Prevalence and impact of scan-related anxiety during coronary CT angiography: A prospective cohort study of 366 patients

Ohana, Mickaël; Sellers, Stephanie; Mooney, John; Kueh, Shaw-Hua; Grover, Rominder; Arepalli, Chesnal; Selvakumar, Kapilan; Kim, Ung; Blanke, Philipp; Leipsic, Jonathon

doi:10.1016/j.jcct.2018.04.013

Cited by 11 publications

(12 citation statements)

References 26 publications

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“…A prospective study of coronary computed tomographic angiography showed mild test-related anxiety. 21 Our results advance previous findings by measuring testing burden using a scale specifically developed to assess the burden of diagnostic imaging tests. Furthermore, we measured the full experience associated with testing, including temporal effects and isolation of anxiety from physical discomfort.…”

Section: Jama Network Open | Imagingsupporting

confidence: 80%

Patient-Reported Testing Burden of Breast Magnetic Resonance Imaging Among Women With Ductal Carcinoma In Situ

et al. 2021

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IMPORTANCEThe use of magnetic resonance imaging (MRI) in pretreatment planning of ductal carcinoma in situ (DCIS) remains controversial. Understanding changes in short-term health-related quality of life associated with breast MRI would allow for a more complete comparative effectiveness assessment. OBJECTIVE To assess whether there are changes in patient-reported quality of life associated with breast MRI among women diagnosed with DCIS. DESIGN, SETTING, AND PARTICIPANTS This cohort study was a substudy of a nonrandomized clinical trial conducted at 75 participating US institutions from March 2015 to April 2016. Women recently diagnosed with unilateral DCIS who were eligible for wide local excision and had a diagnostic mammogram within 3 months of study registration were included. A total of 355 women met the eligibility criteria and underwent the study MRI. Data analysis was performed from June 3, 2020, to July 1, 2021.EXPOSURES Participants underwent bilateral breast MRI within 30 days of study registration and before surgery. Information on patient-reported testing burden for breast MRI was collected after MRI and before surgery. MAIN OUTCOMES AND MEASURESThe primary outcome of this substudy was the patientreported testing burden of breast MRI, measured by the Testing Morbidities Index (TMI) summated scale score. The TMI is a 7-item instrument that evaluates the temporary changes in quality of life associated with imaging before, during, and after the test (0 represents the worst possible, 100 the hypothetical ideal test experience). RESULTSOf the 355 women who met the eligibility criteria, 244 (69%) completed both questionnaires and were included in this analysis. The median age was 59 years (range, 34-85 years).The mean MRI TMI summated scale score was 85.9 (95% CI, 84.6-87.3). Of the 244 women, 142 (58%) experienced at least some fear and anxiety before the examination, and 120 women (49%) experienced fear and anxiety during the examination. A total of 156 women (64%) experienced pain or discomfort during the examination. In multivariable analyses, greater test-related burden was associated with higher levels of cancer worry (regression coefficient, −2.75; SE, 0.94; P = .004). CONCLUSIONS AND RELEVANCEIn this cohort study, a clinically meaningful breast MRI testing burden among women with DCIS was revealed that was significantly associated with cancer worry.Understanding the potential quality-of-life reduction associated with MRI, especially when used in (continued) Key Points Question Is there a short-term reduction in health-related quality of life associated with breast magnetic resonance imaging (MRI) in patients with ductal carcinoma in situ? Findings In this cohort study of 244 women diagnosed with ductal carcinoma in situ, a short-term reduction in quality of life associated with MRI was revealed, primarily owing to fear before the test and fear and physical discomfort during the test. Meaning Understanding the potential reduction in quality of life associated with MRI in patients with ductal carcin...

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Section: Jama Network Open | Imagingsupporting

confidence: 80%

Patient-Reported Testing Burden of Breast Magnetic Resonance Imaging Among Women With Ductal Carcinoma In Situ

et al. 2021

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“…From the start of a CCTA appointment to the end of the examination, inpatients with decreased quality of life are faced with an unfamiliar environment, crowded examination lines, heart rate detection, indentor of intravenous needles, and pre-examination notifications, all of which can make them feel nervous. It was reported that 74.1% of patients experienced a degree of inspection anxiety (Ohana et al, 2018). CCTA is also associated with depression (Sun et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Clinical Application Value of Multimedia Education and Nursing Intervention in a Coronary Computed Tomography Angiography

