Assessment of the Level of Anxiety and Associated Factors among Heart Patients Waiting for Cardiac Procedure at a Tertiary Care Hospital in North India
Kanika Jain, Sujeet K Sinha, Anant K Verma
Citation Information :
Jain K, Sinha SK, Verma AK. Assessment of the Level of Anxiety and Associated Factors among Heart Patients Waiting for Cardiac Procedure at a Tertiary Care Hospital in North India. Int J Res Foundation Hosp Healthc Adm 2017; 5 (2):68-72.
Introduction: The anxiety experienced among patients may have various causes, including not feeling cared about as an individual, not explained by physician regarding plan of treatment, too much waiting time before the procedure begins, and the physical discomfort like not getting proper bed by the hospital authority.
Anxiety can cause behavioral and cognitive changes which can result in increased tension, apprehension, nervousness, and aggression. Some patients may become so nervous and apprehensive that they are unable to understand or follow simple instructions. Some patients may be so aggressive and demanding that they require constant attention of the nursing staff and may end up fighting with the health care provider.
Need of this study: With few public-run cardiac centers, it was always a difficult task of managing the huge patient load on limited beds by the management. Nonavailability of beds forced the clinicians to keep the patients waiting for admission on trolley or postpone the surgery. In addition, it was also noticed that the doctors did not adequately counsel the patients regarding their plan and procedure of treatment. As a result, there is always disgruntlement among the patients, resulting in increased anxiety, apprehension, and aggression.
Objective: To assess the level of anxiety of patients before the cardiac procedure as per the Hamilton Anxiety Rating Scale (HAM-A) and to analyze whether adequate time is being given by the treating physicians in counseling of the patients about the treatment plan.
Materials and methods: This is a cross-sectional study done on patients waiting for cardiac procedure in a cardiac center of a tertiary care hospital. Patients admitted on daycare basis for the procedure were also included. All the patients waiting for the procedure were assessed at the time of admission. Participants were assessed using a performa containing two parts. Part one of the performa was used to capture the demographic profile of the patients and questions related with their disease condition. The second part consisted validated HAM-A. The HAM-A is a widely used scale in both clinical and research settings. The scale consists of 14 items. Each item is scored on a scale of 0 (not present) to 4 (severe), with a total score range of 0 to 56, where <17 indicates mild severity, 18 to 24 mild to moderate severity, and 25 to 30 moderate to severe. These patients were then grouped as having mild, moderate, and severe anxiety based on HAM-A score.
Results: The study was carried out to find out the severity of anxiety of the patients waiting for the cardiac procedure. Total 110 patients were enrolled in the study. It was found that 63 (70.8%) male and 9 (42.9%) female patients had mild anxiety. In contrast, 4 (19%) male and 5 (5.6%) female participants had severe anxiety. There was statistically significant relationship (p < 0.05) in the anxiety level between male and female patients. Patients who were not adequately counseled by the physician were found to be suffering more moderate (33.3%) and severe (16.7%) anxiety in comparison with other groups.
Conclusion: There is no doubt that anxiety is very much relevant before any cardiac procedure. Counseling of the patients before any procedure plays a significant role in reducing the severity of the anxiety level.
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