title: Effect of Patient-Focused Clinical Pathway on Anxiety, Depression and Satisfaction of Patients With Coronary Artery Disease: A Quasi-Experimental Study.
abstract: BACKGROUND
  Coronary artery diseases (CAD) are associated with psychological problems such as anxiety and depression in patients. Thus, management of these problems can consider as an important intervention by health care workers, especially nurses.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the effectiveness of patient-focused clinical pathway on anxiety, depression and satisfaction of patients with CAD.
  
  
  METHODS
  In this quasi-experimental study, 138 patients suffering from CAD in a coronary care unit of a referral teaching hospital affiliated to Semnan University of Medical Sciences in Semnan, Iran, were recruited using a convenience sampling method. The participants were assigned to two groups: Clinical pathway (CP) and routine (RUT) care. The level of anxiety and depression of patients were measured in admission and discharge in both groups. Also, the level of patients' satisfaction was measured at the time of discharge. Data were analyzed using descriptive and inferential statistics.
  
  
  RESULTS
  Prevalence rates of anxiety and depression in total of patients were 7.2% and 8.7%, respectively. In terms of anxiety, the mean of difference between pretest and posttest scores in the CP group (0.52 ± 1.39) was higher compared to the RUT group (-0.17 ± 1.69) and there was a significant difference between the two group (P = 0.009). In terms of depression, the mean of this difference in the CP group (0.75 ± 2.05) was higher compared to the RUT group (0.00 ± 1.08), as there was a significant difference between the two group (P = 0.024). Also, the mean of patients' satisfaction scores in the CP group (3.69 ± 0.39) was higher compared to the RUT group (3.45 ± 0.47) and there was a significant difference between the two groups (P = 0.002).
  
  
  CONCLUSIONS
  According to the positive effects of CP on patients with CADs, it can be considered as a useful, safe and simple instrument for the improvement of patients' outcomes. Thus, the findings of this study can provide a new insight in patient care for clinical nurses.
authors.affiliation: School of Nursing and Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Fakhr-Movahedi
authors.affiliation: School of Nursing and Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, IR Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Soleimani
authors.affiliation: School of Nursing and Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, IR Iran.
authors.forename: Razeyeh
authors.initials: R
authors.lastname: Ghazvininejad
authors.affiliation: Rajaei Cardiovascular, Medical & Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammad Kazem
authors.initials: MK
authors.lastname: Maher
authors.affiliation: Research Center for Social Determinants of Health, Semnan University of Medical Sciences, Semnan, IR Iran.
authors.forename: Raheb
authors.initials: R
authors.lastname: Ghorbani
keywords: Anxiety; Clinical Pathways; Coronary Artery Disease; Depression; Patient Satisfaction