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Perceptions of anxiety in lung cancer patients and their support network

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Abstract

Introduction

Lung cancer is a disease of high symptom burden, major psychosocial impact and poor prognosis. Although diagnosis is individual, each patient operates within a social context. Patient perception of family’s or friends’ concern may affirm the presence of support or may drive personal anxiety. Perceived worry may impact on freedom to discuss illness or symptoms within the support network. The validated palliative outcome scale quantifies physical and psychosocial needs. It also evaluates anxiety felt and anxiety perceived in the support network. This study examined lung cancer patients’ symptoms, performance status, their supportive care needs and their perception of family’s/friends’ anxiety.

Goals of work

The aim of this study was to evaluate lung cancer patients’ anxiety, physical symptoms, performance status and their perception of anxiety within their support network.

Patients and methods

The study was a prospective observational evaluation of 170 lung cancer out-patients using an adapted palliative outcome scale questionnaire. Comparison was made between patients perceiving high anxiety within their support network and those who perceiving low anxiety.

Main results

Perceived familial and self-rated personal anxiety both increased as function declined (p < 0.001; p = 0.001). Increased perceived worry was associated with increased physical symptoms [dyspnoea (p < 0.001), cough (p = 0.001), haemoptysis (p = 0.009)], low self-esteem (p = 0.004) and feeling lack of worth (p = 0.035). Perception of increased worry did not influence whether patients felt able to share their feelings (p = 0.362).

Conclusions

As physical function declines and symptoms increase, patients are more worried themselves and perceive increased anxiety within their support network. However, this circle of anxiety did not impair the perception that feelings could be shared within the support network.

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References

  1. Akechi T, Okuyama T, Akizuki N et al (2006) Course of psychological distress and its predictors in advanced non-small cell lung cancer patients. Psychooncology 15(6):463–473. doi:10.1002/pon.975

    Article  PubMed  Google Scholar 

  2. Boer M, Ryckman R, Pryun J, Van den Borne H (1999) Psychosocial correlates of cancer relapses and survival: a literature review. Patient Educ Couns 37:215–230. doi:10.1016/S0738-3991(99)00029-4

    Article  PubMed  Google Scholar 

  3. Bottomley A (1998) Anxiety and the adult cancer patient. Eur J Cancer Care (Engl) 7(4):217–224. doi:10.1046/j.1365-2354.1998.00101.x

    Article  CAS  Google Scholar 

  4. Broberger E, Tishelman C, von Essen L (2005) Discrepancies and similarities in how patients with lung cancer and their professional and family caregivers assess symptom occurrence and symptom distress. J Pain Symptom Manage 29:572. doi:10.1016/j.jpainsymman.2004.11.006

    Article  PubMed  Google Scholar 

  5. Brown D, McMillan D, Milroy R (2005) The correlation between fatigue, physical function, the systemic inflammatory response, and psychological distress in patients with advanced lung cancer. Cancer 103(2):377–382. doi:10.1002/cncr.20777

    Article  PubMed  Google Scholar 

  6. Scottish Cancer Registry (2006) Cancer in Scotland. Information Services, Division of the NHS in Scotland, Scottish Cancer Registry, Edinburgh

    Google Scholar 

  7. Carlsen K, Jensen AB, Jacobsen E, Krasnik M, Johansen C (2005) Psychosocial aspects of lung cancer. Lung Cancer 47(3):293–300. doi:10.1016/j.lungcan.2004.08.002

    Article  PubMed  Google Scholar 

  8. Cassileth B, Lusk E, Huter R (1984) Concordance of depression and anxiety in patients with cancer. Psychol Rep 54:588–590

    CAS  PubMed  Google Scholar 

  9. Cleeland C, Reyes-Gibby C (2002) When is it justified to treat symptoms? Measuring symptom burden. Oncology 16(9):64–70

    PubMed  Google Scholar 

  10. Collins English Dictionary (2006) Collins English Dictionary, 8th edn. HarperCollins, Glasgow

    Google Scholar 

  11. Cooley M (2000) Symptoms in adults with lung cancer: a systematic research review. J Pain Symptom Manage 19(2):137–153. doi:10.1016/S0885-3924(99)00150-5

    Article  CAS  PubMed  Google Scholar 

  12. Degner L, Sloan J (1995) Symptom distress in newly diagnosed ambulatory cancer patients and as a predictor of survival in lung cancer. J Pain Symptom Manage 10(6):423–431. doi:10.1016/0885-3924(95)00056-5

