Evaluating the Association Between Anxiety and Satisfaction

School Scoliosis Screenings: Family Experiences and Potential Anxiety After Orthopaedic Referral

STUDY DESIGN

Cross-sequential study design that used data from Texas Scottish Rite Hospital for Children (TSRHC).

OBJECTIVE

Examine anxiety symptoms and family experiences subsequent to school scoliosis screening (SSS) referrals.

SUMMARY OF BACKGROUND DATA

Use of SSS remains controversial. Prior research suggested that SSS programs may result in anxiety for both children and parents. Unfortunately, no study has examined the SSS referral processes and anxiety in families.

METHODS

Study consisted of 2 groups-patients/parents from TSRHC evaluated for Adolescent Idiopathic Scoliosis (AIS) (n = 27) and control participants/parents (n = 27) between ages 9 and 17. All participants completed the primary outcome measure (State-Trait Anxiety Inventory) before and after the scoliosis evaluation or controlled wait time. Parents also rated experience and satisfaction with SSS.

RESULTS

Compared with the control group, children/parents in patient group experienced significantly elevated levels of state-anxiety at preappointment. Children/parents in the patient group not diagnosed with AIS experienced a significant decline in state-anxiety. Children/parents in the patient group diagnosed with AIS continued to report elevated levels of anxiety. The control group remained consistent, reporting of low levels of anxiety pre to post. More than half (55.5%) of families indicated they received no information from the school about scoliosis. A third of the families who received information indicated it did not adequately address their concerns. Nonetheless, most families reported overall satisfaction with SSS.

CONCLUSION

This study suggested that children and parents referred through the SSS program experienced significantly elevated levels of state-anxiety. This supports the subjective concerns of anxiety experiences in families voiced by researchers previously. However, families deemed the costs of the SSS referral process as worth the benefits. Though challengers of SSS programs were accurate in observing anxiety in families, it may not constitute significant burden to eliminate SSS programs altogether. Improvements to the current system may be warranted.

LEVEL OF EVIDENCE

3.

Measuring patient anxiety in primary care: Rasch analysis of the 6-item Spielberger State Anxiety Scale

OBJECTIVES

The 6-item Spielberger State Anxiety Scale has been used as a replacement of the original version in many health-care studies. The purpose of this study was to evaluate the measurement properties of the shortened 6-item Spielberger State Anxiety Scale using Rasch analysis in general medical practice patients (N=297).

METHODS

Participants (aged 16 years or above) were recruited on a consecutive basis from three general medical practices. Prior to their appointment, participants were asked to complete a 6-item Spielberger State Anxiety Scale.

RESULTS

The results of the study showed that the scale is unidimentional, and each item measures a different level of patient anxiety. The rating scale operated well and item and person reliability was good. Furthermore, principal-components analysis of the residuals confirmed the scale measures a unitary concept. A scoring key was generated to allow conversion of raw scores to a continuous measurement.

CONCLUSION

The 6-item Spielberger State Anxiety Scale is shorter than the original version and has good psychometric properties. This would suggest the scale is a valid alternative to the full version for use in primary health-care practice and research.