The effects of multimedia education on anxiety and physiological status among patients with cerebral angiography: A randomized controlled clinical trial

  • Leila Sayadi Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
  • Shokoh Varaei Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
  • Elham Faghihzadeh Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Zahra Ahmadkhani* Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
Keywords: multimedia education, anxiety, physiological status, cerebral angiography

Abstract

Background &Aim: Cerebral angiography is a diagnostic procedure for cerebral disorders, particularly the disorders of cerebral blood vessels. However, as an invasive procedure, it can cause patients anxiety and physiological instability. This study aimed to evaluate the effects of multimedia education on anxiety and physiological status among patients with cerebral angiography. Methods & Materials: This randomized controlled clinical trial was conducted from October 2017 to January 2018 in the angiography unit of a university hospital in Tehran, Iran. Participants were 88 candidates for cerebral angiography who were randomly allocated either to an intervention (n = 44) or a control (n= 44) group. Patients in the intervention group were provided with at least thirty-minute multimedia education consisted of video-based education, verbal education, written materials (an educational booklet), and question and answer. Data on participants’ personal characteristics were collected before the intervention, while their state anxiety was assessed before multimedia education and after cerebral angiography via Spielberger State Anxiety Inventory. Moreover, participants’ physiological parameters were measured and documented in a data sheet before and every two hours after angiography up to their discharge from the angiography unit. The independent-sample t, Chi-square, and McNemar’s tests and the Generalized Estimation Equation were used for data analysis. Results: After the intervention, 95.5% of patients in the intervention group and 86.4% in the control group had low level of anxiety; however, the between-group difference was not statistically significant (P > 0.05). Moreover, anxiety level changed significantly neither in the intervention (P > 0.05) nor in the control (P > 0.05) group. In addition, after adjusting the effects of participants’ age, there were no significant between-group differences respecting the means of systolic blood pressure, the means of body temperature, peripheral oxygen saturation, and respiratory rate. However, the means of diastolic blood pressure and heart rate in the intervention group were significantly lower than the control group, irrespective of the effects of participants’ age. Conclusion: Multimedia education has no significant effects on state anxiety but has significant effects on diastolic blood pressure and heart rate among patients with cerebral angiography.

Author Biographies

Leila Sayadi, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
Assistant Professor
Shokoh Varaei, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
Assistant Professor
Elham Faghihzadeh, Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
PhD Candidate of Biostatistics
Zahra Ahmadkhani*, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
Ms Student, Medical Surgical Department

References

Sawiris N, Venizelos A, Ouyang B, Lopes D, Chen M. Current utility of diagnostic catheter cerebral angiography. Journal of Stroke and Cerebrovascular Diseases. 2014;23(3):e145-e50.

Lee SY, Lee KS. Effects of Information Provision on Anxiety, Blood Pressure & and Pulse in Cerebral Angiography Clients. Journal of Korean Biological Nursing Science. 2016;18(4):280-7.

Lundén M, Lundgren SM, Persson L-O, Lepp M. Patients' feelings and experiences during and after peripheral percutaneous transluminal angioplasty. Radiography. 2015;21(1):e9-e15.

Cho M-Y, Min ES, Hur M-H, Lee MS. Effects of aromatherapy on the anxiety, vital signs, and sleep quality of percutaneous coronary intervention patients in intensive care units. Evidence-Based Complementary and Alternative Medicine. 2013;2013, Article ID 381381.

Khayyam Nekouei Z, Yousefy A, Nickneshan S. Comparing anxiety in cardiac patients candidate for angiography with normal population. ARYA Atheroscler. 2011;7(2):93-6.

Shahmari M, Dashti S, Ameli S, Khalilzadeh S, Hosseinian A. Effect of Video Education in Native Language on Vital Signs Caused by Anxiety in Coronary Angiography Patients. Journal of Ardabil University of Medical Sciences. 2016;16(3):241-50.

Demircelik MB, Cakmak M, Nazli Y, Şentepe E, Yigit D, Keklik M, et al. Effects of multimedia nursing education on disease-related depression and anxiety in patients staying in a coronary intensive care unit. Applied Nursing Research. 2016;29:5-8.

West-Gavin J. The Anxiolytic Effects of Self-Selected Music Among Primary Care Patients. PCOM PsychologyDissertations. Doctor of Psychology .2015; P331.

Ferreira NdC, Ramalho EdS, Lopes JdL. Non-pharmacological strategies to decrease anxiety in cardiac catheterization: integrative review. Revista Brasileira de Enfermagem. 2015;68:1093-102.

Zengin S, Kabul S, Al B, Sarcan E, Doğan M, Yildirim C. Effects of music therapy on pain and anxiety in patients undergoing port catheter placement procedure. Complementary therapies in medicine. 2013;21(6):689-96.

Jlala H, French J, Foxall G, Hardman J, Bedforth N. Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia. British journal of anaesthesia. 2010;104(3):369-74.

