Effectiveness of a patient-centered informational video for reducing anxiety before coronary catheterization: A self-controlled trial.
Asaf Arel, Gil Marcus, Ella Levi, Olexiy Bonder, Antoinette Monayer, Saar Minha
Abstract
Open AccessObjectives: To evaluate whether viewing a locally produced, patient-centered informational video is associated with lower peri-procedural anxiety among patients undergoing coronary catheterization. Methods: Prospective, single-center, single-arm, self-controlled study. Consecutive weekday-morning patients were enrolled on recruitment days (N = 259). Anxiety was assessed with the Numeric Visual Analog Anxiety Scale (NVAAS, 0-10) at three time points: post-consent/pre-video (T0), immediately post-video/pre-procedure (T1), and post-procedure (T2). The primary analysis used a Friedman test on complete cases (n = 176) with Kendall's W; pairwise contrasts used Wilcoxon signed-rank tests with Holm adjustment, reporting Hodges-Lehmann median paired differences with 95 % CIs. Available-case and subgroup sensitivity analyses were prespecified. Results: Median baseline anxiety was 5.0 (IQR 3.0-7.9). Anxiety decreased across time (Friedman χ2(2, n = 176) = 167.28, p < 0.0001; Kendall's W = 0.48). Pairwise HL median differences were: T1-T0-1.5 (95 % CI -2.0 to -1.0; p < 0.001), T2-T0-3.5 (-4.0 to -3.0; p < 0.001), and T2-T1-1.5 (-2.0 to -1.0; p < 0.001). Available-case sensitivity analyses yielded consistent effects. Baseline anxiety was higher in females; it also tended to be higher in first-time catheterization patients (p = 0.099). Conclusion: Viewing a patient-centered video was associated with lower anxiety before coronary catheterization; causality cannot be inferred from this single-arm design. Innovation: The intervention was produced by the clinical team, filmed in the actual unit, and is publicly available in three languages, offering a scalable, low-cost approach that can be locally adapted. Randomized, multicenter trials are warranted to confirm efficacy and generalizability.