Prevalence and Determinants of Anxiety Among Hospitalized Children in Nowshera: Anxiety Among Hospitalized Children

Rabia Asghar; Qurat Ul Ain Ali; Neelam Ashraf; Bushra Tabassum; Iram Sohan

doi:10.54393/pbmj.v8i3.1176

Authors

Rabia Asghar Aziz Bhatti Teaching Hospital, Gujrat, Pakistan
Qurat Ul Ain Ali Aziz Bhatti Teaching Hospital, Gujrat, Pakistan
Neelam Ashraf Aziz Bhatti Teaching Hospital, Gujrat, Pakistan
Bushra Tabassum Aziz Bhatti Teaching Hospital, Gujrat, Pakistan
Iram Sohan Aziz Bhatti Teaching Hospital, Gujrat, Pakistan

DOI:

https://doi.org/10.54393/pbmj.v8i3.1176

Keywords:

Anxiety, Children, Hospitalization, Prevalence, State-Trait Anxiety Inventory

Abstract

Hospital admission is a stressful experience for children. It leads to high anxiety levels. Objectives: To investigate the prevalence of anxiety among hospitalized children and the causes contributing to its severity. Methods: 118 children fulfilling inclusion criteria were selected by convenient sampling to carry out a cross-sectional observational study in Qazi Complex, Nowshera from December 2023 to May 2024. The children were aged between 9-15 years. Data were collected using the State-Trait Anxiety Inventory for Children, a validated self-reported questionnaire. Anxiety levels were classified into mild, moderate, and severe anxiety depending upon scoring. Results: The results showed that prior hospitalizations, experiencing painful processes, and lengthy hospital stays considerably increased the probability of severe anxiety. Children experiencing painful procedures had an odds ratio of 6.27 (p<0.001) and those with a history of previous hospitalization were 4.56 times more expected to experience severe anxiety (p<0.001). The key factor was extended hospital stays, with an OR of 9.09 (p<0.001). Gender and age, however, did not significantly affect anxiety levels. Conclusions: The results emphasize the prerequisite for targeted interventions, such as decreasing hospital stays, reducing painful procedures, and providing emotional support. Understanding these features is vital for emerging attitudes to lessen anxiety in hospitalized children, thus refining their overall treatment results and well-being.

References

Daughtrey HR, Ruiz MO, Felix N, Saynina O, Sanders LM, Anand KJS. Incidence of Mental Health Conditions Following Pediatric Hospital Admissions: Analysis of a National Database. Frontiers in Pediatrics. 2024 Feb; 12. doi:10.3389/fped.2024.1344870. DOI: https://doi.org/10.3389/fped.2024.1344870

Penwill NY, Wong CT, Taylor DB, Freyleue SD, Bordogna AL, Bode RS, et al. Hospitalists' Perceptions of Pediatric Mental Health Boarding: Quality of Care and Moral Distress. Hospital Pediatrics. 2023 Mar; 13(3): 233-45. doi:10.1542/hpeds.2022-006913. DOI: https://doi.org/10.1542/hpeds.2022-006913

Correale C, Tondo I, Falamesca C, Capitello TG, Vigevano F, Specchio N, et al. Depression and Anxiety in Hospitalized Children with Epilepsy During COVID-19 Pandemic: Preliminary Findings of A Cross-Sectional Study. European Psychiatry. 2021 Apr; 64(S1): 670-671. doi: 10.1192/j.eurpsy.2021.1780. DOI: https://doi.org/10.1192/j.eurpsy.2021.1780

WHO. Mental Health of Adolescents. 2021. [Last Cited: 7th Jan 2025]. Available at: www.who.int/news-room/fact-sheets/detail/adolescent-mental-health.

Ginanjar MR, Ardianty S, Apriliyani K. Factors Related Anxiety Level On Hospitalized Children. Masker Medika. 2021 Oct; 9(1): 359-64. doi: 10.52523/MASKERMEDIKA.V9I1.439. DOI: https://doi.org/10.52523/maskermedika.v9i1.439

Liang Y, Huang W, Hu X, Jiang M, Liu T, Yue H, et al. Preoperative Anxiety in Children Aged 2–7 Years Old: A Cross-Sectional Analysis of The Associated Risk Factors. Translational Pediatrics. 2021 Aug; 10(8): 2024. doi: 10.21037/tp-21-215.

