The relationship between pain, anxiety, and comfort, and the predictors of comfort in patients undergoing radial angiography

The relationship between pain, anxiety, and comfort, and the predictors of comfort in patients undergoing radial angiography | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The relationship between pain, anxiety, and comfort, and the predictors of comfort in patients undergoing radial angiography Yasemin Eda Tekin, Didem Ayhan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8823880/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background This study aims to determine the relationship between comfort and patients' pain, anxiety levels, and predictors of comfort undergoing radial angiography (RAG). A descriptive cross-sectional study was conducted. Methods The study included 291 patients who underwent radial angiography between February and June 2022. Data were collected using the Sociodemographic Characteristics form, Perianesthesia Comfort Scale (PCS), Visual Analog Scale (VAS), and State-Trait Anxiety Inventory (STAI). Results Analysis revealed a weak negative correlation between pain and comfort (r = -0.116, p = 0.048) and a weak positive correlation between pain and state anxiety (r = -0.126, p = 0.032). Comfort levels were 5.752 times higher in patients who underwent angiography only compared to those who received stent or balloon implantation, and 4.527 times higher in patients who underwent angiography only for follow-up compared to those with acute myocardial infarction (p < 0.05). Conclusion Patient comfort decreases as pain increases, and pain levels following radial angiography are moderate. The perception of pain during RAG procedures is a key factor that directly influences patient comfort. Comfort Pain Anxiety Radial Angiography Background Cardiovascular diseases (CVDs) represent the leading cause of mortality, as reported by the World Health Organization (WHO) [ 1 ]. Globally, CVDs account for 32.4% of all deaths attributed to these conditions [ 2 ]. In Turkey, the 2023 death and cause-of-death statistics published by the Turkish Statistical Institute (TUIK) indicate that this rate rises to 33.4% [ 3 ]. Coronary angiography (CAG) is considered the gold standard for the examination, diagnosis, and treatment of coronary arteries [ 4 , 5 ]. CAG can be performed using either transfemoral or transradial access methods [ 5 , 6 , 7 ]. The transradial approach has become increasingly preferred in recent years due to its association with lower mortality, easier access, and reduced cost [ 8 ]. Notably, the lower incidence of bleeding complications and the potential for early patient mobilization contribute to both clinicians' and patients' preference for radial angiography [ 8 , 9 ]. Despite being regarded as less invasive, radial angiography can significantly affect patient comfort, pain, and anxiety levels during and after the procedure [ 4 ]. Radial angiography offers several advantages, including low levels of post-procedural pain. Multiple anatomical, technical, and physiological factors contribute to this outcome. The superficial location of the radial artery and the ease of applying compression result in fewer post-procedural complications, such as bleeding and hematoma, thereby reducing irritation of surrounding tissues and minimizing pain [ 9 ]. Additionally, the absence of large nerves near the radial artery further decreases the risk of nerve-related pain, which is more commonly associated with femoral artery access [ 10 ]. Nevertheless, pain during and after radial angiography can arise from various sources, including vascular complications, nerve injury, and hemostatic interventions [ 11 ]. Prolonged pain may negatively impact patient comfort, restrict physical activity, delay recovery, and increase cardiac workload, blood pressure, heart rate, and respiratory rate [ 5 , 10 ]. Therefore, effective pain management is essential to enhance patient comfort and expedite recovery following the procedure [ 12 ]. Anxiety is a common psychological response among patients undergoing invasive interventional procedures and significantly influences both pain perception and overall comfort [ 13 ]. The literature demonstrates that elevated anxiety levels lower the pain threshold, resulting in more intense pain experiences during procedures [ 6 , 14 , 15 , 16 ]. This heightened pain perception can reduce patient satisfaction and adversely affect recovery. Moreover, increased anxiety may trigger physiological stress responses, leading to unfavorable changes in cardiovascular parameters [ 6 ]. Consequently, effective anxiety management is essential for facilitating pain control and enhancing post-procedural comfort. Comfort is closely associated with pain and anxiety following angiography [ 4 , 5 ]. It is defined as a state in which patients experience mental and physical well-being, absence of unpleasant sensations such as pain or drowsiness, and fulfillment of physical, psychological, and social needs [ 5 ]. Research indicates that increased state anxiety correlates with decreased comfort levels [ 4 ]. Additionally, factors such as heightened fear and anxiety prior to angiography, advanced age, and the presence of chronic disease contribute to reduced post-procedural comfort [ 17 ]. Ergonomic interventions have been shown to improve patient comfort, decrease pain, and enhance overall well-being during and after angiography [ 18 ]. A comprehensive understanding of the factors influencing pain, anxiety, and comfort in patients undergoing radial angiography supports the development of patient-centered care strategies. This knowledge enables nurses and healthcare teams to more accurately assess individual patient needs and implement personalized pain management plans, reduce anxiety, and enhance comfort. Recent international studies highlight the interrelated nature of these factors and emphasize the necessity of a multidisciplinary approach. The present study aims to determine the relationship between comfort and patients' pain, anxiety levels, and other relevant factors during radial angiography. Methods Study Design This study was conducted using a descriptive cross-sectional design. Sample The descriptive cross-sectional study was conducted at a university hospital in Istanbul, Türkiye. The study population comprised patients who underwent transradial angiography between February and June 2022. Inclusion criteria included patients over 18 years of age who underwent RAG, were able to communicate, and provided informed consent. The sample size was calculated for logistic regression analysis using the G*Power program, considering Cohen's median effect size value of 0.30, a 95% confidence interval, and 80% statistical power [ 19 ]. Based on these criteria, the minimum required sample size was 242 participants. To account for potential data loss, 300 individuals were recruited; however, nine were excluded due to missing data. Consequently, analyses were performed on a final sample of 291 participants. Data Collection The data were collected using the Sociodemographic data collection form, the Perianesthesia Comfort Scale, the Visual Analog Scale, and the State/Trait Anxiety Scale. Sociodemographic data collection form This 10-question form was developed by the researchers and included demographic information (age and gender), the reason for RAG, the type of procedure performed, and past treatment history. Perianesthesia Comfort Scale (PCS) The PCS, developed by Kolcaba in 1991, is a measurement tool designed to assess patients' physical, psychological, and environmental comfort before and after surgical intervention [ 20 ]. The Turkish adaptation and its validity and reliability were established by Üstündağ and Eti Aslan in 2010. The PCS comprises 24 items, each scored on a 6-point Likert-type scale, where 1 indicates "strongly disagree" and 6 indicates "strongly agree." Total scores range from 24 to 144, with higher scores reflecting greater patient comfort. In the Turkish adaptation, Cronbach's alpha was 0.83 and