed using an independent sample t-test, chi-squared, and analysis of variance of repeated measures in SPSS software, and the level of significance was set at 0.05.

FINDINGS

The results showed that before acupressure, there was no statistically significant difference between the two groups. Anxiety and stress scores and comfort levels decreased significantly after the intervention (p < 0.001), while no significant difference was observed in the depression score (p = 0.873). There was a significant decrease in the blood pressure, breathing rate, and heart rate in the intervention group.

CONCLUSION

Acupressure can reduce the anxiety and stress of angiography candidates and make them more comfortable. It also reduces the blood pressure, breathing rate, and heart rate. Further studies at different pressure points and on a larger and more detailed scale are necessary.

Alternative Means of Informed Consent in Cardiology: Strategies and Effectiveness in a Group of Italian Patients

Informed consent practices in healthcare represent a fundamental element of patient-centred care; however, the traditional use of a written, paper-based description of the medical procedure to obtain informed consent presents many limitations. This research aimed to evaluate the effects of an alternative modality of obtaining informed consent using a brief informative video for patients waiting to undergo a coronary angiography procedure in Italy. The study involved 40 participants-28 males and 12 females (mean age: 68.55, SD = 13.03)-divided equally into two groups: one group received the video-based informed consent and the other received a traditional paper-based form. Each group was asked to fill in two questionnaires; one was created by the researchers to measure the patient's level of understanding of the given information and the perception of usefulness of the informed consent, and the other was the Depression Anxiety Stress Scales-21 (DASS-21), which evaluates levels of anxiety, depression and stress. A comparison of the results of the two groups showed that video-based informed consent allowed participants to better understand the given information, to feel more confident concerning their subjective comprehension of it and to perceive the video-based informed consent as more useful than the traditional one. The video-based informed consent did not lead to higher levels of anxiety, depression or stress among the participants. It can be hypothesized that video-based formats may represent a more useful, understandable and safe alternative to traditional paper-based informed consent in healthcare.

Effect of Aromatherapy on the Anxiety of Patients before Coronary angiography

PURPOSE

This study aimed to assess the effect of aromatherapy administered before coronary angiography on anxiety levels and physiological parameters.

MATERIAL AND METHOD

The study used a randomized controlled trial design. The study group consisted of a total of 96 individuals. The research data were collected using the descriptive information form, the State-Trait Anxiety Inventory (STAI), and the Physiological Parameters Assessment Form.

RESULTS

The results of this study indicated a significant difference between the groups in terms of pain levels and mean STAI-I scores prior to coronary angiography.

CONCLUSION

The results revealed that aromatherapy administered before angiography reduced the anxiety and pain levels of patients.

Effectiveness of aromatherapy inhalation on anxiety and haemodynamic variables for patients with cardiovascular disease: A systematic review and meta-analysis

BACKGROUND

Anxiety can negatively affect patients' prognosis in cardiovascular disease. Aromatherapy helps reduce anxiety level in chronic diseases. However, the effectiveness of aromatherapy on anxiety and haemodynamic variables remains uncertain.

OBJECTIVE

To evaluate the evidence for the effectiveness of aromatherapy on anxiety and haemodynamic variables in patients with cardiovascular disease.

DESIGN

A systematic review and meta-analysis.

REVIEW METHODS

The CINAHL COMPLETE, Cochrane Central, Web of Science, Pubmed, Scopus, Science Direct, Ovid and ProQuest databases were searched. The study was conducted in line with the Cochrane and PRISMA guideline. Examination for bias in the included studies was conducted with the Cochrane bias guideline. Heterogeneity and publication bias were evaluated.

RESULTS

Twelve studies published from 2012 to 2020 were included in the meta-analysis. Lavender aromatherapy inhalation was used the most for anxiety in patients. Aromatherapy had a highly significant effect on anxiety, systolic blood pressure and heart rate, a moderate effect on breathing rate and a non-significant effect on diastolic blood pressure. The Cochrane GRADE approach was used to assess the rating of the certainty of evidence. A high level of evidence was found for the effect of aromatherapy on heart rate, a moderate level for the effect of aromatherapy on anxiety and breathing rate and a low level for the effects of aromatherapy on blood pressure and lavender on anxiety.

