Angiography: From a patient's perspective.

In critical care, nurses are expected to react quickly to urgent and emergent situations. It is imperative that nurses have the ability to recognize signs and symptoms in patients that require diagnostic intervention. This article begins with a brief description of angiography and its role in the critical care environment. This is followed by a description and comparison of several modalities used to evaluate the cerebral and carotid vessels. A related case study, from a patient's perspective, provides the context for this discussion.

A music intervention to reduce anxiety before vascular angiography procedures.

Patients scheduled for vascular angiography are often anxious and frightened. High levels of anxiety may result in more difficult and painful procedures. Past research has reported mixed results for anxiety reduction techniques in other procedures settings, such as education, cognitive-behavioral skills, coping and relaxation skills, combinations of techniques, and music. Music as an intervention for pre-procedural anxiety prior to vascular angiography has not been studied. A randomized controlled trial of 170 patients was undertaken to determine whether 15 minutes of self-selected music reduced pre-procedure anxiety. The State Trait Anxiety Inventory was used to measure patients' anxiety. One-hundred sixty-six men and 4 women comprised the sample with an average age of 66.8 years (SD 9.95, range 37 to 85 years). Patients who listened to music (n=89) reduced their anxiety score from 38.57 (SD 10.46) to 35.2 (SD 9.7), while those who did not listen to music (n=81) reduced their anxiety score from 36.23 (SD 10.54) to 35.1 (SD 10.59); the difference between the groups was statistically significant (t=1.95, df 161, p=0.05). Pulse achieved a statistically significant reduction in the music group (t=2.45, df 167, p=0.02). Music is a noninvasive nursing intervention that patients enjoy and reduces their anxiety and their pulse rate. Further research should address using music to reduce anxiety in other interventional vascular angiography settings with equal numbers of men and women and comparing self-selected versus investigator-selected music.

[Informed consent for angiography and endovascular treatment]. / Informacje dla chorego i zgoda na badanie angiograficzne lub zabieg wewnatrznaczyniowy.

The aim of this paper was to evaluate the methods of passing information concerning angiography and endovascular treatment from doctors to patients. Patients undergoing modern procedures are especially prone to anxiety or even panic caused by the lack of sufficient information about the planned procedure. There are many reasons for such phenomena. One of them is extremely fast improvement of new, sophisticated technology and lack of humane attitude to patients. Authors examined 60 patients before and after angiography and endovascular treatment. Most of them (92%) knew nothing about the procedures. 30% of the patients gained information from other patients. After angiography and endovascular treatment most of patients assessed the procedures as less dangerous than expected. Our questionnaire is attached to this paper.

MR and conventional angiography: work in progress toward assessing utility in radiology.

RATIONALE AND OBJECTIVES: The authors assessed health-related quality of life changes associated with peripheral x-ray angiography and magnetic resonance (MR) angiography. MATERIALS AND METHODS: Utility (the desirability or preference that individuals exhibit for a particular health state) was assessed in 30 patients with peripheral vascular disease referred for angiography by using a rating scale, additional categoric scaling questions to separate preference from experience, a willingness-to-pay technique, functional and cognitive status questions, and a time trade-off technique. All patients underwent both MR angiography and x-ray angiography. RESULTS: Patients reported significantly (P < .05) less anxiety after the test, less pain after the test, fewer new physical limitations, and less effect on performance of daily activities with MR angiography. Findings from the overall rating scale and categoric scaling questions also significantly (P < .05) favored MR angiography. Patients were willing to pay a mean of 2.12% of annual income to avoid MR angiography and a mean of 7.41% to avoid x-ray angiography. The median quality-adjusted life gain required by patients to undergo the procedures was 52.5-60 days for x-ray angiography and 10.5 days for MR angiography, without discounting. CONCLUSION: X-ray angiography has more profound short-term adverse effects on life than does MR angiography. Preference-based measures can be adapted to elicit patient values for short-term health states as seen in radiology.

Relaxation response in femoral angiography.

Immediately before they underwent femoral angiography, 45 patients were given one of three types of audiotapes: a relaxation response tape recorded for this study, a tape of contemporary instrumental music, or a blank tape. All patients were instructed to listen to their audiotape during the entire angiographic procedure. Each audiotape was played through earphones. Radiologists were not told the group assignment or tape contents. The patients given the audiotape with instructions to elicit the relaxation response (n = 15) experienced significantly less anxiety (P less than .05) and pain (P less than .001) during the procedure, were observed by radiology nurses to exhibit significantly less pain (P less than .001) and anxiety (P less than .001), and requested significantly less fentanyl citrate (P less than .01) and diazepam (P less than .01) than patients given either the music (n = 14) or the blank (n = 16) control audiotapes. Elicitation of the relaxation response is a simple, inexpensive, efficacious, and practical method to reduce pain, anxiety, and medication during femoral angiography and may be useful in other invasive procedures.

[Informing angiography patients. Results of a survey and critical comments]. / Aufklärung von Angiographiepatienten. Ergebnisse einer Umfrage und kritische Anmerkungen.

100 patients subjected to angiography have been interviewed about their knowledge of the previous diagnostic procedure. The group having cerebral angiography keeps more details and risks in mind than a group having an angiography of the limbs. No patient regards the informed consent as an unnecessary affair and the majority expects to be examined by the informing physician. The radiologist therefore has the opportunity to establish a trustful relationship to the patient and to master his roll as a physician.

Developing a sensation information message for femoral arteriography.

Sensation information is proposed as a way of decreasing the patient's distress during a threatening health care event. A first step in developing a sensation information message is to determine the content of the message. This study, using a systematic theory-based methodology, was conducted to describe and validate the common physical sensations experienced by patients undergoing the diagnostic procedure of femoral arteriography. (A conceptual framework based on how an individual perceives or senses a situation was used.) A three-stage survey design was used including: (1) tool development following observation of the procedure and pilot-testing of the interview schedule, (2) interview of patients who had undergone femoral arteriography about the sensations experienced during the procedure, and (3) validation of the responses. Twenty-one steps in the femoral arteriography procedure of which patients were aware were identified. Nine 'feeling' sensations commonly experienced during the procedure and the sights and sounds associated with the procedure were determined. The sequencing and duration of procedure steps were observed and the environment in which the procedure was performed was described.