the test-retest correlation was 0.98 [ 21 ]. In the present study, the internal consistency coefficient was 0.913 (Table 2 ). Visual Analog Scale (VAS) The VAS is an assessment tool used to measure pain severity, consisting of a 10 cm horizontal line with endpoints labeled "no pain" and "severe pain." Participants indicate the point that best represents their pain, resulting in a score from 0 to 10. Higher scores correspond to greater pain severity. The VAS is widely utilized in both acute and chronic pain assessments. Its Turkish adaptation has been validated and shown to be reliable across various patient groups. The scale is preferred in clinical practice due to its simplicity and rapid administration [ 22 ]. Scores of 1–4, 5–6, and 7–10 represent mild, moderate, and severe pain, respectively [ 13 , 24 ]. State-Trait Anxiety Inventory (STAI) : The STAI, developed by Spielberger and colleagues in 1970, measures individual anxiety levels [ 25 ]. The Turkish adaptation and its validity and reliability were established by Le Compte and Öner in 1976 [ 26 ]. The instrument comprises two subscales: state anxiety (temporary anxiety experienced in specific situations) and trait anxiety (general tendency toward anxiety). The STAI contains 40 items, with the first 20 items forming the State Anxiety Scale and the remaining 20 forming the Trait Anxiety Scale. Each item is rated on a 4-point Likert-type scale. The State Anxiety Scale evaluates current emotional state, while the Trait Anxiety Scale assesses general anxiety tendencies. Both subscales have a total score range of 20–80, with higher scores indicating greater anxiety. Scores of 0–40 indicate no anxiety, 41–60 indicate mild anxiety, and scores above 61 indicate severe anxiety [ 27 ]. In the Turkish reliability analysis, Cronbach's alpha coefficients were 0.94 for the State Anxiety Scale and 0.83 for the Trait Anxiety Scale [ 26 ]. In the present study, the internal consistency coefficients for the state and trait anxiety scales were 0.908 and 0.699, respectively (Table 2 ). Statistical Analyses Data analysis was performed using SPSS software (version 26.0; IBM Inc., Canada). Discrete variables are presented as numbers (n) and percentages (%), while continuous variables are reported as mean ± standard deviation. Kurtosis and skewness values were calculated to assess normality of data distribution. Internal consistency of the measurement tools was evaluated using Cronbach's alpha. The Pearson correlation test was applied to determine relationships between measurement tools, and binary logistic regression was used to assess predictive effects. Findings Analysis of the descriptive characteristics of patients who underwent radial angiography indicated a mean age of 56.56 ± 10.52 years (range: 40–89). Among these patients, 45.4% were between 50 and 59 years old, 91.8% were male, 72.2% had secondary education or less, 89.7% were married, and 74.6% were not employed. Additionally, 82.1% received angioplasty (stent or balloon) during angiography, 61.9% had no previous surgical intervention, 74.9% had been hospitalized previously, and 52.9% had a chronic disease. All patients in this study underwent radial angiography for either acute myocardial infarction (MI) or follow-up, with 79% undergoing the procedure due to acute MI (Table 1 ). Table 1 Descriptive characteristics of patients (N = 291) Variables Group N % Age 49 years and below 84 28.9 50–59 years 132 45.4 60 years and above 75 25.8 Gender Female 24 8.2 Male 267 91.8 Education status Secondary education and below 210 72.2 Higher education and above 81 27.8 Marital status Married 261 89.7 Single 30 10.3 Employment status Yes 74 25.4 No 217 74.6 Procedure reason Acute MI 230 79.0 Follow-up 61 21.0 Procedure Angiography 52 17.9 Angioplasty (Stent/balloon insertion) 239 82.1 Previous surgical intervention Yes 178 61.2 No 113 38.8 Previous hospitalization status Yes 218 74.9 No 73 25.1 Admission type Emergency 180 61.9 Planned 111 38.1 Chronic disease status Yes 154 52.9 No 137 47.1 Giving information about the intervention Yes 245 84.2 No 46 15.8 Analysis of the descriptive characteristics of the measurement tools indicated mean scores of 84.97 ± 28.038 for the Perianesthesia Comfort Scale, 35.69 ± 9.275 for the State Anxiety Scale, and 43.25 ± 6.196 for the Trait Anxiety Scale. The mean pain score was 5.52 ± 2.463 (Table 2 ). Table 2 Descriptive characteristics of the measurement tools Cronbach α Min Max Mean S.D. PCS Total 0.913 39 136 84.97 28.038 State Anxiety Inventory (SAI) 0.908 20 52 35.69 9.275 Trait Anxiety Inventory (TAI) 0.699 28 52 43.25 6.196 Pain scale - 0 10 5.52 2.463 PCS: Perianesthesia Comfort Scale; SAI: State Anxiety Scale; TAI: Trait Anxiety Scale, S.D.: Standard Deviation When the correlation coefficients of the measurement tools were evaluated with each other, it was found that there was a negative weak relationship between comfort and pain (r=-0.116, p = 0.048), a positive weak relationship between pain and state anxiety level (r = 0.126, p = 0.032), and a positive weak relationship between state anxiety and trait anxiety (r = 0.118, p = 0.045) (Table 3 ). Table 3 Correlation between measurement tools Measurement tools 1 2 3 4 1. PCS Score 1 2. State Anxiety Inventory (SAI) Score r p 0.028 0.633 1 3. Trait Anxiety Inventory (TAI) Score r p 0.029 0.623 0.118 * 0.045 1 4. Pain scale r p -0.116 * 0.048 0.126 * 0.032 0.039 0.50 1 r: Pearson Correlation analysis, p < 0.001. PCS: Perianesthesia Comfort Scale; SAI: State Anxiety Scale; TAI: Trait Anxiety Scale Multiple logistic regression analysis was conducted using the Forward Wald method. The state and trait anxiety scale and pain were included as quantitative continuous independent variables, while age, gender, educational status, marital status, employment status, chronic disease status, previous surgical intervention, provision of information about the procedure, the procedure performed, and clinical diagnosis were included as categorical independent variables. The model demonstrated acceptable fit according to the Hosmer-Lemeshow test (χ2HL (8) = 3.60; p > 0.05). The Wald test indicated that both clinical diagnosis group (χ2Wald (1) = 4.88; p < 0.001) and procedure group (χ2Wald (1) = 6.04; p < 0.001) were statistically significant predictors of membership in low and high comfort level groups. The comfort level in the angiography group was 5.752 times higher than in the angioplasty (stent/balloon insertion) group, and the comfort level in the follow-up group was higher than in the acute MI group (p < 0.05) (Table 4 ). Table 4 Factors influencing comfort as shown by binary logistic regression analysis (N = 291). Variables B S.E. Wald df p Exp(B) Age 0.004 0.012 0.141 1 0.707 1.004 Gender 0.554 0.456 1.474 1 0.225 1.740 Education level 0.017 0.277 0.004 1 0.952 1.017 Marital status -0.004 0.404 0.000 1 0.992 0.996 Employment status -0.115 0.282 .166 1 0.683 0.891 Chronic disease status − .0338 0.252 1.801 1 0.180 0.713 Previous surgical intervention 0.326 0.253 1.664 1 0.197 1.385 Previous hospitalization status -0.157 0.283 0.307 1 0.579 0.855 Admission type 0.278 0.252 1.212 1 0.271 1.320 Giving information about the intervention -0.224 0.345 0.422 1 0.516 0.799 Procedure reason 1.510 0.683 4.886 1 0.027 4.527 Procedure 1.749 0.712 6.041 1 0.014 5.752 Pain Scale -0.038 0.052 0.533 1 0.465 0.963 State Anxiety Scale 0.007 0.013 0.240 1 0.624 1.007 Trait Anxiety Scale -0.005 0.020 0.054 1 0.816 0.995 Constant -1.602 1.444 1.230 1 0.267 0.202 S:E: Standard Error; df: Degrees of Freedom; Exp(B): Exponential (B) Discussion Angiography procedures represent a specialized domain within surgical nursing practice. The knowledge and skills of surgical nurses in pre-procedural preparation, intra-procedural support, and post-procedural care directly influence patient safety and treatment outcomes [ 18 ]. Angiography, as a diagnostic and therapeutic imaging intervention, often elevates patient anxiety, generates uncertainty, and impacts comfort, particularly regarding post-procedural considerations