CONCLUSION

It was found that aromatherapy reduced anxiety, systolic blood pressure, heart rate and breathing rate in patients with cardiovascular disease. This study provides information to researchers and health professionals about the effectiveness of aromatherapy on decreasing anxiety and haemodynamic variables in patients with cardiovascular disease. Also, the study can contribute to planning studies which are better designed, conducted and reported.

The of effect of partnership-based education on adherence to the treatment plans in open heart surgery

BACKGROUND

Adherence to the treatment plans is one of the most effective conducts to prevent and reduce postoperative side effects. Partnership-based education is one of the most efficient ways to shape health behaviors. The aim of the present study was to determine the effect of partnership-based education on adherence to the treatment plans in open heart surgery.

MATERIALS AND METHODS

This quasi-experimental study was conducted in 2019-2020 on the patients undergoing open heart surgery in Tehran (Capital of Iran). Sampling was done in one educational hospital. A total of 86 patients and their caregivers participated in the study. Sampling was done nonrandomly by tossing a coin, and patients were allocated into the odd week in the intervention group and the even week in the control group (n = 43 in each group), and data were collected before and after intervention using the Treatment Adherence Questionnaire concerning dietary, physical activity, and medication aspects. The educational intervention was carried out after the pretest analysis in five 20-45 min sessions (two individual and three group educations). Data were analyzed with Chi-square, independent t-test, and paired t-test using SPSS 19 at a significance level of P < 0.05.

RESULTS

Patients and caregivers in both groups did not have a significant difference in terms of demographic variables (P > 0. 05). In addition, there was no significant difference in the mean of dietary, physical activity, and medication plans before the intervention in both groups; however, after the intervention, the mean of the three aspects in the intervention group was significantly higher than that of control (P < 0.001).

CONCLUSION

Implementing partnership-based education with participation of patients and caregivers is influential in improving patients' adherence to the treatment plans and it is recommended as a clinical dynamic educational strategy.

Non-pharmacological interventions to manage fatigue in adults with inflammatory bowel disease: A systematic review and meta-analysis

BACKGROUND AND PURPOSE

The prevalence of fatigue is higher in adults with inflammatory bowel disease (IBD). There is limited information on the effectiveness of non-pharmacological interventions to manage fatigue. The purposes of this review is to evaluate the effectiveness of these interventions to manage fatigue in adults with IBD.

MATERIALS AND METHODS

A systematic review was conducted based on the PRISMA guidelines. Comprehensive Meta-Analysis software was used to compute metaanalysis.

RESULTS

Eleven studies were included in the review. The interventions to manage fatigue included problem-solving therapy, solution-focused therapy, cognitive behavioral therapy, psychoeducational intervention, exercise advice with omega-3 supplements, electro-acupuncture, and AndoSan. The pooled evidence from the metaanalysis demonstrated that non-pharmacological interventions could decrease IBDFatigue (SMD = 0.33, 95% CI [0.10, 0.55], p = 0.005).

CONCLUSION

The pooled data indicate that non-pharmacological interventions are helpful in managing IBD-Fatigue. Additionally, the non-pharmacological interventions reviewed could be utilized to promote self-management in IBD.

Modifying Stressors Using Betty Neuman System Modeling in Coronary Artery Bypass Graft: a Randomized Clinical Trial

Introduction: Coronary artery disease (CAD) is one of the major causes of mortality all over the world. In this relation, coronary artery bypass grafting (CABG) is one of the most important treatments for CAD patients. However, it leads to a lot of stress in the patient. The aim of this study was to use the Neuman model to moderate the stressors in patients undergoing coronary artery bypass graft. Methods: This study was a randomized clinical trial of two groups performed on patients admitted to the coronary artery bypass graft; and the study completed with 64 patients. The intervention was performed by the researcher according to the format of the Neuman Model, which included the investigation of the stressors, and the determination of the goals and strategies for the actions. Intrapersonal, interpersonal, and extra personal factors were evaluated using a Revised Cardiac Surgery Stressor Scale (RCSSS). The intervention program was designed by the researcher based on prevention levels using scientific resources. The collected data were analyzed in SPSS ver. 13 using descriptive and inferential statistics. Results: Before the intervention, the mean score of the stressors was not significantly different between the two groups. But immediately after the intervention and before discharging the intervention group, it was significantly less than the control group. Conclusion: Using a Neuman-based program as an effective and low-cost intervention can moderate the stressors and reduce the stress of patients awaiting coronary artery bypass graft. This theory can be a good guide to offering the roles needed to provide health services in the community.