Foji S, Tadayonfar MA, Mohsenpour M, Rakhshani MH. The study of the effect of guided imagery on pain, anxiety and some other hemodynamic factors in patients undergoing coronary angiography. Complementary Therapies in Clinical Practice.21(2):119-23.

Zainali M, Asadpour M, Aghamolaei T, Esmaeili Nadimi A, Farshidi H, Ghanbarnejad A. Effect of educational intervention based on health belief model to promote preventive behaviors of cardiovascular disease in people with normal angiographic results. Journal of Preventive Medicine 2015; 1(2):1-12.

Wu KL, Chen SR, Ko WC, Kuo SY, Chen PL, Su HF, et al. The effectiveness of an accessibility‐enhanced multimedia informational educational programme in reducing anxiety and increasing satisfaction of patients undergoing cardiac catheterisation. Journal of clinical nursing. 2014;23(13-14)2063-2073.

Tipotsch-Maca SM, Varsits RM, Ginzel C, Vecsei-Marlovits PV. Effect of a multimedia-assisted informed consent procedure on the information gain, satisfaction, and anxiety of cataract surgery patients. Journal of Cataract & Refractive Surgery. 2016;42(1):110-6.

Schofield P, Jefford M, Carey M, Thomson K, Evans M, Baravelli C, et al. Preparing patients for threatening medical treatments: effects of a chemotherapy educational DVD on anxiety, unmet needs, and self-efficacy. Supportive Care in Cancer. 2008;16(1):37-45.

Sørlie T, Busund R, Sexton J, Sexton H, Sørlie D. Video information combined with individualized information sessions: Effects upon emotional well-being following coronary artery bypass surgery—A randomized trial. Patient Education and Counseling. 2007;65(2):180-8.

Ayasrah SM, Ahmad MM. Educational Video Intervention effects on Periprocedural Anxiety Levels among Cardiac Catheterization Patients: A Randomized Clinical Trial. Research and theory for nursing practice. 2016;30(1):70-84.

Steffenino G, Viada E, Marengo B, Canale R. Effectiveness of video-based patient information before percutaneous cardiac interventions. Journal of Cardiovascular Medicine. 2007;8(5):348-53.

Jamshidi N, Abbaszadeh A, Kalyani MN, Sharif F. Effectiveness of video information on coronary angiography patients’ outcomes. Collegian. 2013;20(3):153-9.

Vanderboom TL, Arcari PM, Duffy ME, Somarouthu B, Rabinov JD, Yoo AJ, et al. Effects of a music intervention on patients undergoing cerebral angiography: a pilot study. Journal of neurointerventional surgery. 2011: neurintsurg-2011-010052.

Spielberger CD, Gonzalez-Reigosa F, Martinez-Urrutia A, Natalicio LF, Natalicio DS. Development of The Spanish Edition of the State-Trait Anxiety Inventory. Interamerican Journal of psychology. 1971; 5(3-4):145-158.

Cohen J. Statistical power analysis for the behavioral sciences. 1988. editor: Hillsdale, NJ: Lawrence Earlbaum Associates; 1988.

Cakmak M, Kose I, Zinzircioglu C, Karaman Y, Tekgul ZT, Pektas S, et al. Effect of video-based education on anxiety and satisfaction of patients undergoing spinal anesthesia. Revista Brasileira de Anestesiologia. 2018;68(3):274-9.

Habibzadeh H, Milan ZD, Radfar M, Alilu L, Cund A. Effects of Peer-Facilitated, Video-Based and Combined Peer-and-Video Education on Anxiety Among Patients Undergoing Coronary Angiography: Randomised controlled trial. Sultan Qaboos University Medical Journal. 2018;18(1):e61-e7.

Gerity SL, Silva SG, Reynolds JM, Hoffman B, Oermann MH. Multimedia Education Reduces Anxiety in Lung Transplant Patients. Progress in Transplantation. 2018;28(1):83-6.

Astley CM, Chew DP, Aylward PE, Molloy DA, De Pasquale CG. A randomised study of three different informational AIDS prior to coronary angiography, measuring patient recall, satisfaction and anxiety. Heart, Lung and Circulation. 2008;17(1):25-32.

S. YL, R. C, A. BM, S. GD, C. LMTDP. Prevalence of anxiety in patients awaiting diagnostic procedures in an oncology center in Brazil. Psycho-Oncology. 2011;20(11):1242-5.

Rejeh N, Heravi-Karimooi M, Tadrisi SD, Jahani A, Vaismoradi M, Jordan S. The impact of listening to pleasant natural sounds on anxiety and physiologic parameters in patients undergoing coronary angiography: A pragmatic quasi-randomized-controlled trial. Complementary Therapies in Clinical Practice. 2016;25:42-51.

Published
2018-10-07
How to Cite
1.
Sayadi L, Varaei S, Faghihzadeh E, Ahmadkhani* Z. The effects of multimedia education on anxiety and physiological status among patients with cerebral angiography: A randomized controlled clinical trial. NPT. 5(4):375-84.
Section
Original Article(s)