The effects of environmental factors in waiting rooms on anxiety among patients undergoing coronary angiography: A randomized controlled trial.

Background: According to Florence Nightingale's hypothesis, the environment can play a central role in the healing of the patient's body and mind. The nurse should, therefore, strive to provide a healing and stress‐reducing environment for patients about to undergo invasive procedures. Aims: This study aimed to investigate the effects of environmental factors on anxiety as experienced by patients in waiting rooms prior to coronary angiography. Methods: In this randomized controlled trial, 200 patients undergoing coronary angiography in an urban area of Iran were assigned randomly to the following intervention groups: (1) nature sounds; (2) nature sounds and daylight; (3) nature sounds, daylight, and colour enhancements; and (4) control. Portable monitors were used to measure the patients' physiological indices upon admission and 30 and 60 minutes thereafter. Results: Patients who experienced environmental affecting interventions had significantly lower physiological indices of anxiety than the control group (P < 0.001). Some significance was demonstrated between the three interventions groups, with patients in the intervention group that experienced maximum environmental interventions demonstrating the most overall reduction in anxiety indices. Conclusion: Environmental factors were shown to have a positive effect on the indices of anxiety experienced by patients waiting for the procedure of coronary angiography; this is therefore an area of study and practice worthy of further development. SUMMARY STATEMENT: What is already known about this topic? Waiting for coronary angiography is a source of anxiety for patients.Anxiety can influence patients' physiological responses.People have an inherent tendency to respond positively to nature sounds, daylight, and colour.What this paper adds? Environmental factors had positive effects on the physiological indices of anxiety among patients undergoing coronary angiography.Environmental factors can reduce the physiological indices of anxiety before coronary angiography.Nature sounds, daylight, and colour can affect positively physiological indices of anxiety. The implications of this paper: Environmental factors should be considered, alongside other interventions, during the provision of nursing care to prevent adverse physical and psychological affects in patients.Environmental changes help nurses to relieve patients' anxiety when they are waiting for invasive procedures.Environmental factors can help create a relaxing waiting time and improve the physiological indices of anxiety among patients undergoing coronary angiography. [ABSTRACT FROM AUTHOR]