Effects of psycho-cardiology care on psychological and clinical outcomes among primary aldosteronism patients undergoing adrenal vein sampling: A randomized controlled study

心理心脏病学护理对接受肾上腺静脉取样的原发性醛固酮增多症患者心理和临床结局的影响:一项随机对照研究

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Abstract

Adrenal vein sampling (AVS) is considered the gold standard for the subtyping diagnosis of primary aldosteronism (PA), which is essential for preventing adverse cardiovascular outcomes. Nevertheless, the AVS procedure might induce anxiety in patients with PA because of discomfort and the uncertainty of the outcome. Therefore, this study aimed to assess the effectiveness of psycho-cardiology care in alleviating anxiety and stress, as well as enhancing sleep quality and satisfaction with care in patients undergoing AVS. A total of 516 patients who desired to undergo AVS were randomized into either the usual care group (n = 258) or the psycho-cardiology care group (n = 258). Usual care was defined as conventional cardiovascular care management, whereas psycho-cardiology care comprised conventional care and adjuvant psychotherapy. The effectiveness of psycho-cardiology care was assessed on the basis of various outcomes, including anxiety, stress, sleep quality, and patient satisfaction with care. Compared with those in the usual care group, the scores for anxiety, stress, and sleep quality in the psycho-cardiology care group were significantly lower. The plasma cortisol levels during the perioperative AVS period were also lower in the psycho-cardiology care group than in the usual care group. Furthermore, patients who received psycho-cardiology care demonstrated dramatic increases in satisfaction scores after AVS in comparison to those who received usual care. Our results suggest that psycho-cardiology care has beneficial effects on anxiety, stress status, sleep quality, and patient satisfaction with care in patients with PA. The use of psycho-cardiology care may substantially improve the practice of patients undergoing AVS.

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