et al. 2022

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To explore the application value of multimedia education and nursing intervention in a coronary computed tomography angiography (CCTA). A total of 120 patients who underwent a 256-slice spiral CCTA examination in our hospital from April 2019 to April 2020 were selected. Patients were divided into two groups of 60 patients each, that is, the control group and the observation group, using a random number table method. The control group received traditional education before an examination, and patients were given routine breathing training. The observation group was given multimedia education and nursing intervention. The heart rate (HR), diastolic blood pressure (DBP), systolic blood pressure (SBP), and respiratory rate in the two groups were observed. The psychological status, imaging quality, and incidence of adverse reactions were compared between the two groups. The HR, DBP, SBP, and respiratory rate of the observation group were all lower compared to those in control group, and the differences were statistically significant ( p < 0.05). Following multimedia education and nursing intervention, the anxiety and depression scores of patients in the observation group were considerably lower compared with those in the control group, and the differences were statistically significant ( p < 0.05). Observation group image quality I level higher than the control group, and the proportion of patients with the difference was statistically significant ( p < 0.05). The proportion of grade II to IV patients was lower in the observation group than in the control group; however, the difference was not statistically significant ( p > 0.05). There was a significant difference in the incidence of adverse reactions between the two groups (χ2, p = .031). For patients undergoing a CCTA examination, multimedia education and nursing intervention can effectively improve their immediate psychological state, control their heart rate, and blood pressure before the examination, reduce the incidence of adverse reactions and improve imaging quality, thereby improving the overall reliability of a clinical diagnosis.

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“…This study also showed that using the 360°VCE may relieve patients' fears of needles, cannulation and examination results, as well as feelings of claustrophobia, which commonly arise before medical imaging procedures [7][8][9][10][11][12]14 . Females, younger patients and those with a higher education level may particularly require more counselling with alternative methods, such as 360° environments or videos.…”

Section: Discussionmentioning

confidence: 66%

“…The patient's heart rate is also reduced with medication to reduce motion artifacts [3][4][5] , but if an irregular or high heart rhythm may persists cCTA may not provide sufficiently diagnostic images, or it may lead to increase of the dose 6 . Problematically, 50-74% of cCTA patients felt fear or anxiety before the examination that increased their blood pressure and heart rate 7,8 . Moreover, increases in fear and anxiety levels before medical imaging procedures are common [9][10][11][12] and most pronounced among younger and female patients 8,10,[12][13][14] .…”

Section: Introductionmentioning

confidence: 99%

Patients', radiographers' and radiography students’ experiences of 360° virtual counselling environment for the coronary computed tomography angiography: A qualitative study

et al. 2021

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Introduction:The aim of this study was to describe patients', radiographers' and radiography students' experiences of the developed 360° virtual counselling environment (360°VCE) for the coronary computed tomography angiography (cCTA). Methods:A descriptive qualitative approach was used. The participants were cCTA patients (n=10), radiographers (n=10) and radiography students (n=10) who used the 360°VCE and visited or worked at a university hospital in Finland. The 360°VCE, resembling the authentic environments of a CT imaging unit, included digital counselling materials in text, image, animation and video formats. Data were gathered through thematic interviews individually to obtain an understanding of participants' perspectives and analyzed by inductive content analysis.Results: Five main categories and 15 categories were identified. Identified benefits of the 360°VCE for patients included improvements in knowledge, spatial and environmental orientation, and senses of security and self-efficacy, with reductions in fear and nervousness. Patients found the counselling materials engaging, and that the 360° technology conveniently provided reassuring familiarity with the environment before their visit. Identified benefits for radiographers and radiography students included improvements in patients' mental preparedness, knowledge, spatial and environmental orientation, and reductions in patients' fear, which eased procedures and enhanced diagnostic success. The 360°VCE also provided useful information and familiarization with the cCTA unit for students during clinical practice and staff of referring units. Conclusion:It seems that patients', radiographers' and radiography students' experiences of 360°VCE respond to patients' needs by improved knowledge and reduced fears. Thus, current counselling practices can be usefully complemented with spherical panoramic imaging technology and online information delivery. Implications for practice:The results may be used to improve patient counselling and care, thereby optimizing the cCTA examination procedure and reducing fear. However, further research is needed to characterize experiences of the 360° VCE more comprehensively.

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Prevalence and impact of scan-related anxiety during coronary CT angiography: A prospective cohort study of 366 patients

Cited by 11 publications

References 26 publications

Patient-Reported Testing Burden of Breast Magnetic Resonance Imaging Among Women With Ductal Carcinoma In Situ

Patient-Reported Testing Burden of Breast Magnetic Resonance Imaging Among Women With Ductal Carcinoma In Situ

Clinical Application Value of Multimedia Education and Nursing Intervention in a Coronary Computed Tomography Angiography

Patients', radiographers' and radiography students’ experiences of 360° virtual counselling environment for the coronary computed tomography angiography: A qualitative study

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