Journal of Vascular Nursing
Volume 17, Issue 2 , Pages 41-49, June 1999

Psychologic preparation to decrease anxiety associated with cardiac catheterization

  • Ann M Mott, MS, MPH (RN, CCRN, CS, M-SCNS, FNP)

      Affiliations

    • Corresponding Author InformationAddress reprint requesis to Ann M. Mott, RN, MS, MPH, CCRN, CS, FNP, 1606 Apple Valley CT, Columbia, MO 65202.
    • Ann M. Mott, RN, MS, MPH, CCRN, CS, M-SCNS, FNP, is a family nurse practitioner with Coast to Coast Medical, Kingdom City, Mo.

Article Outline

Abstract 

Undergoing a cardiac catheterization arouses anxiety for most patients. Coronary angiography plays an essential role in the diagnostic evaluation of the patient with suspected or known cardiac disease, and it is an important preoperative cardiac screening protocol for vascular surgery patients. Studies on psychologic preparation have concluded that preparatory techniques—specifically, sensory-perceptual informational and modeling—are beneficial in reducing patients' anxiety in various situations, including cardiac catheterization. The purpose of this study was to compare the preparatory informative (sensory and procedural data) and modeling strategies in reducing anxiety before cardiac catheterization. The research hypothesis that persons (n = 30) given a combination of sensory-perceptual informational preparation and modeling preparation would exhibit less anxiety than persons receiving one preparation alone was not supported. Although no significant difference existed between the postintervention anxiety scores for the 3 different treatment groups, a significant difference existed between the preintervention and postintervention anxiety scores overall. Therefore, this study validates the psychologic and nursing literature that states psychologic preparation is beneficial in reducing patients' anxiety before a stressful experience such as cardiac catheterization. The study findings also revealed an interesting trend for employing a modeling technique. This information contributes to nursing knowledge and may alter and make more effective the nature of standard psychologic preparation for patients undergoing any invasive procedure.

