title: Perception of medical care systems and stress responses in preschoolers' caregivers at a pediatric emergency department in Taiwan.
abstract: OBJECTIVE
  This study was undertaken to understand caregivers' perception of medical care systems and their stress responses throughout their stay with preschoolers at a pediatric emergency department (ED).
  
  
  METHODS
  Overall, 201 preschoolers' caregivers in pediatric ED were recruited in this study. They were asked to answer self-made questionnaires regarding the perception of medical care systems and their stress responses immediately before preschoolers' release.
  
  
  RESULTS
  The results show that caregivers with a low education or low income level were prone to exhibit greater appreciation for the efficiency of medical care systems and greater degree of anxiety for their lack of treatment and care knowledge than those of caregivers with a high education or high income level. Interestingly, caregivers older than 38 years reported greater emotional responses and physical exhaustion than did younger caregivers. Immigrant caregivers had higher emotional reaction and lower concentration than did Taiwanese caregivers. Paradoxically, caregivers undergoing over 3-time pediatric ED visits for observation expressed stronger stress reactions as compared with caregivers with less observation experiences. Not surprisingly, caregivers reported the highest emotional responses when their preschoolers were diagnosed as having very urgent degree in triage classification. Finally, caregivers' perception of "lack of family support" and "lack of treatment and care knowledge" correlated positively with all aspects of the stress responses.
  
  
  CONCLUSIONS
  These results indicate that attention should be paid to the specific psychological weakness and need for the caregivers with certain demographic characteristics by the medical team in pediatric ED.
authors.affiliation: Emergency Division of Pediatric Department, Changhua Christian Hospital, Changhua,Taiwan, Republic of China.
authors.forename: Jun-Kai
authors.initials: JK
authors.lastname: Kao
authors.forename: Chian-Fang G
authors.initials: CF
authors.lastname: Cherng
authors.forename: Ru-Chiao
authors.initials: RC
authors.lastname: Tsai
authors.forename: Lon-Yen
authors.initials: LY
authors.lastname: Tsao
authors.forename: Chin-Yi
authors.initials: CY
authors.lastname: Hung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D010549:Personal Satisfaction; D011787:Quality of Health Care; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D013624:Taiwan; D055815:Young Adult