Anxiety in patients with lower-extremity deep vein thrombosis: a patient-centred sequential explanatory mixed-methods study of prevalence, associated factors, and patient experiences

Lower extremity deep vein thrombosis (LEDVT) is associated with substantial psychological burden. Anxiety after DVT may reflect not only an emotional consequence of thrombosis, but also a signal of unmet informational, functional, and supportive care needs. This study aimed to investigate the prevalence and factors associated with anxiety among LEDVT patients and to explore their lived experiences, perceived triggers, and support needs using a mixed-methods design.

A sequential explanatory mixed-methods study was conducted. In the quantitative phase, 175 LEDVT patients completed the Generalized Anxiety Disorder-7 (GAD-7), Brief Illness Perception Questionnaire (B-IPQ), and Multidimensional Scale of Perceived Social Support (MSPSS). Clinical and care-process variables were collected, including the perceived adequacy of structured counselling at diagnosis using an 8-item checklist. Clinically significant anxiety was defined as GAD-7 score ≥10. Multivariable logistic regression was performed according to a prespecified conceptual framework. In the qualitative phase, semi-structured interviews were conducted with 15 purposively selected participants; data were analyzed using thematic analysis.

The prevalence of clinically significant anxiety was 41.1% (72/175; 95% CI: 33.9%-48.6%). Younger age (OR = 0.95, 95% CI: 0.92-0.98, P = 0.002), higher B-IPQ score (OR = 1.18, 95% CI: 1.11-1.26, P < 0.001), lower MSPSS score (OR = 0.94, 95% CI: 0.90-0.98, P = 0.005), and adequate counselling at diagnosis (OR = 0.42, 95% CI: 0.20-0.88, P = 0.022) were independently associated with anxiety. Qualitative analysis generated five major themes: fear of complications, treatment-related anxiety, role and functional impairment, information delivery and illness meaning-making, and insufficient emotional and social support.

Anxiety affects approximately two in five LEDVT patients in this single-centre cross-sectional cohort. Anxiety was associated not only with younger age, negative illness perception, and low social support, but also with symptom burden and perceived inadequacy of counselling at diagnosis; qualitative findings additionally highlighted symptom burden and functional limitations as key experiential drivers of anxiety. Integrated DVT care should address anticoagulation management, structured education, risk communication, cognitive reframing, functional recovery, and psychosocial support.