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References 

  1. Grossman W, Barry WH. Cardiac catheterization. In:  Braunwald E editors. Heart disease: a textbook of cardiovascular medicine. Philadelphia (PA): WB Saunders; 1988;p. 242–267
  2. Hillis LD, Firth BG. Cardiac catheterization. In:  Kloner RA editors. The guide to cardiology. New York: John Wiley & Sons; 1984;p. 153–180
  3. Lundin L, Sargent T, Burke LJ. Research utilization and improvement in outcomes after diagnostic cardiac catheterization. Crit Care Nurs. 1998;18:30–39
  4. Finesilver C. Preparation of adult patients for cardiac catheterization and coronary cineangiography. Int J Nurs Stud. 1978;15:211–221
  5. Peterson M. Patient anxiety before cardiac catheterization: an intervention study. Heart Lung. 1991;20:643–647
  6. Rice VH, Caldwell M, Butler S, Robinson J. Relaxation training and response to cardiac catheterization: a pilot study. Nurs Res. 1986;35:39–43
  7. Houston S, Eagen M, Freeborg S, Dougherty D. A comparison of structured versus guided preheart catheterization information on mood states and coping resources. Applied Nurs Res. 1996;9:189–194
  8. Stengrevics SS. Cardiac surgical patients' telephone calls use of a decision-making algorithm. Clin Nurse Spec. 1997;11:52–56
  9. Kingma JH. Waiting for coronary artery bypass surgery: Abusive, appropriate or acceptable. Lancet. 1995;346:1570–1571
  10. Montes P. Managing outpatient cardiac catheterization. Am J Nurs. 1997;97:34–37
  11. Billiard SJ, Beattie S. A non-traditional approach to cardiac education: the use of cardiac catheterization films. Prog Cardiovasc Nurs. 1990;5:21–25
  12. Hasse JE. Components of courage in chronically ill adolescents: a phenomenological study. Adv Nurs Sci. 1987;9:61–80
  13. Bohachick P. Progressive relaxation training in cardiac rehabilitation: effect on psychologic variables. Nurs Res. 1984;33:283–287
  14. Connelly AG. An examination of stressors in the patient undergoing cardiac electrophysiologic studies. Heart Lung. 1992;21:335–342
  15. Haak SW, Huether SE. The person with angina pectoris. In:  Guzzetta CE,  Dossey BM editor. Cardiovascular nursing: holistic practice. St Louis (MO): Mosby Year Book; 1992;p. 221–249
  16. Kern LS, Norris S, Constancia P. Coronary artery bypass grafting. In:  Riegel B,  Ehrenreich D editor. Psychological aspects of critical care nursing. Rockville (MD): Aspen; 1989;p. 150–170
  17. Pederson C. Effect of imagery on children's pain and anxiety during cardiac catheterization. J Pediatr Nurs. 1995;10:365–374
  18. Pederson C, Harbaugh BL. Children's and adolescents' experiences while undergoing cardiac catheterization. Maternal Child Nurs J. 1995;23:15–25
  19. Dunn SC, Lowther N. Stress. In:  Baas LS editors. Essentials of cardiovascular nursing. Gaithersburg (MD): Aspen; 1991;p. 63–86
  20. Anderson KO, Masur FT. Psychologic preparation for cardiac catheterization. Heart Lung. 1989;18:154–163
  21. Anderson KO, Masur FT. Psychological preparation for invasive medical and dental procedures. J Behav Med. 1983;6:1–40
  22. Cason CL, Russell DG, Fincher SB. Preparatory sensory information for cardiac catheterization. Cardiovasc Nurs. 1992;28:41–45
  23. Creamer-Bauer C, Webber M. Patient teaching strategies for peripheral laser procedures. Prog Cardiovasc Nurs. 1990;2:50–58
  24. Gordon DA, Terdal L, Sterling E. The use of modeling and desensitization in the treatment of a phobic child patient. J Dent Child. 1974;22:102–105
  25. Hartfield MT, Cason CL, Cason GJ. Effects of information about a threatening procedure on patients' expectations and emotional distress. Nurs Res. 1981;31:202–206
  26. Johnson JE. Effects of structuring patients' expectations on their reactions to threatening events. Nurs Res. 1972;21:499–503
  27. Johnson JE. Effects of accurate expectations about sensations on the sensory and distress components of pain. J Person Soc Psych. 1973;27:261–275
  28. Johnson JE, Morrissey JF, Leventhal H. Psychological preparation for an endoscopic examination. Gastrointest Endosc. 1973;19:180–182
  29. Johnson JE, Rice VH. Sensory and distress components of pain: implications for the study of clinical pain. Nurs Res. 1974;23:203–209
  30. Johnson JE, Kirchoff KT, Endress MP. Altering children's distress behavior during orthopedic cast removal. Nurs Res. 1975;24:404–410
  31. Johnson JE, Fuller SS, Endress MP, Rice VH. Altering patients' responses to surgery: an extension and replication. Res Nurs Health. 1978;1:111–121
  32. Johnson JE, Rice VH, Fuller SS, Endress MP. Sensory information, instruction in a coping strategy, and recovery from surgery. Res Nurs Health. 1978;1:4–17
  33. Kendall PC, Williams L, Pechacek TF, Graham LE, Sisslak C, Herzoff N. Cognitive-behavioral and patient education interventions in cardiac catheterization procedures: the Palo Alto medical psychology project. J Consult Clin Psychol. 1979;47:49–58
  34. Kendall PC, Watson D. Psychological preparation for stressful medical procedures. In:  Prokop CK,  Bradley LA editor. Medical psychology: contributions to behavioral medicine. New York: Academic Press; 1981;p. 197–221
  35. Kendall PC. Stressful medical procedures: cognitive-behavioral strategies for stress management and prevention. In:  Meichenbaum D,  Jaremko ME editor. Stress reduction and prevention. New York: Plenum; 1983;p. 159–190
  36. Lindeman CA, Van Aerman B. Nursing intervention with the presurgical patient—the effects of structured and unstructured preoperative teaching. Nurs Res. 1971;20:319–332
  37. McHugh NG, Christman NJ, Johnson JE. Preparatory information: what helps and why. Am J Nurs. 1982;82:780–782
  38. Melamed BG, Siegel LJ. Reduction of anxiety in children facing hospitalization and surgery by use of filmed modeling. J Consult Clin Psychol. 1975;4:511–521
