Faculty Collaboration Database

An evaluation of short anxiety measures for use in the emergency department. Am J Emerg Med 2021 Dec;50:679-682

Date

12/10/2021

Pubmed ID

34879486

DOI

10.1016/j.ajem.2021.09.028

Scopus ID

2-s2.0-85116041860 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

BACKGROUND: The emergency department (ED) is a stressful environment for children. Few studies assess pediatric anxiety in the ED. "Gold standard" for measuring state-anxiety, Spielberger's State-Trait Anxiety Inventory for Children (STAI-C state), is lengthy and of limited use in this setting.

OBJECTIVE: The objective was to evaluate agreement between STAI-C, Likert, and modified Yale Preoperative Anxiety Scale (m-YPAS) and determine if shorter measures may be adequate replacements for STAI-C in the ED.

METHODS: This is a secondary analysis of data from a previous observational cohort study of a convenience sample of children 5-17 years old presenting to the ED. Anxiety was measured using STAI-C, Likert, and m-YPAS. Spearman correlations were used to evaluate agreement between STAI-C and the brief scales. A sub-analysis evaluated agreement between scales for children ≥9 years old to assess the impact of age.

RESULTS: Eighty children were included. Median (IQR) STAI-C state score was 32.5 (30.0, 37.8). This represents moderate state anxiety with 30% of children exhibiting elevated state anxiety. Median (IQR) Likert score was 2.0 (1.0, 2.0). Correlation between the Likert and STAI-C was moderate (r_s = 0.51; p < 0.0001). Median (IQR) m-YPAS was 28.3 (24.2, 33.3). The m-YPAS and STAI-C were unrelated (r_s = 0.12; p > 0.05). For children ≥9 years old, correlation between Likert and STAI-C remained moderate (r_s = 0.52; p < 0.0001); STAI-C and m-YPAS were unrelated (r_s = 0.10; p > 0.05).

CONCLUSIONS: Children in the ED experienced moderate-elevated state anxiety. Likert scale may be an acceptable substitute for STAI-C state. Further studies of this scale will aid in identifying patients with anxiety to facilitate timely management.

Author List

Coleman KD, Chow Y, Jacobson A, Hainsworth KR, Drendel AL

Authors

Keli D. Coleman MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Amy L. Drendel DO Interim Chief, Professor in the Pediatrics department at Medical College of Wisconsin
Keri Hainsworth PhD Director, Associate Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Age Factors
Anxiety
Child
Child, Preschool
Cohort Studies
Emergency Service, Hospital
Female
Humans
Male
Reproducibility of Results
Time Factors