Responding to anxiety levels on admission to a trauma ward and identifying associated baseline patient factors: A collaboration between Social Work and Psychology, supported by the Multidisciplinary Trauma team.
Anna Wellington-Boyd1, Lara Kimmel2, Devereaux De Silva1,4, Melissa Webb3, Mardi Newing1, Brigitte Beckham1, Doug Mc Caskie4 1Social Work Department, Alfred Hospital, Melbourne, Victoria, Australia2Physiotherapy Department, Alfred Hospital, Melbourne, Victoria, Australia3Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia4Allied Health Executive, Alfred Hospital, Melbourne, Victoria, Australia
Abstract
Patient reported anxiety on hospital admission following trauma is not unexpected but is rarely quantified. This study aimed to determine the factors associated with anxiety on hospital admission following trauma to subsequently improve patient outcomes.
Patient self-reported EQ5D- 5L (5 domains) were collected on admission to and discharge from, The Alfred trauma ward. Responses to the domain of anxiety/depression were combined into a binary response of “none/mild” or “moderate/severe/unable to cope” with Social Work and Psychology providing targeted therapy. Demographic details including age, gender, injury type, frailty and social factors were also collected. Factors with a univariate association to anxiety (p value <0.2) were included in a regression model.
1405 patients were included after admission to the trauma ward between November 9 2020-August 31, 2021. 276 (20%) patients reported anxiety. Female gender, lower age and frailty were associated with anxiety (p value <0.05), with fund group (p=0.058) also being included in the model Female gender (AOR 0.73 95%CI 0.54-0.98, p = 0.03), frailty (AOR 3.5 95%CI 2.23-5.49 p <0.001) and lower age (AOR 0.98 95%CI 0.97-0.99 p <0.001) were associated with reporting admission anxiety in the multi-variate model (fund group and ICU stay were not). Preliminary results suggest a reduction in discharge anxiety for those provided with a targeted psychosocial response.
Conclusion - 20% of trauma patients report anxiety on admission. Targeting patients reporting anxiety with psychosocial support may improve patient and hospital outcomes with implications for psychosocial models of care.
Biography
Anna Wellington-Boyd is a senior social worker with 20 years clinical experience in acute Trauma at The Alfred. She has collaborated on a range of research projects in hospital Trauma care. Anna coordinates a student program for social work across Alfred Health and has oversight of research projects involving social workers.
Devereaux De Silva is the Social Work Manager at Alfred Health with over 15 years experience in hospital Social Work. With a focus on supporting staff to undertake research and quality projects and clinical experience in the Trauma space, he is passionate about staff development and Trauma informed care.