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Original research
Predictors of parental anxiety in a paediatric emergency department
  1. Sarah R Martin1,2,3,
  2. Isaac Hung2,4,
  3. Theodore W Heyming3,5,
  4. Michelle A Fortier2,6,7,
  5. Zeev N Kain1,2,7,8
  1. 1 Anesthesiology & Perioperative Care, University of California Irvine, Irvine, California, USA
  2. 2 Center on Stress & Health, University of California, Irvine, Orange, California, USA
  3. 3 Emergency Medicine, Children's Hospital of Orange County, Orange, California, USA
  4. 4 School of Medicine, University of California Irvine, Irvine, California, USA
  5. 5 Department of Emergency Medicine, University of California Irvine, Irvine, California, USA
  6. 6 Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, California, USA
  7. 7 Children's Hospital of Orange County, Orange, California, USA
  8. 8 Child Study Center, Yale University, New Haven, Connecticut, USA
  1. Correspondence to Dr Zeev N Kain, Department of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, USA; zkain{at}uci.edu

Abstract

Background Children experience significant anxiety in the paediatric ED. Although research from preoperative and primary care samples indicates that parents experience anxiety surrounding their children’s medical procedures, less is known about parental anxiety and factors that contribute to higher parental anxiety in the ED. This study aimed to assess parental anxiety in families presenting to a paediatric ED with a variety of presenting concerns and examine demographic and psychological factors associated with parental anxiety.

Methods This cross-sectional study included parents of children <18 years old presenting to a paediatric ED in Orange County, California, USA, for a non-psychiatric complaint between 20 January 2021 and 26 March 2021. Parents were, on average, 34.76±9.10 years old, 87.5% were mothers, 59.2% identified as non-Latinx and parents reported average levels of mental health (T-score=51.21±9.84). Parent state anxiety was assessed via the State-Trait Anxiety Inventory and validated instruments were used to measure child temperament (ie, emotionality, activity, sociability, shyness), previous medical anxiety, and parent physical and mental health. Data were analysed using multiple linear regression models.

Results Out of 201 families screened, 150 were eligible, and 120 enrolled. In the sample, 42.5% of parents endorsed clinically significant levels of anxiety in the ED. Regression analyses indicated that lower child activity temperament (ie, tendency to be less active/energetic; B=−3.20, 95% CI −5.70 to −0.70, p=0.012) and poorer parent mental health (B=−0.31, 95% CI −0.52 to −0.09, p=0.006) were independently associated with higher parent anxiety (F(5, 99)=6.77, p=0.004).

Conclusion Over 40% of parents sampled endorsed clinically significant anxiety in the paediatric ED. Child temperament, specifically lower activity temperament, and poorer parental mental health were identified as contributors to parent anxiety, whereas clinical condition or severity did not influence parent anxiety. Current results may help identify families in need of additional intervention and may improve patient outcomes.

  • emergency department
  • pediatric emergency medicine
  • mental health

Data availability statement

Data are available upon reasonable request. The de-identified data sets analysed during the current study are available from the corresponding author upon reasonable request.

https://doi.org/10.1136/emermed-2022-212917

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    Data availability statement

    Data are available upon reasonable request. The de-identified data sets analysed during the current study are available from the corresponding author upon reasonable request.

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    Footnotes

    • Handling editor Gene Yong-Kwang Ong

    • Twitter @sarahraemartin

    • Correction notice This article has been amended since it was first published. An additional affiliation has been added for the last author.

    • Contributors SM, IH, TH, MF and ZK made substantial contributions to the conception or design of the work and the acquisition, analysis or interpretation of data for the work. SM and IH drafted the manuscript, and all authors revised the drafted manuscript critically for important intellectual content and interpretation of data. All authors read and approved the final manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. SM and ZK are guarantors of the paper and are responsible for overall content, accept full responsibility for the finished work and conduct of the study, had access to the data, and controlled the decision to publish.

    • Funding Sarah R Martin is supported by the National Institutes of Health National Institute for Child Health and Human Development (K23HD105042, PI: Martin).

    • Competing interests ZNK serves as a consultant for Edwards Lifesciences and Pacira and is the President of the American College of Perioperative Medicine. All other authors have no conflicts of interest to report.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.