Effects of a peer- led group education on fear, anxiety and depression levels of patients undergoing coronary angiography

Zahra Molazem, Zahra Shahabfard, Alireza Askari, Majid Najafi Kalyani


Objective. To investigate the effect of the peer group education on the fear, anxiety and depression levels of the patients undergoing angiography.

Methods. In this clinical trial, 70 patients referred to Vali-E-Asr clinic of Fasa (Iran) for undergoing coronary angiography were selected by random sampling and divided into experimental and control groups. The experimental group (n=35) received the necessary instructions about coronary angiography by those in a trained peer group (Two former patients, having experienced in the procedure), while in the control group (n=35) the routine instructions were presented by the department’s nurses. The levels of fear, anxiety and depression of the patients were measured both before and after conducting this intervention.

Results. The mean score of the patients’ fear and anxiety after the intervention of the peers in the experimental group was reduced compared to that of the control group (p<0.05). But for the mean of the score of the depression test, no statistically significant differences were found between the two groups after the intervention.

Conclusion. The results of this study showed that utilizing the peer group education is effective for reducing the fear and anxiety of patients undergoing coronary angiography.

Descriptors: coronary angiography; control groups; peer group; anxiety; depression; fear.

How to cite this article: Molazem Z, Shahabfard Z, Askari A, Kalyani MN. :  Effects of a peer-led group education on fear, anxiety and depression levels of patients undergoing coronary angiography. Invest. Educ. Enferm. 2018; 36(1):e13.

Full Text:



(1) Jamshidi N, Abbaszadeh A, Kalyani MN. Effects of video information on anxiety, stress and depression of patients undergoing coronary angiography. Pak. J. Med. Sci. 2009; 25(6):901-5.

(2) Loscalzo J. Harrison’s cardiovascular medicine: McGraw-Hill Medical; 2010.

(3) World Health Organization. Non communicable Diseases Country Profiles, 2011 [Internet]. 2012 [cited 2 Feb 2018] Available at: http://apps.who.int/iris/bitstream/10665/44704/1/9789241502283_eng.pdf

(4) Jamshidi N, Abbaszadeh A, Kalyani MN, Sharif F. Effectiveness of video information on coronary angiography patients’ outcomes. Collegian. 2013; 20:153-9.

(5) Rezaei-Adaryani M, Ahmadi F, Asghari-Jafarabadi M. The effect of changing position and early ambulation after cardiac catheterization on patients’ outcomes: a single-blind randomized controlled trial. Int. J. Nurs. Stud. 2009; 46(8):1047-53.

(6) Radcliffe EL, Harding G, Rothman MT, Feder GS. It got right to the spot. The patient experience of primary angioplasty: A qualitative study. Eur. J. Cardiovasc. Nurs. 2009; 8: 216-22.

(7) Kalyani MN, Sharif F, Ahmadi F, Iman MT. Iranian patient’s expectations about coronary angiography: A qualitative study. Iran. J. Nurs. Midwifery Res. 2013; 18:180-5.

(8) Gallagher R, Trotter R, Donoghue J. Preprocedural concerns and anxiety assessment in patients undergoing coronary angiography and percutaneous coronary interventions. Eur. J. Cardiovasc. Nurs. 2010; 9(1):38-44.

(9) Keller R, Frankbader M, Beltrun K, Ascalon M, Bowarferres SL. Peer education: an innovative approach for integrating standards into practice. J. Nurs. Care Qual. 2011; 26(2):120-7.

(10) Gillespie P, O’Shea E, Paul G, O’Dowd T, Smith SM. Cost effectiveness of peer support for type 2 diabetes. Int J Technol Assess Health Care. 2012; 28(1):3-11.

(11) Nematian Jelodar H, Jannati Y, Ghafari R, Yazdani Charati J, Gholami Gorzini M, Esmaeili R. The Impact of Peer Education on Stress Level in Patients Undergoing Coronary Artery Bypass Grafting. J. Babol Univ. Med. Sci. 2015; (11):45-51.

