title: Predictors of maternal state anxiety on arrival at a Japanese hospital outpatient clinic: a cross-sectional study.
abstract: OBJECTIVE
  To identify the factors that predict maternal state anxiety when mothers and their sick children visit the outpatient unit of a paediatric hospital.
  
  
  BACKGROUND
  While previous studies have focused on predictors of anxiety in mothers with ill children, the existing literature is limited in study design, research timing, respondent characteristics, sample size and data analysis.
  
  
  METHODS
  A cross-sectional design with self-administered questionnaires.
  
  
  METHODS
  Mothers were recruited from the outpatient unit of a Japanese paediatric hospital (N = 1077). Participants' state anxiety scores were collected using the Japanese version of Spielberger's State-Trait Anxiety Inventory. The independent variables were the mothers' and sick children's background information.
  
  
  RESULTS
  Participants were 1077 mothers; 990 provided valid responses. Mothers' mean state anxiety score was 49·72. Significant predictors of maternal anxiety were mothers' childrearing anxiety, child age, the sick child having a fever, sick child having siblings, having a person providing childrearing support, the mother's first visit to the hospital, out-of-hours visit and severity of the child's illness. The overall model explained 21·6% of the variance (multiple regression analysis).
  
  
  CONCLUSIONS
  As various factors predicted maternal anxiety, identifying methods to address these factors may reduce maternal state anxiety.
  
  
  CONCLUSIONS
  There is potential for improved understanding of the predictors of maternal state anxiety to aid in the development of materials that would best measure anxiety. The present findings may also suggest some means of providing appropriate information and support to anxious mothers. Our findings cannot demonstrate causation, however, and teaching methods and supportive practices were not investigated; therefore, a qualitative study on the concrete content of maternal anxiety and an intervention study to create support services for anxious mothers is required. In addition, prospective or longitudinal studies are also important for investigating causation.
authors.affiliation: Course of Health Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Shingo
authors.identifier: http://orcid.org/0000-0002-5750-6251
authors.initials: S
authors.lastname: Ueki
authors.affiliation: Course of Health Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Kazuteru
authors.identifier: http://orcid.org/0000-0002-2195-7536
authors.initials: K
authors.lastname: Niinomi
authors.affiliation: Course of Health Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Takashima
authors.affiliation: Toyonaka City Public Health Center, Osaka, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Kimura
authors.affiliation: NAKANO Children's Hospital, Osaka, Japan.
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Komai
authors.affiliation: Children's Hospital, Osaka, Japan.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Murakami
authors.affiliation: Course of Health Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Chieko
authors.initials: C
authors.lastname: Fujiwara
mesh_terms: D000328:Adult; D001007:Anxiety; D002648:Child; D002662:Child Health Services; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D010044:Outpatient Clinics, Hospital; D010372:Pediatrics; D011446:Prospective Studies; D011594:Psychometrics; D011795:Surveys and Questionnaires
keywords: anxiety; cross-sectional study; family nursing; mother; paediatric nursing; paediatrics