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

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 to 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 was 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.