Pain and Anxiety in Rural Acute Coronary Syndrome Patients Awaiting Transfer for Diagnostic Cardiac Catheterization: A Descriptive-Correlational Study

2.50
Hdl Handle:
http://hdl.handle.net/10755/308263
Category:
Abstract
Type:
Presentation
Title:
Pain and Anxiety in Rural Acute Coronary Syndrome Patients Awaiting Transfer for Diagnostic Cardiac Catheterization: A Descriptive-Correlational Study
Author(s):
O'Keefe-McCarthy, Sheila Bridget; McGillion, Michael, H.; Clarke, Sean P.; Nelson, Sioban; McFetridge-Durdle, Judith
Lead Author STTI Affiliation:
Lambda Pi-at-Large
Author Details:
Sheila Bridget O'Keefe-McCarthy, RN BScN MN CCNC (C), celticvoice@sympatico.ca; Michael, H. McGillion, RN PhD; Sean P. Clarke, RN, PhD, CRNP, CS; Sioban Nelson, RN, PhD; Judith McFetridge-Durdle, RN PhD
Abstract:

Poster presented on: Saturday, November 16, 2013, Sunday, November 17, 2013

Background: In rural areas people suffering from acute coronary syndromes (ACS) wait up to 32 hours for transfer for diagnostic cardiac catheterization (CATH). In lieu of rapid access to CATH, it is critical that pain and anxiety management be optimal in order to preserve myocardial muscle and minimize the risk of further deterioration.

Aim: We examined the relationship between pain management and cardiac pain intensity and state anxiety for rural ACS patients awaiting diagnostic CATH.

Methods: A prospective, descriptive-correlational repeated-measure design was used to examine the association of cumulative analgesic administration with cardiac pain intensity (numeric rating scale-NRS) and state anxiety (Speilberger State Anxiety Inventory-SAI) via multiple variable linear mixed effects regression models.

Results: The mean age of ACS patients (n=121) was 67.6 ±13, 50% were male, 60% had unstable angina and 40% had Non-ST-Elevated myocardial infarction. During follow up, cardiac pain intensity scores remained in the mild range over 8 hours from 1.1 ± 2.2 to 2.4 ±2.7. State anxiety ranged from 44.0 ±7.2 to 46.2 ±6.6. Cumulative analgesic dose was associated with a reduction in cardiac pain by 1.0 points (NRS, 0-10) (t(108)=-2.5, SE=-0.25, CI (-0.45, -0.06), p=0.013). Analgesic administration was not associated with state anxiety. Through the course of follow up ACS patients reported high anxiety scores indicating a persistent anxious state.

Implications: Despite adequate analgesic administration anxiety scores remained high, leaving patients at risk for increased thrombus formation and lethal dysrhythmias. A larger prognostic study is required in order to determine whether high levels of anxiety for rural patients are predictive of major adverse cardiac events.

Keywords:
Pain; Acute coronary syndrome; Anxiety
Repository Posting Date:
19-Dec-2013
Date of Publication:
19-Dec-2013
Conference Date:
2013
Conference Name:
42nd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriott
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titlePain and Anxiety in Rural Acute Coronary Syndrome Patients Awaiting Transfer for Diagnostic Cardiac Catheterization: A Descriptive-Correlational Studyen_GB
dc.contributor.authorO'Keefe-McCarthy, Sheila Bridgeten_GB
dc.contributor.authorMcGillion, Michael, H.en_GB
dc.contributor.authorClarke, Sean P.en_GB
dc.contributor.authorNelson, Siobanen_GB
dc.contributor.authorMcFetridge-Durdle, Judithen_GB
dc.contributor.departmentLambda Pi-at-Largeen_GB
dc.author.detailsSheila Bridget O'Keefe-McCarthy, RN BScN MN CCNC (C), celticvoice@sympatico.ca; Michael, H. McGillion, RN PhD; Sean P. Clarke, RN, PhD, CRNP, CS; Sioban Nelson, RN, PhD; Judith McFetridge-Durdle, RN PhDen_GB
dc.identifier.urihttp://hdl.handle.net/10755/308263-
dc.description.abstract<p>Poster presented on: Saturday, November 16, 2013, Sunday, November 17, 2013</p><b>Background:</b> In rural areas people suffering from acute coronary syndromes (ACS) wait up to 32 hours for transfer for diagnostic cardiac catheterization (CATH). In lieu of rapid access to CATH, it is critical that pain and anxiety management be optimal in order to preserve myocardial muscle and minimize the risk of further deterioration. <p align="left" class="TitlePage"><b>Aim:</b> We examined the relationship between pain management and cardiac pain intensity and state anxiety for rural ACS patients awaiting diagnostic CATH. <p><b>Methods:</b> A prospective, descriptive-correlational repeated-measure design was used to examine the association of cumulative analgesic administration with cardiac pain intensity (numeric rating scale-NRS) and state anxiety (Speilberger State Anxiety Inventory-SAI) via multiple variable linear mixed effects regression models. <p><b>Results:</b> The mean age of ACS patients (n=121) was 67.6 ±13, 50% were male, 60% had unstable angina and 40% had Non-ST-Elevated myocardial infarction. During follow up, cardiac pain intensity scores remained in the mild range over 8 hours from 1.1 ± 2.2 to 2.4 ±2.7. State anxiety ranged from 44.0 ±7.2 to 46.2 ±6.6. Cumulative analgesic dose was associated with a reduction in cardiac pain by 1.0 points (NRS, 0-10) (t(108)=-2.5, SE=-0.25, CI (-0.45, -0.06), p=0.013). Analgesic administration was not associated with state anxiety. Through the course of follow up ACS patients reported high anxiety scores indicating a persistent anxious state. <p><b>Implications:</b> Despite adequate analgesic administration anxiety scores remained high, leaving patients at risk for increased thrombus formation and lethal dysrhythmias. A larger prognostic study is required in order to determine whether high levels of anxiety for rural patients are predictive of major adverse cardiac events.en_GB
dc.subjectPainen_GB
dc.subjectAcute coronary syndromeen_GB
dc.subjectAnxietyen_GB
dc.date.available2013-12-19T17:29:01Z-
dc.date.issued2013-12-19-
dc.date.accessioned2013-12-19T17:29:01Z-
dc.conference.date2013en_GB
dc.conference.name42nd Biennial Conventionen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationIndianapolis, Indiana, USAen_GB
dc.description42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriotten_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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