The effect of pastoral care services on anxiety, depression, hope, religious coping, and religious problem solving styles: a randomized controlled study.

This randomized controlled study measured the effect of chaplain interventions on coronary artery bypass graft (CABG) patients over time. One hundred sixty-six CABG patients, received pre- and post-surgery testing at 1 month and 6 months with four instruments. Five chaplain visits were made to the intervention group, the control group received none. Comparison scores for anxiety, depression, hope, positive and negative religious coping, and religious coping styles were analyzed. Significant difference was found between groups in positive religious coping (PRC) (p = .023) and negative religious coping (NRC) (p = .046) scores over time. PRC increased in intervention group, decreased in the control group while NRC decreased in intervention group and increased in the control group. Demographics were comparable between groups. Moderate chaplain visits (average total visits time, 44 min) may be effective in helping CABG patients increase positive religious coping and decrease negative religious coping.

Echocardiography in the Emergency Department: From the Perspective of the Emergency Physician and the Cardiologist.

Echocardiography performed in the emergency department must adapt to this new setting for noninvasive diagnostic testing. Emergency physicians require echocardiography to provide rapid diagnosis in life-threatening emergencies. New initiatives are being proposed by emergency physicians in the delivery of this test. Cardiologists now use echocardiography in the emergency department to make the diagnosis of heart disease earlier and with greater accuracy.

Dobutamine Stress Tele-Echocardiography as a Clinical Service in the Emergency Department to Evaluate Patients With Chest Pain.

Patients presenting with chest pain to the emergency department should be efficiently triaged. During our previous research trial, the use of dobutamine stress tele-echocardiography (DSTE) effectively and safely allowed the diagnosis of patients who could be released from the emergency department. To assess the usefulness of DSTE as a clinical service, the protocols, training, and implementation of our experience are reviewed from > 4 years of testing 734 patients in our emergency department. The patient demographics of those tested appeared to remain consistent during the study period. An average of 12.5% of patients who underwent DSTE yielded abnormal results. In addition to myocardial ischemia, numerous cardiac disorders were uncovered. Side effects from DSTE caused the testing to be prematurely discontinued in 3.1% of patients. Within approximately 6 hours of arrival at the emergency department, 70% were discharged after their normal DSTE. DSTE appears to be safe, rapid, and useful in triaging nonstudy patients with chest pain who are of low to moderate risk for myocardial infarction or ischemia.