Anxiety in the aftermath of acquired brain injury: prevalence, course and correlates

This study aimed to determine the prevalence of anxiety specifically related to discharge in a group of 42 individuals who had sustained moderate to severe acquired brain injury and who were imminently due to return home following a period of inpatient neurorehabilitation. The study also aimed to explore differential relationships between psychological factors (self-efficacy and health control beliefs) alongside the relative influence of demographic (age, gender and ethnicity) and clinical (medical diagnosis and injury location) characteristics on discharge-anxiety.
A cross-sectional, single-group design was employed, wherein correlational and multivariate analyses were used to explore relationships between variables. Data was obtained via self-report tools and retrospective reviews of medical files.
While few participants (14%) reported markedly elevated trait-anxiety almost half (45%) of the sample reported levels of transient, state-anxiety which could be considered to be clinically significant. Notably, state-anxiety (appraised via the State-Trait Anxiety Inventory) was strongly associated with discharge-anxiety (appraised via the Patient Anxieties Questionnaire). Age, self-efficacy and internal health control beliefs made independent contributions to the level of discharge-anxiety reported, with perceived self-efficacy alone explaining 69% of the overall variance and mediating the effect of internal control beliefs. No other demographic or clinical characteristics examined were significantly related to discharge-anxiety.
Although causality cannot be inferred, findings suggest that discharge-related anxiety is best predicted by poor perceptions of self-efficacy. Implications for clinical practice and directions for future research are discussed.