Delvecchio E, Salcuni S, Lis A, Germani A, Di Riso D. Hospitalized Children: Anxiety, Coping Strategies, and Pretend Play. Frontiers in Public Health. 2019 Sep; 7: 1-8. doi:10.3389/fpubh.2019.00250. DOI: https://doi.org/10.3389/fpubh.2019.00250

Correale C, Falamesca C, Tondo I, Borgi M, Cirulli F, Truglio M, et al. Depressive Anxiety Symptoms in Hospitalized Children With Chronic Illness During the First Italian COVID-19 Lockdown. Children. 2022 Aug; 9(8): 1156. doi:10.3390/children9081156. DOI: https://doi.org/10.3390/children9081156

Kaynak H and Çövener Ç. The Effect of Parents on The Hospital Anxiety Level of Hospitalized Children. Journal Of Education And Research In Nursing. 2020 Dec; 17(4): 312-316. doi: 10.5222/head.2020.65471. DOI: https://doi.org/10.5222/HEAD.2020.65471

Lestari AW, Lee CK, Hayati H. The Impact of Parental Psychological Distress on Child Behavior Issues in Hospitalized Children. La Pediatria Medica E Chirurgica. 2023 Jun; 45(1). doi: 10.4081/pmc.2023.311. DOI: https://doi.org/10.4081/pmc.2023.311

Kadan G. Children in Hospital. Research on Prenatal, Postnatal, and Early Childhood Development. 2020; 98-116). doi: 10.4018/978-1-7998-2952-2.ch006. DOI: https://doi.org/10.4018/978-1-7998-2952-2.ch006

Çelikol Ş, Tural Büyük E, Yıldızlar O. Children's Pain, Fear, and Anxiety During Invasive Procedures. Nursing Science Quarterly. 2019 Jul; 32(3): 226-32. doi:10.1177/0894318419845391. DOI: https://doi.org/10.1177/0894318419845391

Essau CA, Muris P, Ederer EM. Reliability and Validity of the Spence Children's Anxiety Scale and the Screen for Child Anxiety-Related Emotional Disorders in German Children. Journal of Behavior Therapy and Experimental Psychiatry. 2002 Mar; 33(1): 1-8. doi:10.1016/S0005-7916(02)00005-8. DOI: https://doi.org/10.1016/S0005-7916(02)00005-8

Doupnik S, Hill D, Palakshappa D, Worsley D, Bae H, Shaik A, et al. Parent Coping Support Interventions During Acute Pediatric Hospitalizations. Pediatrics. 2017; 140(3): 1-16. doi:10.1542/peds.2016-4171. DOI: https://doi.org/10.1542/peds.2016-4171

Eijlers R, Staals L, Legerstee J, Berghmans J, Strabbing E, Van Der Schroeff M, et al. Predicting Intense Levels of Child Anxiety During Anesthesia Induction at Hospital Arrival. Journal of Clinical Psychology in Medical Settings. 2020; 28: 313-322. doi: 10.1007/s10880-020-09716-6. DOI: https://doi.org/10.1007/s10880-020-09716-6

Ahmadipour M, Sattari H, Nejad MA. Incidence and Risk Factors Related to Anxiety of Children and Adolescents Before Elective Surgery. European Journal of Translational Myology. 2022; 32(2). doi:10.4081/ejtm.2022.10449. DOI: https://doi.org/10.4081/ejtm.2022.10449

Liu W, Xu R, Jia J, Shen Y, Li W, Bo L. Research Progress on Risk Factors of Preoperative Anxiety in Children: A Scoping Review. International Journal of Environmental Research and Public Health. 2022; 19(16). doi:10.3390/ijerph19169828. DOI: https://doi.org/10.3390/ijerph19169828

Zheng K, Abraham C, Bruzzese JM, Smaldone A. Longitudinal Relationships Between Depression and Chronic Illness in Adolescents: An Integrative Review. Journal of Pediatric Health Care. 2020; 34(4): 333-45. doi:10.1016/j.pedhc.2020.01.008. DOI: https://doi.org/10.1016/j.pedhc.2020.01.008

Morin H, Worsley D, Zhang X, Faerber J, Pettit AR, Kenyon CC, et al. Depression and Anxiety Symptoms During and After Pediatric Asthma Hospitalization. Hospital Pediatrics. 2021; 11(11): 1272-9. doi:10.1542/hpeds.2020-000950. DOI: https://doi.org/10.1542/hpeds.2020-000950

Raj R, Nguyen M, Pozzo AM, Marsac ML, Vselvoshakaya O, Meadows AL. Effects of Trauma and Anxiety on Adherence in Pediatric Type 1 Diabetes. Diabetes Spectrum. 2022; 35(2): 171-8. doi:10.2337/ds21-0024. DOI: https://doi.org/10.2337/ds21-0024