The Relationship Between Family Anxiety Levels and Knowledge of Initial Patient Management in the Emergency Department
Keywords:
anxiety, knowledge, family, emergency department
Abstract
Family anxiety in the Emergency Department (ED) commonly occurs due to uncertainty regarding the patient’s condition and limited understanding of initial treatment procedures. This condition may influence the family’s ability to receive information and support patient care. This study aimed to analyze the relationship between family anxiety levels and knowledge of initial patient management in the Emergency Department of RSUD M.M. Dunda Limboto. A quantitative correlational study with a cross-sectional design was conducted involving 91 respondents selected through accidental sampling. Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HARS), while knowledge was assessed using a structured questionnaire on initial patient management. Data were analyzed using the Chi-Square test with a significance level of 0.05. The results showed that most respondents experienced mild anxiety (42.9%) and had low knowledge levels (36.3%). Statistical analysis revealed a significant relationship between family anxiety levels and knowledge of initial patient management (p = 0.000). These findings indicate that family anxiety is associated with their understanding of emergency care procedures. Strengthening health education and effective communication by healthcare professionals is necessary to reduce anxiety and improve family comprehension during emergency services.
References
1. World Health Organization. Emergency care systems for universal health coverage: ensuring timely care for the acutely ill and injured [Internet]. Seventy-Fourth World Health Assembly A74/39. Geneva: World Health Organization; 2021. Available from: https://apps.who.int/gb/ebwha/pdf_files/WHA74/A74_39-en.pdf
2. Reynolds TA, Sawe H, Rubiano AM, Shin SD, Wallis L, Mock CN. Strengthening health systems to provide emergency care. Lancet. 2017;390(10101):1324–5.
3. Morley C, Unwin M, Peterson GM, Stankovich J, Kinsman L. Emergency department crowding: A systematic review of causes, consequences and solutions. Ann Emerg Med. 2018;72(4):430–41.
4. Alsharari AF. The needs of family members of patients admitted to the emergency department. J Clin Nurs. 2017;26(9–10):1208–18.
5. Redley B, Botti M, Duke M. Patient and family anxiety in emergency departments: A review of the literature. J Adv Nurs. 2018;74(5):1042–54.
6. O’Reilly GM, Mitchell RD, Rajiv P. Waiting times and patient/family anxiety in emergency departments. BMJ Open. 2020;10(6):e034520.
7. Jenkins JL, McCarthy ML, Sauer LM. Public understanding of triage systems in emergency departments. Emerg Med J. 2017;34(3):176–82.
8. Alqahtani S, Alshehri M, Alghamdi A. Perceptions of triage prioritization and patient satisfaction in emergency departments. BMC Emerg Med. 2022;22(1):45.
9. Wolf LA, Perhats C, Delao AM. Workplace violence and family conflict in emergency departments. J Emerg Nurs. 2019;45(3):279–88.
10. Moran TP. Anxiety and working memory capacity: A meta-analysis and narrative review. Curr Psychiatry Rep. 2016;18(6):1–10.
11. Robinson OJ, Pike AC, Cornwell B, Grillon C. The translational neural circuitry of anxiety. Nat Rev Neurosci. 2019;20(7):437–50.
12. Eysenck MW, Derakshan N, Santos R, Calvo MG. Attentional control theory: Anxiety and cognitive performance. J Anxiety Disord. 2017;50:1–9.
13. Alshahrani MS, Jones P, Alqahtani S. Family anxiety in emergency departments: Associated factors and outcomes. Int Emerg Nurs. 2020;50:100850.
14. Street RL, Makoul G, Arora NK, Epstein RM. How does communication heal? Pathways linking clinician–patient communication to health outcomes. Patient Educ Couns. 2017;100(5):814–21.
15. O’Hara JK, Lawton RJ, Atkinson J. A qualitative study of communication in emergency care: Barriers and facilitators. BMJ Qual Saf. 2018;27(3):205–13.
16. World Health Organization. Basic Emergency Care: Approach to the Acutely Ill and Injured [Internet]. Geneva: World Health Organization; 2018. Available from: https://www.who.int/publications/i/item/basic-emergency-care
17. Mackway-Jones K, Marsden J, Windle J. Emergency triage systems and clinical prioritisation. Emerg Med J. 2017;34(12):826–32.
18. Liu Y, Lee K, Chia YC. Health literacy and anxiety among family members of hospitalized patients: A cross-sectional study. Heal Expect. 2020;23(5):1208–16.
19. Al-Mutair AS, Plummer V, Clerehan R, O’Brien A. Family needs and anxiety in intensive care units: A descriptive study. Intensive Crit Care Nurs. 2018;44:22–7.
20. Kentish-Barnes N, Chevret S, Azoulay E. Information provision and psychological outcomes in intensive care unit family members. J Clin Nurs. 2016;25(1–2):163–72.
