Patterns of anxiety in the chronically ill

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Abstract
A sample of chronically ill patients was interviewed in order to establish some of their biographic characteristics and their perceptions of their handicaps and handicap-related goals when hospitalized and seven months later in the community. Other variables of interest were the type of disability they suffered (from their medical records) and two measures of the success of their rehabilitation (based on patients' perceptions and goals). Canonical correlation was used to relate each of these sets of variables to a set of anxiety measures taken after patients were discharged into the community. These measures represented different sources of anxiety which had been derived by content analysis of patients' relatively unstructured comments about their current experiences of their illnesses. Three major patterns of anxiety were identified. The first consistent of fears of death and vague worries but little loneliness. It was associated with being married and being dissatisfied with work experience and with having visual and communication disabilities. The second consisted of guilt and vague worries and was experienced by patients who perceived themselves to be handicapped in most of their activities but not in relating to others. The third involved the source of anxiety which was most important to chronically ill patients - fears about body damage. This was found to be associated with patients' concurrent perceptions of their handicaps. These bodily fears, together with loneliness, were more likely to be expressed by patients with less successful rehabilitation than those with more successful rehabilitation. Some of the implications of these findings for the care of the chronically ill are discussed.

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