Factors Affecting Stress Levels in Attendants Accompanying Patients to Emergency Department

Staff in emergency departments work in an environment where they are continuously exposed to situations with aggressive patients and their caretakers. With increasing incidents of reported violence, the present study was conducted to identify factors associated with stress levels among patients' attendants.

A prospective, cross-sectional, observational study was conducted among 256 attendants of patients presenting to Emergency Department (ED). Signs of stress and imminent violence were recorded using STAMP method at initial encounter. Stress levels were assessed using Perceived Stress Scale 10 and Visual Analog Scale at the end of 2 h during patient's stay in emergency department. Factors associated with stress were studied using linear regression analysis. There was a follow-up to estimate the level of stress, to identify risk factors and types of violence in the sample population.

98.9% of attendants exhibited some form of stress. Age of <40 years, female gender, single marital status, lower educational background, lack of previous experience with ED, perceived long waiting time, and first-degree relatives were the significant risk factors associated with high stress. Verbal aggression was the most common and frequent form of aggression. Noncritically ill patient attendants, no previous experience with EDs, graduates, middle age group, perceived long waiting time, and poor patient response to treatment were found to be risk factors for impending violence.

Stress was exhibited in majority of caregivers. Further programs are needed to strengthen training for ED staff to identify early and impending violence and to develop coping mechanisms for well-being of both attendants and health-care professionals.