Evaluating anxiety in elective coronary angiography study: rationale, design, and study methodology

Investigating the Effect of Singing Bowl Sound on the Level of State-trait Anxiety and Physiological Variables of Patients Awaiting Angiography

PURPOSE

Many patients are anxious and fearful while waiting for angiography, which may negatively affect the performance of this test and their physiological variables. The aim of this study was to investigate the effect of singing bowl sounds on situational anxiety and physiological variables of patients awaiting angiography.

DESIGN

A semiexperimental pretest and post-test study.

METHODS

This semiexperimental pretest and post-test study with 2 groups was conducted from October 2022 to March 2023 in 60 patients (30 in the intervention group and 30 in the control group) awaiting angiography at the Angiography Department of Rouhani Hospital, affiliated with Babol University of Medical Sciences. One hour before angiography, the intervention group received the singing bowl intervention in addition to routine departmental interventions, whereas the control group received only routine departmental interventions. The State-Trait Anxiety Inventory Form Y-1 was used to measure anxiety.

FINDINGS

State-trait anxiety after the intervention was significantly lower in the intervention group than in the control group (P = .00). Systolic and diastolic blood pressure, pulse rate, and respiration were the same in the intervention and control groups before and after the intervention and showed no statistically significant difference (P > .05).

CONCLUSIONS

The results indicated that the singing bowl intervention led to an improvement in anxiety in patients waiting for angiography. Considering that this intervention was performed with a simple, cheap, and accessible instrument, it is therefore suggested that this method be used to reduce state-trait anxiety in clinical anxiety-provoking conditions. Since the physiological variables of the patients before and after the intervention showed no statistically significant difference in both groups, it is suggested that the physiological variables should be investigated in future studies and several clinical situations so that a scientific opinion on the effect of the singing bowl on these variables can be given with more certainty.

The impact of the stress hyperglycemia ratio on the risk of contrast-associated acute kidney injury in patients undergoing coronary angiography: a large real-world cohort study

BACKGROUND

Contrast-associated acute kidney injury (CA-AKI) is an important complication in the perioperative period of coronary angiography (CAG). Dysglycemia is closely associated with the occurrence of CA-AKI. However, the association between stress hyperglycemia and CA-AKI in patients undergoing CAG remains unclear. The study aims to investigate the association of the stress hyperglycemia ratio (SHR) and CA-AKI under CAG in a large real-world cohort.

METHODS

This was a retrospective observational study, and patients undergoing CAG were enrolled. SHR is calculated by dividing the random blood glucose with the estimated average glucose derived from the glycosylated hemoglobin (HbA1c), and subjects were divided into five groups according to SHR. The outcome was CA-AKI defined as an increase in serum creatinine of ≥ 0.3 mg/dL (26.5 μmol/L) or 1.5-fold higher than normal levels in 48 h. The association was assessed with logistic regression and restricted cubic spline analysis.

RESULTS

In 19,965 participants (men: 73.3%, mean age: 63.1 ± 10.8 years) undergoing CAG, a total of 1,621 CA-AKI cases occurred. There were reverse J-shaped associations between the SHR and CA-AKI after adjustment for other confounding factors. Moreover, SHR improved the predictive effectiveness of the traditional Mehran score (AUC 0.65 vs 0.63, P < 0.001), a predictive model of CA-AKI in patients undergoing percutaneous coronary intervention.

CONCLUSIONS

There were reverse J-shaped associations of SHR with CA-AKI risk among patients undergoing CAG, and the assessment of SHR before CAG may assist clinicians in identifying patients at higher risk of CA-AKI.

Effectiveness of virtual reality on pain and anxiety in patients undergoing cardiac procedures: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Cardiac procedures often induce pain and anxiety in patients, adversely impacting recovery. Pharmachological approaches have limitations, prompting exploration of innovative digital solutions like virtual reality (VR). Although early evidence suggests a potential favourable benefit with VR, it remains unclear whether the implementation of this technology can improve pain and anxiety. We aimed to assess by a systematic review and meta-analysis the effectiveness of VR in alleviating anxiety and pain on patients undergoing cardiac procedures.

METHODS

Our study adhered to the PRISMA method and was registered in PROSPERO under the code CRD42024504563. The search was carried out in the PubMed, Web of Science, Scopus, and the Cochrane Library databases in January 2024. Four randomized controlled trials were included (a total of 382 patients). Risk of bias was employed to assess the quality of individual studies, and a random-effects model was utilized to examine the overall effect.

RESULTS

The results showed that VR, when compared to the standard of care, had a statistically significant impact on anxiety (SMD = -0.51, 95 % CI: -0.86 to -0.16, p = 0.004), with a heterogeneity I2 = 57 %. VR did not show a significant difference in terms of pain when compared to standard care (SMD= -0.34, 95 % CI: -0.75 to -0.07, p = 0.10). The included trials exhibited small sample sizes, substantial heterogeneity, and variations in VR technology types, lengths, and frequencies.

CONCLUSIONS

VR effectively lowers anxiety levels in patients undergoing cardiac procedures, however, did not show a statistically significant difference on pain.

Psychometric Properties of the Slovenian Version of the Cardiac Depression Scale

Introduction

The aim of this study was to translate the Cardiac Depression Scale into the Slovenian language and test its validity and reliability on Slovenian patients with heart disease.

Methods

A total of 272 patients with heart disease who underwent elective coronary angiography at Celje General Hospital participated in this study. We used the Slovenian Cardiac Depression Scale (S-CDS), the Spielberger State Anxiety Inventory (STAI-S), and the Center for Epidemiologic Studies Depression Scale-20 (CES-D) to collect data. An exploratory and confirmatory factor analysis, internal consistency, test-retest reliability, and concurrent validity were performed.

Results

Cronbach's alpha for the total scale was 0.92 and the test-retest reliability was 0.71. Exploratory factor analysis confirmed six factors, accounting for 61% of the total variance. The confirmatory factor analysis indicated that a two- and one-factor solution had acceptable goodness-of-fit measures. However, we kept a more parsimonious one-factor method, given a high correlation between the two factors and the theoretical background in previous studies. Concurrent validation against the CES-D and the STAI-S showed moderate to strong correlations.

Conclusions

The S-CDS is a reliable and valid instrument for screening for depression in Slovenian patients with heart disease.