title: Parental anxiety associated with referral of a child to a pediatric cardiologist for evaluation of a Still's murmur.
abstract: OBJECTIVE
  We assessed factors contributing to parental anxiety when children are referred to a cardiology clinic for evaluation of a Still's murmur.
  
  
  METHODS
  Parents of 95 children completed questionnaires designed to assess family and patient characteristics, parents' ratings of their anxiety and the reassurance they received from their pediatrician, and current (state) and general anxiety levels.
  
  
  RESULTS
  Parents reported anxiety about multiple issues including the need for medication (49%), sports restrictions (41%), cardiac surgery (29%), cardiac risk for siblings (20%), and premature death (13%). Of reporting mothers, 19% felt the murmur resulted from something they did wrong during pregnancy. Although 54% of parents were extremely reassured by their pediatrician, only 17% had no anxiety associated with the specialty visit. After reassurance from the cardiologist, 7% of parents had persistent anxiety. In multivariable analysis, 2 features, both related to the referring pediatrician, were significantly related to parental anxiety level. High parental anxiety was associated with lower pediatrician reassurance ratings and greater pediatrician practice years.
  
  
  CONCLUSIONS
  Parental anxiety is common among parents of children referred for specialty evaluation. Educational strategies to improve pediatrician communication skills with parents may improve quality of care.
authors.affiliation: Department of Cardiology, Children's Hospital, Boston, Massachusetts 02115, USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Geggel
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Horowitz
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Brown
authors.forename: Marytheresa
authors.initials: M
authors.lastname: Parsons
authors.forename: Philip S
authors.initials: PS
authors.lastname: Wang
authors.forename: David R
authors.initials: DR
authors.lastname: Fulton
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety; D002648:Child; D002675:Child, Preschool; D005260:Female; D006337:Heart Murmurs; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010290:Parents; D012017:Referral and Consultation