An investigation into the factors that influence discharge-related anxiety in medium secure unit patients

Abstract

This study examines discharge-related anxiety in a group of 65 patients resident in five medium secure units located in the South of England. The study is part of a larger investigation of non-compliance within medium secure unit environments. Participants completed standardised questionnaire measures of self-efficacy, self-esteem, anxiety and locus of control, together with a newly constructed questionnaire investigating anxiety relating to discharge. Results of ordinal regression procedures indicated that the main predictors of a general discharge-related anxiety scale were low self-esteem and perceived absence of social support, although on univariate analysis high trait anxiety also exerted a significant independent effect. The clinical implications of the findings are discussed.

Keywords:

• Medium secure units
• discharge-related anxiety
• self-esteem
• locus of control

Notes

Patients with no set discharge date were asked to imagine that they were close to being discharged, and to report what they thought their worries would be. Although the authors appreciate that this may have been difficult for some patients, particularly those who were not close to being discharged, it was believed that wording the question in this way rather than asking patients how they felt about discharge at the time of the interview was one means of focussing the patients' attention on potential future issues raised by discharge in addition to any current discharge-related concerns.

One patient was excluded from any analysis involving questionnaire measures due to the unreliability of his responses (he answered all the questions to each questionnaire with the same response). Two patients declined to participate in the second of the two interviews. They chose not to provide a reason for their decision to drop out of the study.