rather than the procedure itself [ 29 ]. During angiography, the condition of the coronary arteries is assessed via the femoral or radial artery, and blocked vessels may be treated with stent or balloon placement, depending on clinical indications. Patients unsuitable for this intervention are referred for cardiac surgery. This imaging technique is utilized both in patients presenting with acute myocardial infarction and those undergoing routine follow-up [ 29 , 30 ]. The present study aimed to determine the relationship between pain and anxiety levels in patients undergoing radial angiography, their comfort level, and the variables predicting comfort. The findings indicate a weak negative correlation between pain levels and patient comfort following radial angiography (RAG), suggesting that increased pain is associated with decreased comfort. No prior research specifically addresses this relationship in the context of RAG. However, a randomized controlled trial demonstrated that pain and discomfort were lower with the RAG approach compared to the femoral approach [ 31 ]. While direct studies on RAG are lacking, existing literature indicates that femoral angiography is associated with greater negative effects on patient comfort and pain due to factors such as femoral access, use of a sheath, application of a sandbag, prolonged leg immobilization, and its longer historical use [ 5 , 10 , 32 ]. Although the direct relationship between pain and comfort has not been examined in femoral angiography patients, studies have evaluated these variables separately. These studies found that auricular acupressure improved pain management and comfort [ 5 ], head elevation in the supine position reduced pain and increased comfort [ 32 ], and that pain and comfort were not significantly affected in the head-of-bed elevation group [ 33 ]. In summary, even procedures with a low risk of complications and rapid mobilization, such as RAG, can impact patient pain and comfort levels. Interventions aimed at increasing comfort and reducing pain remain essential. Higher comfort levels may contribute to more favorable patient perceptions of the procedure, faster recovery, and greater satisfaction with healthcare services. The present study found no significant relationship between state and trait anxiety scores and comfort levels in patients undergoing RAG. No prior research has addressed this relationship in RAG. However, studies utilizing the State-Trait Anxiety Inventory (STAI) in femoral angiography have reported an association between anxiety and comfort [ 4 ], as well as a weak negative correlation between comfort and pain levels [ 34 ]. These findings suggest that healthcare professionals should inform patients before and after the procedure, provide psychological support, and tailor interventions to individual risk factors to reduce anxiety and enhance comfort. The study identified a weak positive correlation between patients' pain and state anxiety levels. Few studies have compared pain and anxiety levels following RAG. Randomized controlled trials have examined the effects of various interventions on pain and anxiety. For example, one study found that needle size did not affect anxiety or pain, but a significant difference existed between anxiety and pain levels before arterial puncture [ 35 ]. Another study using a stress ball intervention reported a significant decrease in STAI scores (p < 0.05), with a positive and significant correlation between mean pain and STAI post-test scores in the experimental group (p < 0.05), indicating that reduced pain was associated with decreased anxiety [ 36 ]. These findings suggest that pain during RAG may disrupt psychological comfort by increasing anxiety. Anxiety is thus not only a psychological state but is also directly related to physical experiences [ 37 ]. The relationship between pain and anxiety after RAG is clinically significant and reciprocal. Therefore, it is essential to assess and manage both anxiety and pain together after RAG using holistic approaches to optimize patient comfort and recovery. In addition to pain and anxiety, sociodemographic variables were evaluated for their contribution to predicting comfort level groups. The Wald test results indicated that pain and anxiety were not significant predictors of comfort level groups. The intervention was limited to examination, while treatment involved the insertion of balloons or stents to improve comfort. Patients who underwent only angiography had a 5.752 times higher likelihood of transitioning from low to high comfort compared to those who underwent angioplasty (stent or balloon application). Thus, angioplasty appears to decrease comfort, potentially due to its use in more severe cases, such as treating narrowed or blocked arteries resulting from coronary artery disease [ 38 ]. Among the groups categorized by reason for the procedure, only patients who underwent follow-up exhibited a 4.527 times higher comfort level. This finding is supported by evidence that both physical and psychological factors contribute to decreased comfort in patients with acute myocardial infarction (MI). Physically, symptoms such as severe chest pain, shortness of breath, fatigue, and discomfort from invasive procedures significantly reduce comfort during and after hospitalization [ 39 , 40 ]. Psychologically, stressors including uncertainty about the disease, fear of death, and lifestyle changes negatively impact comfort by triggering anxiety and depression [ 41 ]. Study Limitations As the study was conducted at a single center within a specific date range, the findings may not be generalizable to all patients undergoing angiography. Additionally, the descriptive design evaluated predictive effects but does not establish causality. Conclusion The study identified a weak negative relationship between comfort and pain, indicating that increased pain is associated with decreased comfort. A weak positive correlation was also observed between pain and state anxiety, suggesting that higher pain levels correspond with increased situational anxiety. Patients who underwent angiography experienced a 5.752 times higher comfort level compared to those who received angioplasty (stent or balloon placement), and those undergoing follow-up had a 4.527 times higher comfort level compared to the acute MI group. Following RAG, it is essential to assess both anxiety and pain and manage them holistically to optimize patient comfort and recovery. Abbreviations CVD Cardiovascular diseases WHO World Health Organization TUIK Turkish Statistical Institute PCS Perianesthesia Comfort Scale VAS Visual Analog Scale STAI Statit anxiety score AG Angiography MI Miyorcardial infarction Declarations Ethics approval and consent to participate The study adhered to the principles outlined in the Declaration of Helsinki. Permission to use the scales to be used in the study was obtained from the researchers via email. Ethics committee approval was secured from XXX University Social and Human Science Ethics Committee (Date: 22.12.2021, Number: 150). Permission was obtained from Beykent University Hospital to conduct the study at the relevant institution. Participants included in the sample were provided with information regarding the research’s objectives, voluntary participation, and the necessity of obtaining their written consent. Patients included in the study completed the questionnaire after reading and approving the "Informed Voluntary Consent Form," which detailed the study’s purpose and emphasized the voluntary nature of participation. Informed consent was obtained from all individual participants. Participants were also informed that the results might be published anonymously in scientific journals, and they provided their consent for publication. All author have contributed to the above paper and are familiar with the final draft and have no conflict of interest. The author also received no supporting source for assistance with the study design, data collection, data analysis, or manuscript preparation. Consent for publication Not applicable. Availability of data and materials The datasets used and/or analyzed in this study are available from the corresponding author on reasonable request. Competing interests The authors declare no competing interests. Funding The authors declare no conflict of interest. Authors' contributions Author contributions Y.E.T. and D.A. designed the research study. Y.E.T. and D.A performed the research. Y.E.T. involved in patient recruitment, study conduct and follow-up. D.A. analyzed the data. Y.E.T. and D.A. wrote the manuscript. D.A. analyzed the data and Y.E.T. and D.A. edited the manuscript. All authors contributed to editorial changes in the manuscript. All authors read and approved the final manuscript Acknowledgements Not applicable Clinical trial number Not applicable References World Health Organization. World health statistics 2024: Monitoring health for the SDGs, sustainable development goals. World Health Organization; 2024. