Dhikr Istighfar and Preprocedural Anxiety in Patients Undergoing Percutaneous Coronary Intervention: A Quasi-Experimental Pre–Post Study in Indonesia

Abstract

Purpose

This study examined the immediate holistic effects of a single-session Dhikr Istighfar intervention on anxiety among Indonesian patients undergoing percutaneous coronary intervention (PCI), guided by Kolcaba's Comfort Theory.

Design

A single-arm quasi-experimental pre–post study.

Method

Thirty-four adult Muslim patients scheduled for PCI participated in a 20-min, nurse-facilitated Dhikr Istighfar session, delivered at the bedside one hour before the procedure. Anxiety was measured using a validated scale. Paired t-tests and effect sizes assessed pre–post changes.

Findings

Anxiety scores decreased significantly from 22.3 ± 3.1 at baseline to 7.7 ± 2.1 after the intervention, indicating a large effect size (Cohen's d = 0.90). While reductions were substantial, causal inference is limited due to the absence of a control group. Ninety-one percent of participants transitioned to the “no anxiety” category, with improvements across all cognitive, somatic, and autonomic subdomains. Participants also reported enhanced psychospiritual comfort, consistent with the domains of relief, ease, and transcendence.

Conclusions

A brief, spiritually integrated nursing intervention using Dhikr Istighfar promotes immediate reductions in preprocedural anxiety and supports psychospiritual well-being, reflecting the holistic principles of mind–body–spirit care. Findings support incorporating culturally congruent spiritual practices within holistic nursing approaches for patients facing high-stress cardiac procedures.