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Sarah R Martin ,1,2,3 Isaac Hung,2,4 Theodore W Heyming,3,5 Michelle A Fortier,2,6,7 Zeev N Kain1,2,7,8- Correspondence to Dr Zeev N Kain, Department of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, USA; zkain@uci.edu
Sarah R Martin ,1,2,3 Isaac Hung,2,4 Theodore W Heyming,3,5 Michelle A Fortier,2,6,7 Zeev N Kain1,2,7,8Abstract 
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.
