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Anxiety reduction after pre-procedure meetings in patients with CHD

Published online by Cambridge University Press:  05 June 2020

Preston J. Boyer
Affiliation:
University of Arizona, Department of Pediatrics, Tucson, AZ, USA
Joshua A. Yell
Affiliation:
University of Arizona, College of Medicine, Tucson, AZ, USA
Jennifer G. Andrews
Affiliation:
University of Arizona, Department of Pediatrics, Division of Cardiology, Tucson, AZ, USA
Michael D. Seckeler*
Affiliation:
University of Arizona, Department of Pediatrics, Division of Cardiology, Tucson, AZ, USA
*
Author for correspondence: Michael D. Seckeler, MD, MSc, Department of Pediatrics (Cardiology), The University of Arizona, 1501 N. Campbell Ave, PO Box 245073, Tucson, AZ85724, USA. Tel: +1 520 626 6508; Fax: +1 520 626 6571. E-mail: mseckeler@peds.arizonaedu

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.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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