Abstract

Discharge from the hospital has been identified as a time when patients are in need of additional nursing support. The prospect of leaving the protective hospital environment to return to the home environment with its life stresses can cause anxiety. This study was designed to test the effect of a nursing intervention, discharge counseling sessions, on the anxiety level of the neurotically-depressed female prior to discharge.

The null hypothesis guiding this study was: nursing discharge counseling sessions will have no significant (α=0.05) effect on the pre-discharge anxiety level of the neurotically-depressed female in a community hospital setting. The State-Trait Anxiety Inventory (STAI) was used to obtain the measurements of anxiety.

This study was a prospective, quasi-experimental study involving 24 female subjects diagnosed as depressive neurosis by their psychiatrist. The sample was a convenience selection of the first 24 patients to fit the selection criteria. After the study began the first patient admitted was assigned to the control group and the second patient admitted was assigned to the experimental group. Group assignment continued in an alternating manner.

Each patient completed the Self-Rating Depression Scale (SDS) on the second day of hospitalization and patients who scored 60 or above were included in the study. After being assessed for absence of psychotic behavior, each subject completed the STAI on the fourth day of hospitalization to establish an anxiety baseline. On the two consecutive evenings immediately preceding discharge, each experimental group patient participated in the discharge counseling sessions conducted by the nurse researcher. During these sessions the following items were discussed: identification of coping behaviors learned during hospitalization; feelings about discharge; discussion of anticipated difficulties after discharge; discussion of application of coping behaviors to anticipated problems; identification of situational supports; information regarding outpatient therapy; patient concerns and feelings about discharge counseling sessions. Both groups completed the State portion of the STAI on the evening before discharge.

Demographic data for each group were compared using the Chi Square test which revealed no significant differences between the two groups with respect to age, marital status, number of previous psychiatric hospitalizations at the facility utilized, level of education and length of hospital stay. The Mann-Whitney U test was used to analyze SDS scores and revealed no significant (α=0.05) differences between degree of depression among the two groups on the second day of hospitalization. The State1 and Trait scores obtained on the fourth day of hospitalization were analyzed using the Mann-Whitney U test which revealed no significant (α=0.05) differences between groups with regard to State1 or Trait anxiety. The Wilcoxon Matched-Pairs Signed-Ranks test was used to analyze State1 anxiety levels as compared to State2 anxiety levels for each group. This revealed that both the control and experimental groups had significant (p < .001) decrease in anxiety levels prior to discharge. The Mann-Whitney U test indicated that there was no significant (α=0.05) difference between the State2 anxiety levels of the control group subjects. The null hypothesis was retained and it was concluded that discharge counseling sessions did not significantly lower pre-discharge anxiety levels.

The design of the testing procedure may have influenced the findings of the study. The length of time between pre and post testing may have allowed many extraneous variables to be introduced. A further study which pre-tests patients 72 hours before discharge may provide more definitive results. The study findings seemed to indicate that anxiety accompanies discharge. All subjects in this study experienced some degree of anxiety as evidenced by the fact that none of the subjects scored less than 25 on the State2 portion of the STAI, which had a minimum score of 20.

LLU Discipline

Nursing

Department

Nursing

School

Graduate School

First Advisor

Nancy S. Testerman

Second Advisor

Eva Miller

Third Advisor

L. Frances Pride

Degree Name

Master of Science (MS)

Degree Level

M.S.

Year Degree Awarded

1980

Date (Title Page)

5-1980

Language

English

Library of Congress/MESH Subject Headings

Patient Discharge; Anxiety Disorders

Type

Thesis

Page Count

viii; 99

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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