Non-pharmacological Interventions for Managing Pre-angiography Anxiety: A Systematic Review

Context: Coronary angiography is a crucial diagnostic procedure, yet it often induces significant anxiety in patients. Various non-pharmacological interventions have been proposed to alleviate anxiety in patients undergoing coronary angiography. Despite existing methods, comprehensive comparative reviews on their effectiveness are lacking. Objectives: This systematic review aimed to evaluate the effectiveness of various non-pharmacological interventions in reducing anxiety for patients preparing for coronary angiography. Evidence Acquisition: In this systematic review, articles published in both Persian and English were collected from various databases, including Web of Science, PubMed, Scopus, Medlib, Magiran, SID, Iranmedex, and Google Scholar. The search used keywords related to coronary angiography, cardiac catheterization, anxiety, and non-pharmacological methods. The search was limited to studies published between 2009 and 2024. Articles that met the inclusion criteria were then selected for review. Out of the 1,457 articles retrieved, 33 were thoroughly examined and analyzed. To ensure data accuracy, two experienced researchers simultaneously reviewed the articles while the research team's faculty members independently assessed each article's quality. This collaborative approach was implemented to enhance the validity and reliability of the study. Results: Thirty-three articles were reviewed, revealing several effective interventions for reducing anxiety before angiography. These interventions included educational programs such as video-based education, virtual networks, and familiarization tours, as well as complementary medicine approaches like aromatherapy, herbal medicine, massage therapy, relaxation techniques, and emotional expression. Each of these methods showed promise in reducing anxiety levels among patients scheduled for coronary angiography. Conclusions: This review concludes that educational programs and orientation tours are the most practical, cost-effective, and side-effect-free approach for reducing anxiety before coronary angiography. Aromatherapy was noted as the second most effective intervention. Additionally, acupressure and muscle relaxation are also commonly used. Limited studies exist on guided imagery and emotional expression, highlighting the need for future research to standardize methodologies and further assess the effectiveness of these interventions in reducing pre-angiography anxiety.