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Psychological problems in patients awaiting coronary angiography: a preliminary study/Koroner anjiyografiyi bekleyen hastalarda psikolojik problemler: bir on calisma.

Coronary angiography (CA) is the gold standard for diagnosis of coronary artery disease (CAD) (1, 2). Currently, in many centers in Iran CA has become a main diagnostic procedure for diagnosis of CAD (1). CA is very stressful procedure for most patients (3). Patients experience psychological problems and consequently hemodynamic instability in response to an invasive CA (2, 4). Many studies investigated patients' anxiety before CA and used of interventions to reduce this problem (3, 5), but assessment of stress, anxiety and depression of patients awaiting elective CA in our country has not yet been investigated.

The present study is a descriptive cross sectional study conducted in southeast Iran. From January to April 2009, patients aged 25 to 75 years, free of known psychiatric disorders, without history of previous CA and free of taking psychotropic drugs recruited for this study. After admission to the ward, the purpose of the study was explained. In addition, informed written consent form was completed by all the patients. Psychological variables as stress, anxiety and depression were collected by interview. The depression, anxiety, stress scale -21 (DASS-21) was used for assessment of psychological problems. This tool is a widely used scale for measuring depression, anxiety and stress in adults (4). For analysis of data, frequencies, mean and standard deviation were reported. Chi-square test and correlation coefficient test were performed to comparison of DAS based on sex, job, marital status and other demographic data. The level of significance was set at <0.05.

The mean and standard deviation age of 128 patients included in this preliminary study was 53.23 (SD=9.51). In the assessment of psychological variables, the results of this preliminary study showed that the abnormal levels of stress, anxiety and depression in patients awaiting CA were 97.6% (40.6% moderate, 57.0% severe), 66.4% anxiety (55.5% moderate, 10.9% severe) and 20.3%, respectively.

The differences between the levels of anxiety and stress in male and female was statistically significant (p=.000) and stress (p=.04). Also, a statistically significant was seen between marital status and anxiety level (p=.000).

The findings of this preliminary study showed that the patients awaiting elective CA experienced higher levels of psychological problems. In other studies results showed that the anxiety and stress of patients before CA was high (3, 5). Harkness et al. (6) concluded that waiting for cardiac catheterization can cause anxiety of patients. In a qualitative study by Beckerman et al. (7), anxiety of patients before cardiac catheterization was related to physical discomfort and fear. Anxiety of patients waiting for CA may be related to lack of knowledge and uncertainty (8). In this study, we assessed the levels of psychological variables at the admission time to the wards and most of the patients were not informed about the procedure of CA.

It is necessary to inform patients waiting for CA about procedure and psychological support for decrease in the levels of anxiety, stress and depression of these patients. The nursing cares before CA should focus on informing and support of patients.


(1.) Rezaei-Adaryani M, Ahmadi F, Asghari-Jafarabadi M. The effect of changing position and early ambulation after cardiac catheterization on patients' outcomes: a single-blind randomized controlled trial. Int J Nurs Stud 2009;46:1047-53.

(2.) Chair SY, Li KM, Wong SW. Factors that affect back pain among Hong Kong Chinese patients after cardiac catheterization. Eur J Cardiovasc Nur 2004; 3:279-85.

(3.) Ruffinengo C, Versino E, Renga G. Effectiveness of an informative video on reducing anxiety levels in patients undergoing elective coronarography: an RCT. Eur J Cardiovasc Nur 2009; 8: 57-61.

(4.) Jamshidi N, Abbaszadeh A, Kalyani MN. Effects of video information on anxiety, stress and depression of patients undergoing coronary angiography. Pak J Med Sci 2009; 25: 901-5.

(5.) Phillipe F, Meney M, Larrazet F, Ben-Abderrazak F, Dibie A, Meziane T, et al. Effects of video information in patients undergoing coronary angiography. Arch Mai Coeur Vaiss 2006; 99: 95-101.

(6.) Harkness K, Morrow L, Smith K, Kiczula M, Arthur HM. The effect of early education on patient anxiety while waiting for elective cardiac catheterization. Eur J Cardiovasc Nur 2003; 2:113-21.

(7.) Beckerman A, Grossman D, Marquez L. Cardiac catheterization: the patients' perspective. Heart Lung 1995; 24: 213-9.

(8.) Uzun S, Vural H, Uzun M, Yokusoglu M. State and trait anxiety levels before coronary angiography. J Clin Nurs 2008; 17: 602-7.

Nahid Jamshidi, Abbas Abbaszadeh [1], Majid Najafi Kalyani [2]

Department of Postgraduate Studies, Fatemeh (P.B.U.H) Nursing & Midwifery School, Shiraz University of Medical Sciences, Shiraz-Iran

[1] Department of Medical-Surgical Nursing, Razi Nursing School, Kerman University of Medical Sciences, Kerman-Iran

[2] Department of Nursing, Fasa University of Medical Sciences, Fasa-Iran

Address for Correspondence/Yazisma Adresi: Dr. Majid Najafi Kalyani Department of Nursing, Fasa University of Medical Sciences Ebn-E-Sina Sq, Fasa-Iran Phone: ????6 E-mail: Available Online Date/Cevrimici Yayin Tarihi: 16.11.2012

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Article Details
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Title Annotation:Letters to the Editor/Editore Mektuplar
Author:Jamshidi, Nahid; Abbaszadeh, Abbas; Kalyani, Majid Najafi
Publication:The Anatolian Journal of Cardiology (Anadolu Kardiyoloji Dergisi)
Article Type:Letter to the editor
Date:Feb 1, 2013
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