Interventions in reducing anxiety among patients undergoing percutaneous coronary intervention (PCI): an integrated literature review

Effita Piscesiana, Tuti Herawati, Sri Yona


Background: The percutaneous coronary intervention procedure (PCI) is an action to restore reduced coronary artery blood flow due to occlusion or blockage. Complex actions using sophisticated tools with the patient's condition fully aware can cause clients to experience anxiety, both before, during, and after the action. Many patients undergoing PCI experience this symptom of anxiety. These symptoms can lead to activation of the sympathetic nerves, changes in hemodynamic status, to the risk of arrhythmias during or after the procedure. Intervention to reduce anxiety hopefully can stabilize haemodynamic, avoid unwanted effects during and after the procedure, further can also improve the patient's quality of life.

Purpose: This integrated literature review aims to find complementary interventions that can be carried out independently to overcome the anxiety experienced among patients undergoing PPCI.

Methods: The compiled database was taken from the EBSCO, Scopus, Clinical Key, ProQuest, Science Direct, PubMed, and Cochrane databases, and published in 2015 - 2020 which were then matched with certain specific keywords to get the appropriate articles. A total of 11 selected articles were reviewed and the results were presented in a table. The results of 6 types of intervention were found, almost all of them were significant in reducing anxiety. Next, appraisal of the quality of selected articles is done by using The Critical Appraisal Skills Programme (CASP).

Results: There were 11 articles that discussed 6 different forms of intervention in reducing anxiety, including physical therapy (2 articles), relaxation therapy (2 articles), cognitive therapy (2 articles), psychological therapy (1 article), and psychological therapy programs (combined) (1 article) and information / support / counseling (3 articles).

Conclusion: This intervention in addition to reducing anxiety can also reduce stress, hemodynamic balance / physiological indicators, reduce pain, improve quality of life and coping mechanisms.


percutaneous coronary intervention; intervention to treat anxiety or stress; complementary therapy; nursing intervention

Full Text:



Trotter R, Gallagher R, Donoghue J. Anxiety in patients undergoing percutaneous coronary interventions. Hear Lung J Acute Crit Care. 2011;40(3):185–92.

Olsen SJS, Schirmer H, Wilsgaard T, Bønaa KH, Hanssen TA. Cardiac rehabilitation and symptoms of anxiety and depression after percutaneous coronary intervention. Eur J Prev Cardiol. 2018;25(10):1017–25.

CASP. CASP Randomised Controlled Trial Standard Checklist. Casp [Internet]. 2020;(September 2020):4–7. Available from:

Cavaleri R, Bhole S, Arora A. Critical appraisal of quantitative research. Handb Res Methods Heal Soc Sci. 2019;1027–49.

Peng S, Ying B, Chen Y, Sun XM. Effects of massage on the anxiety of patients receiving percutaneous coronary intervention. Psychiatr Danub. 2015;27(1):44–9.

Forooghy M, Mottahedian Tabrizi E, Hajizadeh E, Pishgoo B. Effect of Music Therapy on Patients’ Anxiety and Hemodynamic Parameters During Coronary Angioplasty: A Randomized Controlled Trial. Nurs Midwifery Stud. 2015;4(2).

Lv J, Zhang X, Ou S, Gu S, Su Z, Tong S, et al. Influence of cognitive behavioral therapy on mood and quality of life after stent implantation in young and middle-aged patients with coronary heart disease. Int Heart J. 2016;57(2):167–72.

Corones-Watkins KM, Theobald KA, White KM. Outcomes of a randomised pilot trial of a nurse-led clinic for patients after percutaneous coronary intervention. Aust Crit Care [Internet]. 2019;32(4):285–92. Available from:

Shen, X. Z, Y. WW, Y. Z, L. Y, Y. WW, et al. Effects of a psychological intervention programme on mental stress, coping style and immune function in percutaneous coronary intervention patients. PLoS One [Internet]. 2018;13(1):e0187745. Available from:

Haddad NE, Saleh MN, Eshah NF. Effectiveness of nurse‐led video interventions on anxiety in patients having percutaneous coronary intervention. Int J Nurs Pract. 2018;24(4):1–8.

Chang Z, Guo A qing, Zhou A xia, Sun TW, Ma L le, Gardiner FW, et al. Nurse-led psychological intervention reduces anxiety symptoms and improves quality of life following percutaneous coronary intervention for stable coronary artery disease. Aust J Rural Health. 2020;28(2):124–31.

Akarsu K, Koç A, Ertuğ N. The effect of nature sounds and earplugs on anxiety in patients following percutaneous coronary intervention: A randomized controlled trial. Eur J Cardiovasc Nurs. 2019;18(8):651–7.

Brand A, Gao L, Hamann A, Martineck S, Stangl V. Annals Graphic Medicine - Patient-Informed Consent. Ann Intern Med. 2019;170(8):W90–106.

Hou Y, Zhao X, Lu M, Lei X, Wu Q, Wang X. Brief, one-on-one, telephone-adapted mindfulness-based stress reduction for patients undergoing percutaneous coronary intervention: A randomized controlled trial. Transl Behav Med. 2019;9(6):1216–23.

Liu J, Yu P, Lv W, Wang X. The 24-Form Tai Chi Improves Anxiety and Depression and Upregulates miR-17-92 in Coronary Heart Disease Patients After Percutaneous Coronary Intervention. Front Physiol. 2020;11(March):1–10.



  • There are currently no refbacks.

Jurnal Ners dan Kebidanan Indonesia (JNKI) indexed by:


Lisensi Creative Commons

  View My Stats