Comparison of anxiety assessments between clinicians and patients with acute myocardial infarction in cardiac critical care units.
BACKGROUND
Although anxiety is common after acute myocardial infarction and can adversely affect physical recovery, it is not part of the routine clinical assessment of patients with myocardial infarction. Furthermore, evidence suggests that patients and clinicians differ significantly in their assessments of patients' anxiety levels.


OBJECTIVE
To determine the extent to which clinicians assess anxiety in patients with acute myocardial infarction and to compare patients' self-ratings with their clinicians' assessments.


METHODS
In a prospective, descriptive study, 101 patients used the Spielberger State Anxiety Index to assess their anxiety during the first 48 hours after admission for acute myocardial infarction. Patients' scores were compared with nurses' and physicians' assessments of the patients' anxiety as reported in the medical record.


RESULTS
Only 45 patients (45%) had anxiety assessments noted in the record. Of those 45, 26 patients (58%) were described simply as anxious without any further description of the level of anxiety. Eleven (24%) of those 45 patients had behaviors of anxiety recorded, again without any indication of the level of anxiety. No association between patients' self-assessments and their clinicians' assessments was apparent (lambda = .03; P > .05).


CONCLUSIONS
Anxiety was not routinely assessed, despite nearly half the patients reporting moderate to extreme anxiety when asked. When clinicians assessed anxiety, their assessments did not match patients' self-ratings of anxiety. A simple, easy-to-use instrument for discriminating levels of anxiety is needed.
College of Nursing, Ohio State University, Columbus, Ohio, USA.
J L
JL
O'Brien
D K
DK
Moser
B
B
Riegel
S K
SK
Frazier
B J
BJ
Garvin
K A
KA
Kim
D000368:Aged; D001007:Anxiety / Q000145:classification* / Q000451:nursing; D002983:Clinical Competence; D003422:Critical Care / Q000592:standards*; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015146:Midwestern United States; D009203:Myocardial Infarction / Q000451:nursing / Q000523:psychology*; D009730:Nursing Assessment; D011446:Prospective Studies; D012647:Self-Assessment