Objective  To examine characteristic and influencing factors of anxiety among air passengers and to provide evidences for improving service quality and health care during air travel.

  Methods  A total of 2 526 air passengers were selected with simple random sampling at 10 airports in various regions of China and surveyed with Trait Anxiety Inventory, Simple Coping Style Scale, and an Anxiety Tendency Scale self-designed based on psychological needs of air passengers.

  Results  The respondents′ mean scores were 38.85 ± 8.23 for trait-anxiety, 23.65 ± 5.44 for positive coping, 15.77 ± 3.92 for negative coping, and 70.33 ± 6.55 for anxiety tendency, respectively. The mean scores for major factors affecting the passengers′ anxiety were 4.01 ± 0.97 for the right to get the information on flight delays, 3.83 ± 0.92 for accommodation quality in case of flight delay, 3.68 ± 1.12 for flight punctuality rate, 3.62 ± 0.86 for smooth flight during takeoff and landing, and 3.57 ± 0.91 for good condition of checked baggage; the mean scores for passengers′ most desired to be improved anxiety-related items were 4.43 ± 0.82 for safety and good condition of checked baggage , 4.28 ± 0.86 for timeliness for flight related notification, 4.27 ± 0.99 for accommodation quality, 4.25 ± 1.13 for the right to get the information on flight delays, and 4.14 ± 0.80 for commitment of flight delay compensation, respectively. Among the passengers, the trait-anxiety differed significantly by age, time of air travel, and travel destination ( all P < 0.001); the positive coping differed significantly by gender, age, and air travel frequency (all P < 0.05) and negative coping by gender, age, air travel frequency, time of air travel, and travel destination (all P < 0.01); the anxiety tendency differed significantly by gender, age, air travel frequency, time of air travel, and travel destination (all P < 0.001). There were significant correlations among trait-anxiety, coping style and anxiety tendency. Coping style played a significant multiple mediation effect on the correlation between trait anxiety and anxiety tendency, accounting for 34.8% of the total variance. Both positive and negative coping had significant mediation effect on the correlation between trait anxiety and anxiety tendency, accounting for 60.5% and 39.5% of the indirect effect. The proportions of passengers reporting anxious emotion during different period of time were 61.8% for flight delay, 41.6% at the time of takeoff, 35.9% for baggage reclaim, 32.3% at the time of waiting for departure, and 31.8% at the time of check-in; the proportions of passengers reporting anxiety-related symptoms were 41.8% for increased heart rate, 32.5% for earache, 31.8% for dizziness and headache, and 21.9% for nausea and other symptoms. There were 51.5% and 44.2% of the passengers reporting adoptions of sleep and listening to music/reading newspaper/watching videos to cope with anxious emotion.

  Conclusion  Anxiety is prevalence and influenced by multiple factors among air passengers and specific management measures and service modes should be developed by relevant agencies to promote passengers′ health care during air travel.