title: Non-pharmacological interventions to reduce psychological distress in patients undergoing diagnostic cardiac catheterization: a rapid review.
abstract: Cardiac catheterization is the standard procedure for the diagnosis of coronary heart disease. The threat physically and emotionally from this procedure can affect the patient's perception of their health. The heightened psychological distress associated with this diagnostic procedure can cause adverse patient outcomes. Non-pharmacologic interventions have been implemented to reduce psychological distress associated with cardiac catheterization.
  
  
  
  The objective of this rapid review is to assess the efficacy of non-pharmacologic interventions (procedural education, relaxation techniques, psychological preparation) on psychological distress experienced by patients as they undergo a cardiac catheterization.
  
  
  
  Published, peer-reviewed, English-language intervention studies from 1981 to 2014 were identified in a search of CINAHL, Medline, and Cochrane Library. Eligible studies included adults undergoing cardiac catheterization. Studies included in this review used experimental and quasi-experimental designs and assessed at least one primary outcome: anxiety, depression, and pain to test non-pharmacologic interventions pre and post-cardiac catheterization. Researchers independently extracted data from included studies and completed a quality assessment using a published tool. Data were synthesized as a narrative.
  
  
  
  There were 29 eligible experimental and quasi-experimental studies that tested the three interventions ( n=2504). Findings suggest that non-pharmacologic interventions were able to effectively reduce psychological distress in some patients undergoing cardiac catheterization.
  
  
  
  Evidence is stronger in recent studies that non-pharmacologic interventions of procedural education and psychological preparation can reduce psychological distress in patients undergoing cardiac catheterization. Further research is needed to define the various relaxation techniques that can be effectively implemented for patients undergoing cardiac catheterization.
authors.affiliation: 1 Yvonne L. Munn Center for Nursing Research, Institute for Patient Care, Massachusetts General Hospital, USA.
authors.forename: Diane L
authors.initials: DL
authors.lastname: Carroll
authors.affiliation: 2 School of Healthcare, Faculty of Medicine & Health, University of Leeds, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Malecki-Ketchell
authors.affiliation: 3 University of Huddersfield and Calderdale and Huddersfield NHS Trust, UK.
authors.forename: Felicity
authors.initials: F
authors.lastname: Astin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology* / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012064:Relaxation Therapy
keywords: Rapid review; cardiac catheterization; procedural education; psychological distress; psychological preparation; relaxation techniques