An overview of clinical associate roles in the neurointerventional specialty.

Neurointerventionalists have long partnered with certain types of clinical associates to provide longitudinal care. This overview summarizes differences in education, background, roles, and scopes of practice of the various clinical associates (physician assistants, nurse practitioners, clinical nurse specialists, radiology practitioner assistants, radiologist assistants, and nursing care coordinators). Key differences and similarities are highlighted to alleviate confusion about the roles clinical associates can assume on a neurointerventional service. This overview is intended to guide practices as they consider broadening their clinical support teams.

Effects of a music intervention on patients undergoing cerebral angiography: a pilot study.

PURPOSE: To test the effect of a music intervention on procedural anxiety, stress response and medication requirements in participants with a cerebral aneurysm or arteriovenous malformation (AVM) undergoing cerebral angiography. METHOD AND MATERIALS: A prospective pilot study was conducted using an experimental two group pre-test, post-test design. 48 participants were randomly assigned to a control group (standard care) or experimental group (standard care plus self-selected music via overhead stereo system). The stress response was measured by heart rate (HR) and systolic blood pressure (SBP) at baseline, and during and following the procedure. Anxiety was measured by the State Trait Anxiety Inventory for Adults (STAI) before and after the procedure, and total medications administered periprocedurally were recorded. RESULTS: 24 participants in each group were enrolled. R-ANCOVA revealed non-significant findings for HR (F=1.4; p=0.27; power=0.38) and SBP (F=2.1; p=0.10; power=0.57). The ANCOVA for anxiety revealed significantly lower STAI scores in the control group (F=3.8; p=0.003) compared with the experimental group. Independent t test analysis for the total doses of fentanyl and midazolam were found to be F=0.08, p=0.78 and F=0.38, p=0.54, respectively. CONCLUSION: A music intervention on participants with a brain aneurysm or AVM undergoing cerebral angiography did not have a statistically significant impact on reducing the stress response, anxiety or medication requirements. Interestingly, participants in the control group had significantly less anxiety after their angiogram than did participants in the experimental group. This pilot study sets the stage for future research to further examine these findings.