Improving Provider Knowledge and Screening of Cardiac Anxiety Through an Educational Module

Abstract

Background: Cardiac-specific anxiety (CSA) is often underrecognized and affects patients after events like myocardial infarction (MI), coronary artery bypass grafting (CABG), heart failure (HF), or implantable cardioverter defibrillator (ICD) placement. Higher CSA levels are associated with worse cardiac outcomes, lower quality of life, poor treatment adherence, and increased healthcare use (Schmitz et al., 2022; Van Beek et al., 2016). Although organizations like the American Heart Association (AHA) and the American Psychiatric Association (APA) recommend routine psychosocial screening, real-world adoption is inconsistent. Evidence shows that only about 60% of patients in cardiac rehab are screened for anxiety or depression, with significant variation in screening methods across different groups (Helmark et al., 2022). The Cardiac Anxiety Questionnaire (CAQ), a validated screening tool for CSA, is underused in clinical practice due to gaps in provider knowledge and workflow challenges. Purpose: This quality improvement (QI) project aimed to enhance advanced practice providers’ (APPs) knowledge, confidence, and intention to screen for cardiac-specific anxiety with the CAQ via a brief, self-paced educational module at HonorHealth. Methods: A 15-minute online module was created to educate APPs about CSA prevalence, risk factors, and CAQ administration and interpretation. Participants completed pre- and post-module surveys assessing knowledge, confidence, and screening intent, which were distributed through Qualtrics. Data were analyzed using descriptive statistics to evaluate participant knowledge and attitude changes, and open-ended responses offered qualitative feedback on the module's usability. Results: Six APPs completed the pre-survey, while four completed both pre- and post-surveys. The average knowledge quiz scores rose from 6.25 to 8.0, showing a positive trend in learning. Participants also reported increased familiarity with CSA and the CAQ after the intervention, higher confidence in recognizing CSA, and a stronger willingness to include screening in their clinical work. Conclusions: This project showed that a short, targeted educational intervention can improve provider awareness and preparedness to carry out CSA screening in a busy cardiology setting. Despite a small sample size, the findings indicate the practicality and clinical importance of integrating standardized anxiety screening into cardiac care to support holistic, patient-focused outcomes.