Recovery-related anxiety and disability following upper limb injury: the importance of context

Abstract

Purpose: Anxiety following traumatic upper limb injury is common and may affect rehabilitation outcomes. Most previous research has focused on psychiatric anxiety disorders among those with severe injuries. The aims of this study were to determine the prevalence of anxiety among patients with mild to moderate traumatic upper limb injuries, to investigate the correlation between anxiety and disability, and to provide preliminary validation of the Recovery-Related Anxiety Questionnaire (RRAQ). Method: Eighty-four adults with a recent traumatic upper limb injury completed the State & Trait Anxiety Inventory (STAI), the Pain Anxiety Symptoms Scale (PASS-20), the RRAQ and the shortened Disability of the Arm, Shoulder and Hand Questionnaire (QuickDASH). Prevalence rates of anxiety were calculated and linear regression analysis was used to identify predictors of QuickDASH scores. Results: All participants reported some anxiety, with higher levels of recovery-related anxiety than general anxiety. In linear regression analysis, the four types of anxiety accounted for 29% of the variability in QuickDASH scores. The RRAQ accounted for 19% of the variability in QuickDASH scores. Conclusions: Recovery-related forms of anxiety appear to be more common and more strongly associated with disability than general anxiety symptoms for patients with mild to moderate traumatic upper limb injuries.

Implications for Rehabilitation

• Following mild to moderate traumatic upper limb injury, anxiety about the injury and recovery is common.

• Recovery-related anxiety is more strongly associated with disability than general anxiety symptoms.

• Phrasing questions about anxiety directly associated with the recovery experience may give greater insight into the anxiety patients with mild to moderate upper limb injuries are experiencing.

• This insight may help clinicians to directly address recovery-related issues, potentially decreasing disability experienced by patients.

• Anxiety
• traumatic injury Implications for rehabilitation
• upper limb

Acknowledgements

The authors would like to thank the therapists who participated in helping to distribute questionnaires for this study and those who took the time to share their experiences by completing the questionnaires for us.

Declaration of Interests

This study was supported by a Disability Placement Program Grant from the New Zealand Health Research Council and by a PhD scholarship from the University of Otago.