Subjective perceptions of the demands of hospitalization and anxiety in bone marrow transplant patients
The purpose of this study was to explore the relationship of hospital related demands to the presence of anxiety in hospitalized patients, and to detect a relationship between anxiety, uncertainty, and loss of control in hospitalized patients. A third purpose was to examine for partial effects of perceived uncertainty and control in accounting for levels of hospital related demands in these patients.Anxiety is an emotional response to the perception of threat related to a patient's cognition of uncertainty, loss of control, and resultant perceptions of vulnerability. The self-assessment of uncertainty and loss of control may influence, and be influenced by the frequency and intensity of small demands, or hassles, encountered in the daily hospitalization experience.Research was completed in two parts. First a pilot study was conducted to develop an instrument which measured hospital related demands as perceived by Bone Marrow Transplant (BMT) patients. For this study, 153 questionnaire items generated from a literature review were administered to fifty nurses, nurse researchers, and recently hospitalized individuals in the community, U. of W. School of Nursing, Fred Hutchinson Cancer Research Center (FHCRC), and Swedish Hospital Medical Center. Seventy-Five final scale items divided into six subscales (alpha coefficients range from.78 to.91, overall scale alpha:.9635) were retained.For the main study, thirty-two individuals admitted to the FHCRC for BMT were recruited. Informed consent, demographic data, trait anxiety, and a subjective degree of illness rating were collected prior to hospitalization.Psychometric data gathered on the third day after the BMT procedure, included the State Anxiety Inventory, the Perceived Social Control subscale of the Coan Personal Opinion survey, the Mishel Uncertainty in Illness Scale, and the Hospital Related Demands Scale (from the pilot study).Data were analyzed using basic descriptive statistics, correlations and multiple regression procedures. Results indicated that perceptions of anxiety were higher for patients who perceived significantly more hassles (r =.6705; p $<$.001). Anxiety was also related to uncertainty (r =.5904; p $<$.001), and to control (r = $_$.4246; p $<$.01). Educational level, LAF room assignment, perceived health, marital status, or gender had no effect on anxiety levels, although women had a significantly lower level of perceived control (p =.004). These results may help in the understanding and development of nursing interventions to reduce anxiety.
- Nursing - Seattle