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8823880","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":617086413,"identity":"67c82d9a-07ce-4d77-8106-9cb8557a6830","order_by":0,"name":"Yasemin Eda Tekin","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAxklEQVRIiWNgGAWjYHACAwaGAwxyINaBB0RrOXCAwRisJYEULYkNICZRWgyON2/8/OHMnfT5YYcfAm2xk9NtIKTlzLFiiQM3nuVuvJ1mANSSbGx2gJCWGzkGEgc+HM7dODsBpOVA4jaCWu6/Mf4B1JJuODv9A5FabvCYAR12OEFeOodIWyTPpJVZnDlz2HCDdE7BgQQDIvzCd/zw5hsVxw7Ly89O3/zhQ4WdHEEtCjAFBmCGAQHlICDfgM4YBaNgFIyCUYAOADx3U0Jiz/TQAAAAAElFTkSuQmCC","orcid":"","institution":"Mudanya University","correspondingAuthor":true,"prefix":"","firstName":"Yasemin","middleName":"Eda","lastName":"Tekin","suffix":""},{"id":617086414,"identity":"bad5b570-9d8c-4985-87d0-b5c19b8fb04e","order_by":1,"name":"Didem Ayhan","email":"","orcid":"","institution":"Bandırma Onyedi Eylül University","correspondingAuthor":false,"prefix":"","firstName":"Didem","middleName":"","lastName":"Ayhan","suffix":""}],"badges":[],"createdAt":"2026-02-08 19:38:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8823880/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8823880/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106225891,"identity":"6327e0da-ac3d-44b0-91a0-1af74ddc92f6","added_by":"auto","created_at":"2026-04-06 11:11:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":761313,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8823880/v1/1b9f62fb-8231-4165-bb45-168a457e210f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The relationship between pain, anxiety, and comfort, and the predictors of comfort in patients undergoing radial angiography","fulltext":[{"header":"Background","content":"\u003cp\u003eCardiovascular diseases (CVDs) represent the leading cause of mortality, as reported by the World Health Organization (WHO) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Globally, CVDs account for 32.4% of all deaths attributed to these conditions [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In Turkey, the 2023 death and cause-of-death statistics published by the Turkish Statistical Institute (TUIK) indicate that this rate rises to 33.4% [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCoronary angiography (CAG) is considered the gold standard for the examination, diagnosis, and treatment of coronary arteries [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. CAG can be performed using either transfemoral or transradial access methods [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The transradial approach has become increasingly preferred in recent years due to its association with lower mortality, easier access, and reduced cost [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Notably, the lower incidence of bleeding complications and the potential for early patient mobilization contribute to both clinicians' and patients' preference for radial angiography [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Despite being regarded as less invasive, radial angiography can significantly affect patient comfort, pain, and anxiety levels during and after the procedure [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRadial angiography offers several advantages, including low levels of post-procedural pain. Multiple anatomical, technical, and physiological factors contribute to this outcome. The superficial location of the radial artery and the ease of applying compression result in fewer post-procedural complications, such as bleeding and hematoma, thereby reducing irritation of surrounding tissues and minimizing pain [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Additionally, the absence of large nerves near the radial artery further decreases the risk of nerve-related pain, which is more commonly associated with femoral artery access [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Nevertheless, pain during and after radial angiography can arise from various sources, including vascular complications, nerve injury, and hemostatic interventions [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Prolonged pain may negatively impact patient comfort, restrict physical activity, delay recovery, and increase cardiac workload, blood pressure, heart rate, and respiratory rate [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Therefore, effective pain management is essential to enhance patient comfort and expedite recovery following the procedure [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAnxiety is a common psychological response among patients undergoing invasive interventional procedures and significantly influences both pain perception and overall comfort [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The literature demonstrates that elevated anxiety levels lower the pain threshold, resulting in more intense pain experiences during procedures [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. This heightened pain perception can reduce patient satisfaction and adversely affect recovery. Moreover, increased anxiety may trigger physiological stress responses, leading to unfavorable changes in cardiovascular parameters [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Consequently, effective anxiety management is essential for facilitating pain control and enhancing post-procedural comfort.\u003c/p\u003e \u003cp\u003eComfort is closely associated with pain and anxiety following angiography [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. It is defined as a state in which patients experience mental and physical well-being, absence of unpleasant sensations such as pain or drowsiness, and fulfillment of physical, psychological, and social needs [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Research indicates that increased state anxiety correlates with decreased comfort levels [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Additionally, factors such as heightened fear and anxiety prior to angiography, advanced age, and the presence of chronic disease contribute to reduced post-procedural comfort [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Ergonomic interventions have been shown to improve patient comfort, decrease pain, and enhance overall well-being during and after angiography [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA comprehensive understanding of the factors influencing pain, anxiety, and comfort in patients undergoing radial angiography supports the development of patient-centered care strategies. This knowledge enables nurses and healthcare teams to more accurately assess individual patient needs and implement personalized pain management plans, reduce anxiety, and enhance comfort. Recent international studies highlight the interrelated nature of these factors and emphasize the necessity of a multidisciplinary approach. The present study aims to determine the relationship between comfort and patients' pain, anxiety levels, and other relevant factors during radial angiography.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eThis study was conducted using a descriptive cross-sectional design.