Anxiety and well-being in first-time coronary angioplasty patients and repeaters.

INTRODUCTION: Preparatory information before an invasive procedure has positive effects (e.g. on recovery, well-being and anxiety). However, preparation of patients for a repeat procedure is hardly investigated. The question is whether these patients benefit from the same preparatory information. AIMS: To determine whether there are differences in terms of anxiety and well-being between patients undergoing their first percutaneous transluminal coronary angioplasty (PTCA) and those undergoing a repeat PTCA.
DESIGN: Descriptive correlational study with a quantitative and qualitative research component.
METHOD: First-time PTCA patients (n=46) and re-PTCA patients (n=40) were asked to complete three psychological self-report questionnaires (HADS, HPPQ and VAS) before the procedure. Five re-PTCA patients were interviewed the day after the procedure.
RESULTS: We were not able to show statistically significant differences between the two groups. On the anxiety scales re-PTCA patients scored 6.5 (HADS) and 4.0 (VAS) vs. 5.0 (P=0.25) and 2.6 (P=0.30) for first-time PTCA patients. On well-being (HPPQ) these differences were 18.0 vs. 19.0 (P=0.40). Once the interview data were coded, four themes were apparent, namely: recurrent symptoms, information, experience and future prospects.
CONCLUSION: A trend is seen towards a worse condition in the re-PTCA group with respect to anxiety and well-being. However, the differences are not statistically significant, they seem to be clinically relevant. The interviews point out that the return of symptoms and future prospects, rather than the procedure itself, are an important part in preparing for a repeat intervention. This aspect is currently no part of the provided preparatory information. Future research will have to determine the most beneficial method of preparing these patients (e.g. tailored preparation, emotional support, coaching).