Mediation and moderation of the effects of watching the angiography screen on patients

Abstract

It has been reported that allowing patients to watch the coronary angiography screen during the procedure results in psychological benefits. This study aimed to investigate the roles of illness perceptions as mediators of this outcome and to examine whether individual differences in monitoring coping style moderated these effects. The experiment compared patients who were instructed to watch the monitor screen (n = 57) with those who were not (n = 51). Questionnaires were used to measure the research variables at one day and one month after the procedure. Results showed that watching the angiography screen increased patients’ personal and treatment control perceptions that mediated changes in self-assessed health, risk perceptions, negative affect, general and diet outcome expectancies, and diet and physical activity intentions. The behavior-related outcomes were moderated by monitoring coping style. These findings illustrate the significance of illness perceptions, perceived control and monitoring coping style in achieving desirable outcomes among patients undergoing coronary angiography, and reveal opportunities for interventions using medical imaging technologies.

Keyword:

• Cardiac patients
• coronary angiography
• illness perceptions
• perceived control
• monitoring coping style

Acknowledgements

This research was done in partial fulfillment of the PhD degree requirements of E.D. and in partial fulfillment of the M.A. degree requirements of S.P. at Tel Aviv University. This article was prepared while the first author (S.S.) was an associate of the Department of Population Health, NYU Langone Medical Center. We thank Dr Yigal Abramowitz for his valuable comments, the staff and patients at the Department of Cardiology, Tel Aviv Sourasky Medical Center for their cooperation, and Yasmin Alkalay for her assistance with statistical analyses.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Illness severity was assessed using standard medical parameters: (1) A quantitative coronary angiography program (Xcelera, Philips healthcare, Andover, MA) at the discretion of the interventional cardiologist; (2) The presence of a coronary lesion resulting in a lumen diameter stenosis >70% in a major epicardial artery or one of its main branches; (3) The presence of a clinically significant left main coronary artery disease defined as a lumen diameter stenosis >50%; (4) The number of involved vessels (none, 1-, 2- and 3-vessel disease); (5) The presence of a significant disease of the left main coronary artery, with or without concomitant lesions in other vessels.

2. The original theory of information seeking styles (Miller, 1987) included a ‘blunting’ scale which has later been abandoned due to inadequate reliability and questionable validity (Miller et al., 1996; Shiloh, Ben-Sinai, & Keinan, 1999; vanZuuren et al., 1996).

3. We thank an anonymous reviewer for this comment.