Comparison of the Effectiveness of Nursing Consultation and Guided Imagery-Based Training on Stress and Anxiety in Angiography Candidates: A Clinical Trial

Abstract

Background: Despite the use of various pharmacological and non-pharmacological methods for reducing stress among patients, one of the most important nursing challenges is how to control anxiety and stress in patients undergoing coronary angiography. Objectives: The present study aimed to compare the effectiveness of nursing consultation and guided imagery-based training on the level of stress and anxiety in patients undergoing coronary angiography. Methods: The participants in this clinical trial included 60 angiography candidates, admitted to the coronary care unit (CCU) of Ali-Ibn Abi-Taleb Hospital in Zahedan, southeast of Iran, in 2019. The participants were selected using convenience sampling and randomly assigned to three groups: nursing consultation, guided imagery, and control groups. The instruments used to collect the data included a demographic information form and the Depression, Anxiety, and Stress scale (DASS-21). The questionnaires were completed by the participants in all three groups on the day of hospitalization and one hour before angiography. A guided imagery audio file was played one day before angiography for each participant in the nursing consultation group for a maximum of two hours. On the other hand, the guided imagery group, besides receiving routine care, listened to the same audio file for 30 - 45 minutes. However, the participants in the control group only received routine hospital training. The collected data were analyzed in SPSS version 25, using statistical tests, such as analysis of variance (ANOVA), Tukey’s post hoc test, analysis of covariance (ANCOVA), paired samples t-test, Fisher’s exact test, and chi-square test at a significance level of less than 0.05 (P < 0.05). Results: After controlling for the significant effect of pretest scores, the results of ANCOVA test showed significant differences between the two intervention groups in terms of the mean scores of anxiety and stress after the intervention (P < 0.001). Also, the mean scores of anxiety and stress decreased in the guided imagery and nursing consultation groups as compared to the control group. However, the two interventions were not significantly different in reducing anxiety and stress among patients undergoing coronary angiography (P = 1). Conclusions: In this study, nursing consultation and guided imagery interventions led to a reduction in the stress and anxiety of patients undergoing angiography. Although the two interventions showed no significant difference in terms of effectiveness, they had positive effects on the mental health of angiography candidates. Therefore, these techniques can be employed by nurses, depending on their ease of use and conditions, to reduce stress and anxiety among angiography candidates.