(12) Heikkila J, Paunonen M. Fear of patients related to coronary arteriography. J. Adv. Nurs., 1998; 28(1):54-62.

(13) Kaviani H, Seyfourian H, Sharifi V, Ebrahimkhani N.Reliability and validity of Anxity and Depression Hospital scale (HADS):iranian patients with anxity and depression disorders. Tehran Univ. Med. J. 2009; 67(5):379-85.

(14) Phillipe E, Meney M, Larrazet F, Ben-Abderrazak F, Dibie A, Meziane T, et al. Effects of video information in patients undergoing coronary angiography. Arch. Mal. Coeur. Vaiss. 2006; 99(2):95-101.

(15) Dehghani A,Mohammadkhan Kermanshahi S, Memarian R. The effect of peer group educational program on multiple sclerosis patients’ level of stress. Arak Med. Univ. J. 2012; 15(65):17-26.

(16) De Vries L, van der Heijden AA, van ‘t Riet E, Baan CA, Kostense PJ, Rijken M, et al. Peer support to decrease diabetes-related distress in patients with type 2 diabetes mellitus: design of a randomised controlled trial. BMC Endocr. Disord. J. 2014; 14:21

(17) Varaei Sh, Cheraghi MA, Seyedfatemi N, Talebi M, Bahrani N, Dehghani A, Shamsizadeh M. Effect of peer education on anxiety in patients candidate for coronary artery bypass graft surgery: a randomized control trial. J. Nurs. Educ. 2013; 2(3):28-37.

(18) Chan D, Cheung H. The effects of education on anxiety among Chinese patients with heart disease undergoing cardiac catheterization in Hong Kong. Contemp. Nurse. 2003; 15(3):310-20.

(19) Doğan M, Şenturan L. The effect of music therapy on the level of anxiety in the patients undergoing coronary angiography. Open J. Nurs. 2012; 2:165-9.

(20) Thomas KM, Sethares KA. Is guided imagery effective in reducing pain and anxiety in the postoperative total joint arthroplasty patient? Orthop. Nurs. 2010; 29(6):393-9.

(21) Jong M, Pijl A, De Gast H, Sjöling M. P02.128. The effects of guided imagery on preoperative anxiety and pain management in patients undergoing laparoscopic cholecystectomy in a multi-centre RCT study. BMC Complement. Altern. Med. 2012; 12(Suppl 1):184.

(22) Krannich JHA, Weyers P, Lueger S, Herzog M, Bohrer T, Elert O. Presence of depression and anxiety before and after coronary artery bypass graft surgery and their relationship to age. BMC Psychiatry. 2007; 7(1):47.

(23) Behrozian F, Chapari Ilkhchi A, Yazdani Nejad S, Khajemogahi N, Sheikhi M.A, Bahrami Ilkhchi R, Salehivayisi M, Bahrami Ilkhchi A. Depression Prevalence before and after Coronary Artery Bypass Surgery and its Correlation with Some Clinical and Demographic Factors. Jentashapir Sci. Med. J. 2013; 73-85.

(24) Khatibi NKH, AhmadiKoumeleh S, Mamianloo H, AbbasiAbyaneh N. Relationship between Perceived Social Support and Pre/ post-operation Anxiety and Depression in Patients undergoing CABG. Iran J. Nurs. 2013; 26(84):63-70.

(25) Kumakech E, Cantor-Graae E, Maling S, Bajunirwe F. Peer-group support intervention improves the psychosocial well-being of AIDS orphans: Cluster randomized trial. Soc. Sci. Med. 2009; 68(6):1038-43.

DOI: https://doi.org/10.17533/udea.iee.v36n1e13 Abstract : 767 PDF : 718 ENGLISH : 34

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM

Esta publicación hace parte del Sistema de Revistas de la Universidad de Antioquia
¿Quieres aprender a usar el Open Journal system? Ingresa al Curso virtual
Este sistema es administrado por el Programa Integración de Tecnologías a la Docencia
Universidad de Antioquia
Powered by Public Knowledge Project