21. Ong LM, de Haes JC, Hoos AM, Lammes FB. Communication, information needs and family outcomes in emergency settings. BMC Health Serv Res. 2019;19(1):456.
22. Carpenter CR, Griffey RT, Stark S. Family experiences in emergency departments: A mixed-methods study. BMJ Open. 2021;11(3):e044012.
23. Henderson K, Long J, Duffy M. Educational interventions for families in emergency departments and their impact on anxiety. J Emerg Nurs. 2020;46(4):498–506.
24. McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res. 2016;45(8):1027–35.
25. Li SH, Graham BM. Why are women so vulnerable to anxiety, trauma-related and stress-related disorders? The potential role of sex hormones. Front Psychol. 2017;8:1644.
26. Teachman BA. Anxiety and aging: Clinical and research implications. J Anxiety Disord. 2020;74:102267.
27. Stormacq C, Van den Broucke S, Wosinski J. Does health literacy mediate the relationship between socioeconomic status and health disparities? Soc Sci Med. 2018;199:52–60.
28. Van der Heide I, Wang J, Droomers M, Spreeuwenberg P, Rademakers J. The relationship between health, education, and health literacy: Results from the Dutch Adult Literacy and Life Skills Survey. BMC Public Health. 2018;13:179.
29. Meilyana BD, Yunita A, Maula LN, Suroso H, Hasyim AW, Tandilangi E, et al. The Relationship Between the Level of Knowledge and Attitudes About Triage with Family Anxiety Level Patients in the Emergency Room of the Kasembon Hospital. Synth Glob Heal J. 2024;2(1):47–55.
30. Adeliani, Qorahman W, Wahyono, Lestari L. HUBUNGAN PENGETAHUAN TENTANG TRIASE TERHADAP TINGKAT KECEMASAN KELUARGA PASIEN DI RUANGAN INSTALASI GAWAT DARURAT (IGD) RSUD SULTAN IMANUDDIN PANGKALAN BUN. Yahya Bima Sci J Heal [Internet]. 2025;2(1):114–26. Available from: https://jurnal.stikesyahyabima.ac.id/index.php/sjh/article/view/54
31. Norfita A, Melastuti E, Ahmad Ikhlasul Amal. Hubungan Tingkat Kegawatdaruratan Pasien dengan Tingkan Kecemasan Keluarga Pasien di IGD RSI Sultan Agung Semarang. OBAT J Ris Ilmu Farm dan Kesehat [Internet]. 2025 Mar 11;3(2 SE-Articles):306–18. Available from: https://journal.arikesi.or.id/index.php/OBAT/article/view/1216
32. Lasman L, Islamy A, Farida F, Nurhidayati N, Rohmawati I, Osella D. Relationship between Emergency Level (Triage) and Anxiety Level of the Patient’s Family. Prism Sains J Pengkaj Ilmu dan Pembelajaran Mat dan IPA IKIP Mataram. 2023;11(2):463–70.
2. Reynolds TA, Sawe H, Rubiano AM, Shin SD, Wallis L, Mock CN. Strengthening health systems to provide emergency care. Lancet. 2017;390(10101):1324–5.
3. Morley C, Unwin M, Peterson GM, Stankovich J, Kinsman L. Emergency department crowding: A systematic review of causes, consequences and solutions. Ann Emerg Med. 2018;72(4):430–41.
4. Alsharari AF. The needs of family members of patients admitted to the emergency department. J Clin Nurs. 2017;26(9–10):1208–18.
5. Redley B, Botti M, Duke M. Patient and family anxiety in emergency departments: A review of the literature. J Adv Nurs. 2018;74(5):1042–54.
6. O’Reilly GM, Mitchell RD, Rajiv P. Waiting times and patient/family anxiety in emergency departments. BMJ Open. 2020;10(6):e034520.
7. Jenkins JL, McCarthy ML, Sauer LM. Public understanding of triage systems in emergency departments. Emerg Med J. 2017;34(3):176–82.
8. Alqahtani S, Alshehri M, Alghamdi A. Perceptions of triage prioritization and patient satisfaction in emergency departments. BMC Emerg Med. 2022;22(1):45.
9. Wolf LA, Perhats C, Delao AM. Workplace violence and family conflict in emergency departments. J Emerg Nurs. 2019;45(3):279–88.
10. Moran TP. Anxiety and working memory capacity: A meta-analysis and narrative review. Curr Psychiatry Rep. 2016;18(6):1–10.
11. Robinson OJ, Pike AC, Cornwell B, Grillon C. The translational neural circuitry of anxiety. Nat Rev Neurosci. 2019;20(7):437–50.
12. Eysenck MW, Derakshan N, Santos R, Calvo MG. Attentional control theory: Anxiety and cognitive performance. J Anxiety Disord. 2017;50:1–9.