  39. Melamed BG, Hawes RR, Heiby E, Glick J. Use of filmed modeling to reduce uncooperative behavior of children during dental treatment. J Dent Res. 1975;54:797–801
  40. Melamed BG, Yurcheson R, Fleece EL, Hutcherson S, Hawes RR. Effects of film modeling on the reduction of anxiety-related behaviors in individuals varying in level of previous experience in the stress situation. J Consult Clin Psychol. 1978;6:1357–1367
  41. Melamed BG, Siegel LJ. Psychological preparation for hospitalization. In:  Melamed BG,  Siegel LJ editor. Behavioral medicine: practical applications in health care. New York: Springer; 1980;p. 307–355
  42. Scheinblum ST. Film modeling: reducing student anxiety. Nurs Educ. 1987;12:20–23
  43. Shipley RH, Butt JH, Horwitz B, Fabry JE. Preparation for a stressful medical procedure: effects of stimulus preexposure and coping style. J Consult Clin Psychol. 1978;46:499–507
  44. Watkins LD, Weaver L, Odegaard V. Preparation for cardiac catheterization: tailoring the content of the instruction to coping style. Heart Lung. 1986;15:382–389
  45. Zeimer MM. Effects of information on postsurgical coping. Nurs Res. 1983;32:282–287
  46. Taylor Smith P, Cason CL. Suitability of patient education materials for cardiac catheterization. Clin Nurs Spec. 1998;12:140–144
  47. In:  Bulechek GM,  McCloskey JC editor. Nursing interventions: essential nursing treatments. 2nd ed.. Toronto, Canada: Saunders; 1992;
  48. Davis TMA, Maguire TO, Haraphongse M, Schaumberger MR. Undergoing cardiac catheterization: the effects of informational preparation and coping style on patient anxiety during the procedure. Heart Lung. 1994;23:140–150
  49. Davis TMA, Maguire TO, Haraphongse M, Schaumberger MR. Preparing adult patients for cardiac catheterization: informational treatment and coping style interactions. Heart Lung. 1994;23:130–139
  50. Johnson JE. The influence of purposeful nurse-patient interaction on the patients' postoperative course. In: Exploring progress in medical-surgical nursing practice. New York: American Nurses' Association; 1966;p. 1–92
  51. Dumas G, Leonard RC. The effect of nursing on the incidence of postoperative vomiting. Nurs Res. 1963;12:12–15
  52. Elms RR, Leonard RC. Effects of nursing approaches during admission. Nurs Res. 1966;15:39–48
  53. MaHaffy PR. The effects of hospitalization on children admitted for tonsillectomy and adenoidectomy. Nurs Res. 1965;14:12–19
  54. Schachter S, Singer JE. Cognitive, social, and physiological determinants of emotional state. Psychol Rev. 1962;69:379–399
  55. Nisbett RE, Schachter S. Cognitive manipulation of pain. J Exp Soc Psychol. 1966;2:227–236
  56. Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the state-trait anxiety inventory (form y). In: Palo Alto (CA): Consulting Psychologists Press; 1983;p. 1–36
  57. In:  Spielberger CD editors. Anxiety: current trends in theory and research. 7th ed.. Conceptual and methodological issues in anxiety research. New York: Academic Press; 1972;p. 481–493
  58. Cardiac catheterization: a patient's story. Squibb Diagnostics; 1988; [videotape]
  59. In: Understanding cardiac catheterization and coronary angiography. Dale City (CA): Krames Communications; 1987;p. 1–8
  60. Braun LT, Murphy MP, Carlson EV. Coronary artery disease. In:  Kinney MR,  Packa DR,  Andreoli KG,  Zipes DP editor. Comprehensive cardiac care. 7th ed.. St. Louis (MO): Mosby Year Book; 1991;p. 253–269
  61. Murdaugh CL. The person with coronary artery disease risk factors. In:  Guzzetta CE,  Dossey BM editor. Cardiovascular nursing: holistic practice. St. Louis (MO): Mosby Year Book; 1992;p. 197–219
  62. Rankin SH. Differences in recovery from cardiac surgery: a profile of male and female patients. Heart Lung. 1990;19:481–485
  63. Moser DK. Correcting misconceptions about women and heart disease. Am J Nurs. 1997;97:26–33
  64. Hill EM. Perioperative management of patients with vascular disease. AACN Clin Issues. 1995;6:547–561
  65. Eagle KA, Rihal CS, Foster ED, Mickel MC, Gersh BJ. Long-term survival in patients with coronary artery disease: importance of peripheral vascular disease. J Am Coll Cardiol. 1994;23:1091–1095
  66. Schueppert MT, Kresowik TF, Corry DC, Jacobovicz C, Mohan CR, Slaymaker E, et al.  Selection of patients for cardiac evaluation before peripheral vascular operations. J Vasc Surg. 1996;23:802–808
  67. Bacharach JM, Marwick TH. Association of coronary artery disease with peripheral vascular disease. In:  Young JS,  Olin JW,  Bartholomew JR editor. Peripheral vascular diseases. 2nd ed.. St. Louis (MO): Mosby Year Book; 1996;p. 250–260
  68. Smith GD, Shipley MJ, Rose G. Intermittent claudication, heart disease risk factors, and mortality: the Whitehall study. Circulation. 1990;82:1925–1931
  69. Kannel WB, Skinner JJ, Schwartz M, Shurtleff D. Intermittent claudication: incidence in the Framingham study. Circulation. 1970;41:875–883
  70. Kannel WB, McGee DL. Update on some epidemiologic features of intermittent claudication: the Framingham study. J Am Geriatr Soc. 1985;33:13–18
  71. Criqui MH, Fronek A, Klauber MR, Barrett-Conner E, Gabriel S. The sensitivity, specificity and predictive value of traditional clinical evaluation of peripheral arterial disease: results from noninvasive testing in a defined population. Circulation. 1985;71:516–522
  72. Herbert LM. Assessment of the vascular patient. In:  Herbert LM editors. Caring for the vascular patient. New York: Churchill Livingstone; 1997;p. 83–110
  73. Auerbach SM. Trait-state anxiety and adjustment to surgery. J Consult Clin Psychol. 1973;40:264–274

PII: S1062-0303(99)90028-6

Journal of Vascular Nursing
Volume 17, Issue 2 , Pages 41-49, June 1999