Anxiety, acute traumatic stress symptoms, and discharge home among patients referred for occupational therapy in an emergency and critical care center: A prospective observational study

Introduction: Patients in emergency and critical care settings may experience acute psychological stress that disrupts everyday occupations. This study estimated the proportion of patients with elevated acute traumatic stress symptoms and examined associations with anxiety and discharge home. Method: This prospective observational study used a cross-sectional psychological assessment in an emergency and critical care center in Japan. Forty adults referred for occupational therapy and able to complete self-report questionnaires completed the Impact of Event Scale–Revised and Hospital Anxiety and Depression Scale once clinically stable. Exploratory logistic regression examined associated factors and discharge home. Results: Thirteen of 40 patients (32.5%) had elevated acute traumatic stress symptoms. Higher anxiety was associated with elevated symptoms (adjusted odds ratio (OR) 1.50, 95% confidence interval (CI) 1.19–2.07). Elevated symptoms were associated with lower odds of discharge home after adjustment for illness severity and emergency department length of stay (adjusted OR 0.09, 95% CI 0.02–0.44). Conclusion: Higher anxiety was cross-sectionally associated with elevated acute traumatic stress symptoms among selected patients referred for occupational therapy. Elevated symptoms were also associated with lower odds of discharge home. These exploratory findings suggest that psychological distress may be relevant to occupation-focused assessment and discharge planning in acute care.