title: Seeing what's happening on the inside: patients' views of the value of diagnostic cardiac computed tomography angiography.
abstract: OBJECTIVE
  Cardiac computed tomography angiography (CCTA) is a commonly used diagnostic test for coronary artery disease. Despite its considerable clinical value, few studies have explored the psychological value of CCTA from the perspective of patients undergoing testing. This study aimed to investigate the patient-perceived value of diagnostic CCTA testing, specifically in relation to patients' perceptions of their heart health and health behaviours.
  
  
  METHODS
  The study used a qualitative methodology incorporating thematic analysis before and after testing.
  
  
  METHODS
  Semi-structured interviews were conducted before and after the receipt of CCTA test results among 13 non-acute patients attending a heart clinic in New Zealand for diagnostic CCTA. Data analysis followed a thematic analysis approach applied at each interview time point.
  
  
  RESULTS
  Three themes were identified from the pre-diagnostic interviews: expectations that testing would facilitate heart-related understanding; the role of CCTA as an essential requirement for considering the use of cardiac medication; and awareness of the importance of heart-healthy behaviours. Post-diagnostic interview analysis identified four themes: positive psychological responses to cardiac diagnosis; perceived value of viewing scan images; the potential impact of testing on health behaviour intentions; and patients' reflections on the procedure.
  
  
  CONCLUSIONS
  These results suggest that CCTA has the potential to meet knowledge-gaining expectations that patients bring to clinic and may increase motivation of health-protective behaviours. Diagnostic CCTA may therefore provide an ideal opportunity to address patients' illness understanding and behavioural intentions. The effective utilization of scan images as a supplement to consultation may enhance such practice objectives and warrants further investigation.
  What is already known on this subject? Cardiac computed tomography angiography (CCTA) is an advanced diagnostic test that is particularly useful for early diagnosis of coronary artery disease. Cardiac computed tomography angiography is able to produce highly detailed images of the formation and build-up of calcium deposits in coronary vasculature, thus providing a window into an otherwise unseen disease process. Although CCTA is increasingly utilized by clinicians, little is known about its psychological value for cardiac patients undergoing the test. What does this study add? Cardiac computed tomography angiography testing can be a potentially important experience for cardiac patients in understanding their cardiac health. Cardiac computed tomography angiography could provide an opportune time to address patients' health behaviour intentions and treatment beliefs. Effective utilization of CCTA scan images in consultation may help to enhance consultation objectives.
authors.affiliation: Department of Psychological Medicine, The University of Auckland, New Zealand.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Devcich
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Ellis
authors.forename: Natasha
authors.initials: N
authors.lastname: Waltham
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Broadbent
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Petrie
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D017023:Coronary Angiography / Q000523:psychology*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000523:psychology*
keywords: cardiac computed tomography angiography; diagnostic testing; health care communication; medical images