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSample\u003c/h3\u003e\n\u003cp\u003eThe descriptive cross-sectional study was conducted at a university hospital in Istanbul, T\u0026uuml;rkiye. The study population comprised patients who underwent transradial angiography between February and June 2022. Inclusion criteria included patients over 18 years of age who underwent RAG, were able to communicate, and provided informed consent. The sample size was calculated for logistic regression analysis using the G*Power program, considering Cohen's median effect size value of 0.30, a 95% confidence interval, and 80% statistical power [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Based on these criteria, the minimum required sample size was 242 participants. To account for potential data loss, 300 individuals were recruited; however, nine were excluded due to missing data. Consequently, analyses were performed on a final sample of 291 participants.\u003c/p\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eThe data were collected using the Sociodemographic data collection form, the Perianesthesia Comfort Scale, the Visual Analog Scale, and the State/Trait Anxiety Scale.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSociodemographic data collection form\u003c/strong\u003e \u003cp\u003eThis 10-question form was developed by the researchers and included demographic information (age and gender), the reason for RAG, the type of procedure performed, and past treatment history.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePerianesthesia Comfort Scale (PCS)\u003c/strong\u003e \u003cp\u003eThe PCS, developed by Kolcaba in 1991, is a measurement tool designed to assess patients' physical, psychological, and environmental comfort before and after surgical intervention [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The Turkish adaptation and its validity and reliability were established by \u0026Uuml;st\u0026uuml;ndağ and Eti Aslan in 2010. The PCS comprises 24 items, each scored on a 6-point Likert-type scale, where 1 indicates \"strongly disagree\" and 6 indicates \"strongly agree.\" Total scores range from 24 to 144, with higher scores reflecting greater patient comfort. In the Turkish adaptation, Cronbach's alpha was 0.83 and the test-retest correlation was 0.98 [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. In the present study, the internal consistency coefficient was 0.913 (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eVisual Analog Scale (VAS)\u003c/strong\u003e \u003cp\u003eThe VAS is an assessment tool used to measure pain severity, consisting of a 10 cm horizontal line with endpoints labeled \"no pain\" and \"severe pain.\" Participants indicate the point that best represents their pain, resulting in a score from 0 to 10. Higher scores correspond to greater pain severity. The VAS is widely utilized in both acute and chronic pain assessments. Its Turkish adaptation has been validated and shown to be reliable across various patient groups. The scale is preferred in clinical practice due to its simplicity and rapid administration [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Scores of 1\u0026ndash;4, 5\u0026ndash;6, and 7\u0026ndash;10 represent mild, moderate, and severe pain, respectively [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eState-Trait Anxiety Inventory (STAI)\u003c/b\u003e: The STAI, developed by Spielberger and colleagues in 1970, measures individual anxiety levels [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The Turkish adaptation and its validity and reliability were established by Le Compte and \u0026Ouml;ner in 1976 [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. The instrument comprises two subscales: state anxiety (temporary anxiety experienced in specific situations) and trait anxiety (general tendency toward anxiety). The STAI contains 40 items, with the first 20 items forming the State Anxiety Scale and the remaining 20 forming the Trait Anxiety Scale. Each item is rated on a 4-point Likert-type scale. The State Anxiety Scale evaluates current emotional state, while the Trait Anxiety Scale assesses general anxiety tendencies. Both subscales have a total score range of 20\u0026ndash;80, with higher scores indicating greater anxiety. Scores of 0\u0026ndash;40 indicate no anxiety, 41\u0026ndash;60 indicate mild anxiety, and scores above 61 indicate severe anxiety [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. In the Turkish reliability analysis, Cronbach's alpha coefficients were 0.94 for the State Anxiety Scale and 0.83 for the Trait Anxiety Scale [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. In the present study, the internal consistency coefficients for the state and trait anxiety scales were 0.908 and 0.699, respectively (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eStatistical Analyses\u003c/h3\u003e\n\u003cp\u003eData analysis was performed using SPSS software (version 26.0; IBM Inc., Canada). Discrete variables are presented as numbers (n) and percentages (%), while continuous variables are reported as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation. Kurtosis and skewness values were calculated to assess normality of data distribution. Internal consistency of the measurement tools was evaluated using Cronbach's alpha. The Pearson correlation test was applied to determine relationships between measurement tools, and binary logistic regression was used to assess predictive effects.\u003c/p\u003e"},{"header":"Findings","content":"\u003cp\u003eAnalysis of the descriptive characteristics of patients who underwent radial angiography indicated a mean age of 56.56\u0026thinsp;\u0026plusmn;\u0026thinsp;10.52 years (range: 40\u0026ndash;89). Among these patients, 45.4% were between 50 and 59 years old, 91.8% were male, 72.2% had secondary education or less, 89.7% were married, and 74.6% were not employed. Additionally, 82.1% received angioplasty (stent or balloon) during angiography, 61.9% had no previous surgical intervention, 74.9% had been hospitalized previously, and 52.9% had a chronic disease. All patients in this study underwent radial angiography for either acute myocardial infarction (MI) or follow-up, with 79% undergoing the procedure due to acute MI (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive characteristics of patients (N\u0026thinsp;=\u0026thinsp;291)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49 years and below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50\u0026ndash;59 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 years and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e91.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEducation status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary education and below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e72.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigher education and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e261\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEmployment status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e74.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eProcedure reason\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAcute MI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e79.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFollow-up\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eProcedure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAngiography\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAngioplasty (Stent/balloon insertion)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e82.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePrevious surgical intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e61.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePrevious hospitalization status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e218\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e74.