Abstract
Aim: The purpose of this study was to develop a scale, “parental anxiety about pediatric emergency medical care services” (PAPEMCS), and to evaluate its psychometric properties. Methods: Participants were 14,510 parents with children 6 years old or younger in Kagawa Prefecture. Using each half of the participants, exploratory factor analysis was performed to generate items and factors for the PAPEMCS, and confirmatory factor analysis (CFA) was used to establish the construct validity. The generalizability of the PAPEMCS was evaluated by congruence tests and multigroup CFA. The usefulness of the PAPEMCS was established by the relationship between the PAPEMCS and non-urgent usage of pediatric emergency medical care services (PEMCS). Results: The PAPEMCS compromised 4 factors: “anxiety about quality of PEMCS”, “anxiety about PEMCS system”, “anxiety about public support”, and “anxiety about private support”. All reliability estimates (polychoric ordinal alpha coefficients, item-rest correlations), the item discrimination, 5 fit indices for CFA, the convergent validity (indicator reliabilities, composite reliabilities, average variance extracteds), and the discriminant validity fulfilled the acceptability thresholds. All generalizability estimates fulfilled the predetermined levels of acceptability (Tucker’s congruence coefficients, congruence tests, strict factorial invariance). The usefulness of the PAPEMCS was established by the higher scores of the PAPEMCS being related to non-urgent usage of PEMCS. Conclusions: The PAPEMCS demonstrated satisfactory reliability, validity, generalizability and usefulness. The PAPEMCS is useful to quantify the contents and extent of parental anxiety about PEMCS, and to clarify the mechanisms of non-urgent PEMCS usage.
Highlights
The appropriate enforcement of pediatric emergency medical care service (PEMCS) is a vital component of pediatric health services
Okawa or Mitoyo secondary medical region (Mitoyo) care is performed with a pediatric emergency medical care services (PEMCS) system of a pediatric emergency night clinic only, and Shozu secondary medical region (Shozu), a remote island, care is performed with an on-call emergency medical service system at two hospitals
Generalized linear models and multiple comparison using Wilcoxon rank-sum tests were not adjusted by two other variables, the differences in PAPEMCS scores among parental vulnerabilities and PEMCS systems were similar to the results examined by multiple correspondence analysis
Summary
The appropriate enforcement of pediatric emergency medical care service (PEMCS) is a vital component of pediatric health services. Around the world, especially in developed nations, pediatric emergency department (PED) crowding due to PED visits for non-urgent health concerns prevents the efficient and efficacious use of health services. The overcrowding threatens the quality (treatment delays for children requiring attention and urgent medical care), wastes resources, and is a financial burden to parents and to society [1]-[6]. It increases a lack of continuity care and adequate access to primary care [7] [8]. The characteristics of children who returned to PED within 72 hours (6968, 4.3%) and the characteristics of children who were admitted to the hospital on their return visit (2925, 42%) would help in directing future strategies to reduce potentially avoidable reattendance and admission [9]
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