13. Alshahrani MS, Jones P, Alqahtani S. Family anxiety in emergency departments: Associated factors and outcomes. Int Emerg Nurs. 2020;50:100850.
14. Street RL, Makoul G, Arora NK, Epstein RM. How does communication heal? Pathways linking clinician–patient communication to health outcomes. Patient Educ Couns. 2017;100(5):814–21.
15. O’Hara JK, Lawton RJ, Atkinson J. A qualitative study of communication in emergency care: Barriers and facilitators. BMJ Qual Saf. 2018;27(3):205–13.
16. World Health Organization. Basic Emergency Care: Approach to the Acutely Ill and Injured [Internet]. Geneva: World Health Organization; 2018. Available from: https://www.who.int/publications/i/item/basic-emergency-care
17. Mackway-Jones K, Marsden J, Windle J. Emergency triage systems and clinical prioritisation. Emerg Med J. 2017;34(12):826–32.
18. Liu Y, Lee K, Chia YC. Health literacy and anxiety among family members of hospitalized patients: A cross-sectional study. Heal Expect. 2020;23(5):1208–16.
19. Al-Mutair AS, Plummer V, Clerehan R, O’Brien A. Family needs and anxiety in intensive care units: A descriptive study. Intensive Crit Care Nurs. 2018;44:22–7.
20. Kentish-Barnes N, Chevret S, Azoulay E. Information provision and psychological outcomes in intensive care unit family members. J Clin Nurs. 2016;25(1–2):163–72.
21. Ong LM, de Haes JC, Hoos AM, Lammes FB. Communication, information needs and family outcomes in emergency settings. BMC Health Serv Res. 2019;19(1):456.
22. Carpenter CR, Griffey RT, Stark S. Family experiences in emergency departments: A mixed-methods study. BMJ Open. 2021;11(3):e044012.
23. Henderson K, Long J, Duffy M. Educational interventions for families in emergency departments and their impact on anxiety. J Emerg Nurs. 2020;46(4):498–506.
24. McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res. 2016;45(8):1027–35.
25. Li SH, Graham BM. Why are women so vulnerable to anxiety, trauma-related and stress-related disorders? The potential role of sex hormones. Front Psychol. 2017;8:1644.
26. Teachman BA. Anxiety and aging: Clinical and research implications. J Anxiety Disord. 2020;74:102267.
27. Stormacq C, Van den Broucke S, Wosinski J. Does health literacy mediate the relationship between socioeconomic status and health disparities? Soc Sci Med. 2018;199:52–60.
28. Van der Heide I, Wang J, Droomers M, Spreeuwenberg P, Rademakers J. The relationship between health, education, and health literacy: Results from the Dutch Adult Literacy and Life Skills Survey. BMC Public Health. 2018;13:179.
29. Meilyana BD, Yunita A, Maula LN, Suroso H, Hasyim AW, Tandilangi E, et al. The Relationship Between the Level of Knowledge and Attitudes About Triage with Family Anxiety Level Patients in the Emergency Room of the Kasembon Hospital. Synth Glob Heal J. 2024;2(1):47–55.
30. Adeliani, Qorahman W, Wahyono, Lestari L. HUBUNGAN PENGETAHUAN TENTANG TRIASE TERHADAP TINGKAT KECEMASAN KELUARGA PASIEN DI RUANGAN INSTALASI GAWAT DARURAT (IGD) RSUD SULTAN IMANUDDIN PANGKALAN BUN. Yahya Bima Sci J Heal [Internet]. 2025;2(1):114–26. Available from: https://jurnal.stikesyahyabima.ac.id/index.php/sjh/article/view/54
31. Norfita A, Melastuti E, Ahmad Ikhlasul Amal. Hubungan Tingkat Kegawatdaruratan Pasien dengan Tingkan Kecemasan Keluarga Pasien di IGD RSI Sultan Agung Semarang. OBAT J Ris Ilmu Farm dan Kesehat [Internet]. 2025 Mar 11;3(2 SE-Articles):306–18. Available from: https://journal.arikesi.or.id/index.php/OBAT/article/view/1216
32. Lasman L, Islamy A, Farida F, Nurhidayati N, Rohmawati I, Osella D. Relationship between Emergency Level (Triage) and Anxiety Level of the Patient’s Family. Prism Sains J Pengkaj Ilmu dan Pembelajaran Mat dan IPA IKIP Mataram. 2023;11(2):463–70.
Published
2026-05-25
How to Cite
Ahmad, F. P. A.-Z., Ani Retni, Pipin Yunus, & Setiawan. (2026). The Relationship Between Family Anxiety Levels and Knowledge of Initial Patient Management in the Emergency Department. International Journal of Health, Economics, and Social Sciences (IJHESS), 8(3), 1818~1823. https://doi.org/10.56338/ijhess.v8i3.11125
Issue
Section
Articles
Copyright (c) 2026 Fatimah Putri Az-Zahra Ahmad
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