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdmission type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmergency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e61.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePlanned\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eChronic disease status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e154\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGiving information about the intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e245\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e84.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAnalysis of the descriptive characteristics of the measurement tools indicated mean scores of 84.97\u0026thinsp;\u0026plusmn;\u0026thinsp;28.038 for the Perianesthesia Comfort Scale, 35.69\u0026thinsp;\u0026plusmn;\u0026thinsp;9.275 for the State Anxiety Scale, and 43.25\u0026thinsp;\u0026plusmn;\u0026thinsp;6.196 for the Trait Anxiety Scale. The mean pain score was 5.52\u0026thinsp;\u0026plusmn;\u0026thinsp;2.463 (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive characteristics of the measurement tools\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCronbach α\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMin\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMax\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eS.D.\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePCS Total\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.913\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e84.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e28.038\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eState Anxiety Inventory (SAI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.908\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e35.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e9.275\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrait Anxiety Inventory (TAI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.699\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e43.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e6.196\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePain scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.463\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003ePCS: Perianesthesia Comfort Scale; SAI: State Anxiety Scale; TAI: Trait Anxiety Scale, S.D.: Standard Deviation\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWhen the correlation coefficients of the measurement tools were evaluated with each other, it was found that there was a negative weak relationship between comfort and pain (r=-0.116, p\u0026thinsp;=\u0026thinsp;0.048), a positive weak relationship between pain and state anxiety level (r\u0026thinsp;=\u0026thinsp;0.126, p\u0026thinsp;=\u0026thinsp;0.032), and a positive weak relationship between state anxiety and trait anxiety (r\u0026thinsp;=\u0026thinsp;0.118, p\u0026thinsp;=\u0026thinsp;0.045) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCorrelation between measurement tools\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeasurement tools\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. PCS Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2. State Anxiety Inventory (SAI) Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003er\u003c/p\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003cp\u003e0.633\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3. Trait Anxiety Inventory (TAI) Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003er\u003c/p\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003cp\u003e0.623\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.118\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.045\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4. Pain scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003er\u003c/p\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.116\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.048\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.126\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.032\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.039\u003c/p\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003er: Pearson Correlation analysis, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001.\u003c/p\u003e \u003cp\u003ePCS: Perianesthesia Comfort Scale; SAI: State Anxiety Scale; TAI: Trait Anxiety Scale\u003c/p\u003e \u003cp\u003eMultiple logistic regression analysis was conducted using the Forward Wald method. The state and trait anxiety scale and pain were included as quantitative continuous independent variables, while age, gender, educational status, marital status, employment status, chronic disease status, previous surgical intervention, provision of information about the procedure, the procedure performed, and clinical diagnosis were included as categorical independent variables. The model demonstrated acceptable fit according to the Hosmer-Lemeshow test (χ2HL (8)\u0026thinsp;=\u0026thinsp;3.60; p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The Wald test indicated that both clinical diagnosis group (χ2Wald (1)\u0026thinsp;=\u0026thinsp;4.88; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and procedure group (χ2Wald (1)\u0026thinsp;=\u0026thinsp;6.04; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were statistically significant predictors of membership in low and high comfort level groups. The comfort level in the angiography group was 5.752 times higher than in the angioplasty (stent/balloon insertion) group, and the comfort level in the follow-up group was higher than in the acute MI group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors influencing comfort as shown by binary logistic regression analysis (N\u0026thinsp;=\u0026thinsp;291).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eS.E.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWald\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003edf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eExp(B)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.707\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.554\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.456\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.474\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.225\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.740\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.277\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.952\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.404\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.992\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.996\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.282\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.683\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.891\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChronic disease status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.0338\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.252\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.801\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.713\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrevious surgical intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.326\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.664\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.385\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrevious hospitalization status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.283\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.307\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.579\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.855\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdmission type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.278\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.252\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.212\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.271\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.320\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGiving information