title: The effectiveness of an accessibility-enhanced multimedia informational educational programme in reducing anxiety and increasing satisfaction of patients undergoing cardiac catheterisation.
abstract: OBJECTIVE
  To evaluate the effectiveness of an accessibility-enhanced multimedia informational educational programme in reducing anxiety and increasing satisfaction with the information and materials received by patients undergoing cardiac catheterisation.
  
  
  BACKGROUND
  Cardiac catheterisation is one of the most anxiety-provoking invasive procedures for patients. However, informational education using multimedia to inform patients undergoing cardiac catheterisation has not been extensively explored.
  
  
  METHODS
  A randomised experimental design with three-cohort prospective comparisons.
  
  
  METHODS
  In total, 123 consecutive patients were randomly assigned to one of three groups: regular education; (group 1), accessibility-enhanced multimedia informational education (group 2) and instructional digital videodisc education (group 3). Anxiety was measured with Spielberger's State Anxiety Inventory, which was administered at four time intervals: before education (T0), immediately after education (T1), before cardiac catheterisation (T2) and one day after cardiac catheterisation (T3). A satisfaction questionnaire was administrated one day after cardiac catheterisation. Data were collected from May 2009-September 2010 and analysed using descriptive statistics, chi-squared tests, one-way analysis of variance, Scheffe's post hoc test and generalised estimating equations.
  
  
  RESULTS
  All patients experienced moderate anxiety at T0 to low anxiety at T3. Accessibility-enhanced multimedia informational education patients had significantly lower anxiety levels and felt the most satisfied with the information and materials received compared with patients in groups 1 and 3. A statistically significant difference in anxiety levels was only found at T2 among the three groups (p = 0·004).
  
  
  CONCLUSIONS
  The findings demonstrate that the accessibility-enhanced multimedia informational education was the most effective informational educational module for informing patients about their upcoming cardiac catheterisation, to reduce anxiety and improve satisfaction with the information and materials received compared with the regular education and instructional digital videodisc education.
  
  
  CONCLUSIONS
  As the accessibility-enhanced multimedia informational education reduced patient anxiety and improved satisfaction with the information and materials received, it can be adapted to complement patient education in future regular cardiac care.
authors.affiliation: Nursing Department, Cathay General Hospital, Taipei, Taiwan; School of Nursing, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ka-Lai
authors.initials: KL
authors.lastname: Wu
authors.forename: Su-Ru
authors.initials: SR
authors.lastname: Chen
authors.forename: Wen-Chin
authors.initials: WC
authors.lastname: Ko
authors.forename: Shu-Yu
authors.initials: SY
authors.lastname: Kuo
authors.forename: Ping-Ling
authors.initials: PL
authors.lastname: Chen
authors.forename: Hui-Fang
authors.initials: HF
authors.lastname: Su
authors.forename: Wen-Yin
authors.initials: WY
authors.lastname: Chang
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000451:nursing / Q000523:psychology*; D005260:Female; D006266:Health Education; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D019212:Multimedia; D011446:Prospective Studies; D011795:Surveys and Questionnaires
keywords: anxiety; informational education; instructional digital videodisc; multimedia; satisfaction