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放射技师主导的干预对正常冠状动脉 CT 血管造影患者的安慰、治疗满意度和复发性胸痛的影响:一项随机对照试验。

Effect of radiographer-led intervention on reassurance, treatment satisfaction, and recurring chest pain in patients with a normal coronary computed tomography angiography-a randomized controlled trial.

机构信息

Department of Heart Disease, Haukeland University Hospital, P.O. box 1400, NO-5021, Bergen, Norway.

Department of Radiography, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.

出版信息

Eur J Cardiovasc Nurs. 2022 Jun 2;21(4):318-324. doi: 10.1093/eurjcn/zvab064.

Abstract

BACKGROUND

Chest pain is a common complaint in the general practitioner's (GP) office. Computed tomography (CT) is one of the main diagnostic tools available for assessing coronary artery disease (CAD), with a low probability of a false-negative result (<1%). Despite normal CT findings, many patients with non-coronary chest pain believe they suffer from CAD.

AIMS

To determine the effect of an intervention on reassurance, treatment satisfaction, and recurring chest pain in patients with non-coronary chest pain at follow-up after 1 month.

METHODS

Patients with chest pain, but with normal coronary CT angiography, i.e., no CAD, were randomized into two groups. The intervention group received extended information about the CT examination, including visualization of their individual coronary calcium score images, before the radiographer conveyed the final examination result. The control group received standard care, i.e., neither extended information nor the examination result and were encouraged to consult their referring cardiologist or GP after 1 week. Items from the Seattle Angina Questionnaire and a question regarding reassurance measured the effect of the intervention at follow-up after 1 month.

RESULTS

The study included 92 patients, 63 female and 29 male, with a follow-up response rate of 80%. Reassurance and overall treatment satisfaction were significantly higher in the intervention group (P = 0.016 and P = 0.046 respectively). The incidence of chest pain was significantly reduced in the intervention group (P = 0.042).

CONCLUSION

This study demonstrated that the intervention group showed significantly higher reassurance, overall treatment satisfaction, and experienced significantly less chest pain at follow-up after 1 month.

CLINICAL TRIALS DATABASE ID

NCT03781661.

摘要

背景

胸痛是全科医生(GP)办公室常见的主诉。计算机断层扫描(CT)是评估冠状动脉疾病(CAD)的主要诊断工具之一,其假阴性结果的概率较低(<1%)。尽管 CT 检查结果正常,但许多非冠状动脉胸痛患者仍认为自己患有 CAD。

目的

确定干预措施对 1 个月后随访时非冠状动脉胸痛患者的安慰、治疗满意度和复发性胸痛的影响。

方法

将胸痛但冠状动脉 CT 血管造影正常(即无 CAD)的患者随机分为两组。干预组在放射技师传达最终检查结果之前,接受关于 CT 检查的扩展信息,包括他们个体的冠状动脉钙评分图像的可视化。对照组接受标准护理,即既不提供扩展信息,也不提供检查结果,并在 1 周后鼓励咨询转诊心脏病专家或 GP。西雅图心绞痛问卷的项目和一个关于安慰的问题,在 1 个月后的随访时衡量了干预的效果。

结果

该研究纳入了 92 名患者,其中 63 名女性和 29 名男性,随访应答率为 80%。干预组的安慰和整体治疗满意度显著更高(P=0.016 和 P=0.046 分别)。干预组胸痛的发生率显著降低(P=0.042)。

结论

本研究表明,干预组在 1 个月后的随访中表现出更高的安慰、整体治疗满意度和明显较少的胸痛。

临床试验注册号

NCT03781661。

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