about the intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.224\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.345\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.422\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.516\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.799\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProcedure reason\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.510\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.683\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.886\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.027\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4.527\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProcedure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.749\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.712\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.041\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.014\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e5.752\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePain Scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.038\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.533\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.465\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.963\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eState Anxiety Scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.624\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrait Anxiety Scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.816\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.995\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.602\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.444\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.202\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eS:E: Standard Error; df: Degrees of Freedom; Exp(B): Exponential (B)\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eAngiography procedures represent a specialized domain within surgical nursing practice. The knowledge and skills of surgical nurses in pre-procedural preparation, intra-procedural support, and post-procedural care directly influence patient safety and treatment outcomes [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Angiography, as a diagnostic and therapeutic imaging intervention, often elevates patient anxiety, generates uncertainty, and impacts comfort, particularly regarding post-procedural considerations rather than the procedure itself [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. During angiography, the condition of the coronary arteries is assessed via the femoral or radial artery, and blocked vessels may be treated with stent or balloon placement, depending on clinical indications. Patients unsuitable for this intervention are referred for cardiac surgery. This imaging technique is utilized both in patients presenting with acute myocardial infarction and those undergoing routine follow-up [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. The present study aimed to determine the relationship between pain and anxiety levels in patients undergoing radial angiography, their comfort level, and the variables predicting comfort.\u003c/p\u003e \u003cp\u003eThe findings indicate a weak negative correlation between pain levels and patient comfort following radial angiography (RAG), suggesting that increased pain is associated with decreased comfort. No prior research specifically addresses this relationship in the context of RAG. However, a randomized controlled trial demonstrated that pain and discomfort were lower with the RAG approach compared to the femoral approach [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. While direct studies on RAG are lacking, existing literature indicates that femoral angiography is associated with greater negative effects on patient comfort and pain due to factors such as femoral access, use of a sheath, application of a sandbag, prolonged leg immobilization, and its longer historical use [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Although the direct relationship between pain and comfort has not been examined in femoral angiography patients, studies have evaluated these variables separately. These studies found that auricular acupressure improved pain management and comfort [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], head elevation in the supine position reduced pain and increased comfort [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e], and that pain and comfort were not significantly affected in the head-of-bed elevation group [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn summary, even procedures with a low risk of complications and rapid mobilization, such as RAG, can impact patient pain and comfort levels. Interventions aimed at increasing comfort and reducing pain remain essential. Higher comfort levels may contribute to more favorable patient perceptions of the procedure, faster recovery, and greater satisfaction with healthcare services.\u003c/p\u003e \u003cp\u003eThe present study found no significant relationship between state and trait anxiety scores and comfort levels in patients undergoing RAG. No prior research has addressed this relationship in RAG. However, studies utilizing the State-Trait Anxiety Inventory (STAI) in femoral angiography have reported an association between anxiety and comfort [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], as well as a weak negative correlation between comfort and pain levels [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. These findings suggest that healthcare professionals should inform patients before and after the procedure, provide psychological support, and tailor interventions to individual risk factors to reduce anxiety and enhance comfort.\u003c/p\u003e \u003cp\u003eThe study identified a weak positive correlation between patients' pain and state anxiety levels. Few studies have compared pain and anxiety levels following RAG. Randomized controlled trials have examined the effects of various interventions on pain and anxiety. For example, one study found that needle size did not affect anxiety or pain, but a significant difference existed between anxiety and pain levels before arterial puncture [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Another study using a stress ball intervention reported a significant decrease in STAI scores (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), with a positive and significant correlation between mean pain and STAI post-test scores in the experimental group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), indicating that reduced pain was associated with decreased anxiety [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. These findings suggest that pain during RAG may disrupt psychological comfort by increasing anxiety. Anxiety is thus not only a psychological state but is also directly related to physical experiences [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. The relationship between pain and anxiety after RAG is clinically significant and reciprocal. Therefore, it is essential to assess and manage both anxiety and pain together after RAG using holistic approaches to optimize patient comfort and recovery.