Anxiety related to discharge from inpatient neurorehabilitation: Exploring the role of self-efficacy and internal health control beliefs

Abstract

The study aimed to determine the prevalence of anxiety, related to discharge, among a group of 42 participants who were likely to have sustained an at least moderate-severe ABI and who were due to be discharged home following a period of inpatient neurorehabilitation. Differential relationships between psychological factors (self-efficacy and internal health control beliefs) were examined, alongside the relative influence of demographic and clinical characteristics on discharge-anxiety.Data were obtained via self-report measures and retrospective reviews of participant's inpatient, medical records. While relatively few participants (n = 6; 14%) reported markedly elevated trait-anxiety, almost half the sample (n = 19; 45%) reported clinically significant levels of transient, state-anxiety. Notably, state-anxiety was strongly associated with discharge-anxiety. Multivariate analyses revealed that age, self-efficacy and internal health control beliefs made independent contributions to self-reported discharge-anxiety, with perceived self-efficacy alone explaining 69% of the variance and mediating the effects of age and internal health control beliefs.None of the other demographic or clinical characteristics examined were significantly associated with discharge-anxiety. While causality cannot be inferred, findings suggest that anxiety related to discharge from rehabilitation might be best predicted by poor perceptions of self-efficacy. Implications for clinical practice and future research are discussed.

A study of the influence of cognitive complaints, cognitive performance and symptoms of anxiety and depression on self-efficacy in patients with acquired brain injury

“…23,42 As already mentioned in section 'Introduction', higher selfefficacy is also known to reduce feelings of distress, anxiety and depression. [6][7][8][9] Our findings suggest that treatment programmes should focus explicitly on reinterpretation of interfering thoughts and emotions and the reinforcement of self-beliefs to improve self-efficacy. Self-efficacy is essential in the development of self-management.…”

“…23,42 As already mentioned in section ‘Introduction’, higher self-efficacy is also known to reduce feelings of distress, anxiety and depression. 6–9…”

“…2,3 Furthermore, as well at discharge from inpatient rehabilitation 4 as at one-year post-discharge home patients with acquired brain injury who showed higher levels of self-efficacy experienced less symptoms of anxiety and depression and were more successful in attaining important life goals. 5 In many diseases, such as acquired brain injury, [6][7][8][9] spinal cord injury 10 and rheumatoid arthritis, 11 it has been shown that highly self-efficacious patients report lower levels of distress, anxiety and depression.…”

Experiences of an adolescent inpatient model of care: Adolescent and caregiver perspectives

“…At the end of the admission, many adolescents and caregivers expressed fear and uncertainty in the context of being discharged home. This has been observed as a challenge and concern in relation to outcomes in many medical studies (Aislinn et al, 2015;Genis, Camic, & Harvey, 2016). Less has been researched in youth mental health inpatient settings.…”

Effects of discharge education and telephone follow-up on patient satisfaction and readmission after orthopedic surgery

“…The educational role of nurses is one of the criteria for work adequacy, productivity, success, and job satisfaction (6). Other benefits of discharge planning include accountability enhancement, mortality reduction, self-confidence increase, and inpatient decrease (1,7,8). Currently, the hospitalization period has been shortened, and the opportunity for the instruction and discharge planning has decreased (9).…”