Factors Influencing Caregiver Anxiety in the Pediatric Emergency Department

Abstract

OBJECTIVES: This study identified demographic and experiential factors associated with caregiver anxiety in a pediatric emergency department (PED). METHODS: We conducted a cross-sectional survey of caregivers for children brought to our PED. Participant anxiety was assessed with the short-form Spielberger State-Trait Anxiety Inventory (STAI). State anxiety reflects how one feels at the moment; trait anxiety indicates how one generally feels. Each is scored using a 5-item Likert Scale. Primary outcomes were continuous state and trait scores. We also examined the impact of prior ED visits and caregiver characteristics on STAI scores. RESULTS: Five hundred two caregivers participated in the study and completed the survey. Caregivers with more children showed lower anxiety levels (mean state anxiety: 6.9 vs. 7.7, P = 0.03; mean trait anxiety: 6.5 vs. 7.2, P = 0.04), as did those with children who had prior PED visits (mean trait anxiety: 6.5 vs. 7.1, P = 0.02). Caregivers with a primary care provider (PCP) for their children reported higher state anxiety than those without a PCP (mean: 7.4 vs. 6.3, P = 0.04), although trait anxiety was not significantly different. Anxiety was not linked to length of stay, caregiver education level, or day of the week (all P >0.10). Only 2.6% (n = 13) of caregivers exceeded the short-form STAI anxiety thresholds. CONCLUSIONS: Our study showed that caregiver anxiety was more closely linked to caregiver experience, such as prior visits to the PED and the number of children, than to their child's illness severity. Triage acuity level and ED length of stay were not associated with anxiety levels.