\u003c/p\u003e \u003cp\u003eIn addition to pain and anxiety, sociodemographic variables were evaluated for their contribution to predicting comfort level groups. The Wald test results indicated that pain and anxiety were not significant predictors of comfort level groups. The intervention was limited to examination, while treatment involved the insertion of balloons or stents to improve comfort. Patients who underwent only angiography had a 5.752 times higher likelihood of transitioning from low to high comfort compared to those who underwent angioplasty (stent or balloon application). Thus, angioplasty appears to decrease comfort, potentially due to its use in more severe cases, such as treating narrowed or blocked arteries resulting from coronary artery disease [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAmong the groups categorized by reason for the procedure, only patients who underwent follow-up exhibited a 4.527 times higher comfort level. This finding is supported by evidence that both physical and psychological factors contribute to decreased comfort in patients with acute myocardial infarction (MI). Physically, symptoms such as severe chest pain, shortness of breath, fatigue, and discomfort from invasive procedures significantly reduce comfort during and after hospitalization [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. Psychologically, stressors including uncertainty about the disease, fear of death, and lifestyle changes negatively impact comfort by triggering anxiety and depression [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e].\u003c/p\u003e"},{"header":"Study Limitations","content":"\u003cp\u003eAs the study was conducted at a single center within a specific date range, the findings may not be generalizable to all patients undergoing angiography. Additionally, the descriptive design evaluated predictive effects but does not establish causality.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study identified a weak negative relationship between comfort and pain, indicating that increased pain is associated with decreased comfort. A weak positive correlation was also observed between pain and state anxiety, suggesting that higher pain levels correspond with increased situational anxiety. Patients who underwent angiography experienced a 5.752 times higher comfort level compared to those who received angioplasty (stent or balloon placement), and those undergoing follow-up had a 4.527 times higher comfort level compared to the acute MI group. Following RAG, it is essential to assess both anxiety and pain and manage them holistically to optimize patient comfort and recovery.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eCVD\u0026nbsp;\u003c/strong\u003eCardiovascular diseases\u003c/p\u003e\n\u003cp\u003eWHO World Health Organization\u003c/p\u003e\n\u003cp\u003eTUIK Turkish Statistical Institute\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePCS Perianesthesia Comfort Scale\u003c/p\u003e\n\u003cp\u003eVAS Visual Analog Scale\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSTAI Statit anxiety score\u003c/p\u003e\n\u003cp\u003eAG Angiography\u003c/p\u003e\n\u003cp\u003eMI Miyorcardial infarction\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study adhered to the principles outlined in the Declaration of Helsinki. Permission to use the scales to be used in the study was obtained from the researchers via email. Ethics committee approval was secured from XXX University Social and Human Science Ethics Committee (Date: 22.12.2021, Number: 150). Permission was obtained from Beykent University Hospital to conduct the study at the relevant institution. Participants included in the sample were provided with information regarding the research\u0026rsquo;s objectives, voluntary participation, and the necessity of obtaining their written consent. Patients included in the study completed the questionnaire after reading and approving the \u0026quot;Informed Voluntary Consent Form,\u0026quot; which detailed the study\u0026rsquo;s purpose and emphasized the voluntary nature of participation. Informed consent was obtained from all individual participants. Participants were also informed that the results might be published anonymously in scientific journals, and they provided their consent for publication. All author have contributed to the above paper and are familiar with the final draft and have no conflict of interest. The author also received no supporting source for assistance with the study design, data collection, data analysis, or manuscript preparation.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed in this study are available from the corresponding author on reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthor contributions Y.E.T. and D.A. designed the research study. Y.E.T. and D.A performed the research. Y.E.T. involved in patient recruitment, study conduct and follow-up. D.A. analyzed the data. Y.E.T. and D.A. wrote the manuscript. D.A. analyzed the data and Y.E.T. and D.A. edited the manuscript. All authors contributed to editorial changes in the manuscript. All authors read and approved the final manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. World health statistics 2024: Monitoring health for the SDGs, sustainable development goals. World Health Organization; 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEuropean Commission. Cardiovascular diseases statistics. 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Front Psychol. 2023;14:1302699. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fpsyg.2023.1302699\u003c/span\u003e\u003cspan address=\"10.3389/fpsyg.2023.1302699\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Comfort, Pain, Anxiety, Radial Angiography","lastPublishedDoi":"10.21203/rs.3.rs-8823880/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8823880/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThis study aims to determine the relationship between comfort and patients' pain, anxiety levels, and predictors of comfort undergoing radial angiography (RAG). A descriptive cross-sectional study was conducted.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe study included 291 patients who underwent radial angiography between February and June 2022. Data were collected using the Sociodemographic Characteristics form, Perianesthesia Comfort Scale (PCS), Visual Analog Scale (VAS), and State-Trait Anxiety Inventory (STAI).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAnalysis revealed a weak negative correlation between pain and comfort (r = -0.116, p\u0026thinsp;=\u0026thinsp;0.048) and a weak positive correlation between pain and state anxiety (r = -0.126, p\u0026thinsp;=\u0026thinsp;0.032). Comfort levels were 5.752 times higher in patients who underwent angiography only compared to those who received stent or balloon implantation, and 4.527 times higher in patients who underwent angiography only for follow-up compared to those with acute myocardial infarction (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003ePatient comfort decreases as pain increases, and pain levels following radial angiography are moderate. The perception of pain during RAG procedures is a key factor that directly influences patient comfort.\u003c/p\u003e","manuscriptTitle":"The relationship between pain, anxiety, and comfort, and the predictors of comfort in patients undergoing radial angiography","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-06 11:09:16","doi":"10.21203/rs.3.rs-8823880/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-18T07:49:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"327889095690656026872332963804236341149","date":"2026-04-11T02:41:26+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-06T14:41:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"198294636348323104541301028274319880860","date":"2026-04-02T08:25:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"314900657802608092383198736590135036730","date":"2026-04-01T23:05:21+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-01T16:19:53+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-11T09:39:22+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-10T03:58:24+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-10T03:58:08+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Cardiovascular Disorders","date":"2026-02-08T19:34:13+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d3cdc490-1882-458b-b1c6-b0c4ee062857","owner":[],"postedDate":"April 6th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-06T11:09:16+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-06 11:09:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8823880","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8823880","identity":"rs-8823880","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}