    Article  CAS  PubMed  Google Scholar 

  13. Edmonds P, Karlsen S, Khan S, Addington-Hall J (2001) A comparison of the palliative care needs of patients dying from chronic respiratory diseases and lung cancer. Palliat Med 15(4):287–295. doi:10.1191/026921601678320278

    Article  CAS  PubMed  Google Scholar 

  14. Graves KD, Arnold SM, Love CL, Kirsh KL, Moore PG, Passik SD (2007) Distress screening in a multidisciplinary lung cancer clinic: Prevalence and predictors of clinically significant distress. Lung Cancer 55(2):215–224. doi:10.1016/j.lungcan.2006.10.001

    Article  PubMed  Google Scholar 

  15. Gregor A, Milroy R (2001) Cancer scenarios: an aid to planning cancer services in Scotland in the next decade. Scottish Executive Health Department, Scotland

    Google Scholar 

  16. Hearn J, Higginson I (1999) Development and validation of a core outcome measure for palliative care: the palliative care outcome scale. Qual Health Care 8(4):219–227. doi:10.1136/qshc.8.4.219

    Article  CAS  PubMed  Google Scholar 

  17. Hearn J, Higginson I (1997) Outcome measures in palliative care for advanced cancer patients: a review. J Public Health Med 19(2):193–199

    CAS  PubMed  Google Scholar 

  18. Henoch I, Bergman B, Gustafsson M, Gaston-Johansson F, Danielson E (2007) The impact of symptoms, coping capacity, and social support on quality of life experience over time in patients with lung cancer. J Pain Symptom Manage 34(4):370–379. doi:10.1016/j.jpainsymman.2006.12.005

    Article  PubMed  Google Scholar 

  19. Higginson I (2004) Relationship between 3 palliative outcome scales. Health Qual Life Outcomes 2:68

    Article  PubMed  Google Scholar 

  20. Hill KM, Amir Z, Muers MF, Connolly CK, Round CE (2003) Do newly diagnosed lung cancer patients feel their concerns are being met? Eur J Cancer Care (Engl) 12(1):35–45. doi:10.1046/j.1365-2354.2003.00324.x

    Article  CAS  Google Scholar 

  21. Hoda B, Cindy L, Carmack T (2006) Social constraints and spousal communication in lung cancer. Psychooncology 15(8):673–683. doi:10.1002/pon.996

    Article  Google Scholar 

  22. Hopwood P, Stephens RJ (2000) Depression in patients with lung cancer: prevalence and risk factors derived from quality-of-life data. J Clin Oncol 18(4):893

    CAS  PubMed  Google Scholar 

  23. Hughes R, Aspinal F, Higginson I et al (2004) Assessing palliative care outcomes for people with motor neurone disease living at home. Int J Palliat Nurs 10(9):449–453

    PubMed  Google Scholar 

  24. World Health Organisation (1994) International statistical classification of diseases and related health problems. World Health Organisation, Geneva

    Google Scholar 

  25. Jiong Li AG (2006) Supportive care needs: are patients with lung cancer a neglected population? Psychooncology 15(6):509–516. doi:10.1002/pon.983

    Article  PubMed  Google Scholar 

  26. Khalid U, Spiro A, Baldwin C et al (2007) Symptoms and weight loss in patients with gastrointestinal and lung cancer at presentation. Support Care Cancer 15(1):39–46. doi:10.1007/s00520-006-0091-0

    Article  CAS  PubMed  Google Scholar 

  27. Krishnasamy M, Wilkie E, Haviland J (2001) Lung cancer health care needs assessment: patients' and informal carers' responses to a national mail questionnaire survey. Palliat Med 15(3):213–227. doi:10.1191/026921601678576202

    Article  CAS  PubMed  Google Scholar 

  28. Lloyd-Williams M, Friedman T, Rudd N (2001) An analysis of the validity of the hospital anxiety and depression scale as a screening tool in patients with advanced metastatic cancer. J Pain Symptom Manage 22(6):990–996. doi:10.1016/S0885-3924(01)00358-X

    Article  CAS  PubMed  Google Scholar 

  29. Lobchuk M, Kristijanson L, Degner L, Blood P, Sloan J (1997) Perceptions of symptom distress in lung cancer patients: I. Congruence between patients and primary family caregivers. J Pain Symptom Manage 14(3):136–146. doi:10.1016/S0885-3924(97)00022-5

    Article  CAS  PubMed  Google Scholar 

  30. Mary EC, Thomas HS, Helene JM (2002) Patterns of symptom distress in adults receiving treatment for lung cancer. J Palliat Care 18(3):150

    Google Scholar 

  31. Meinir K, Mary W, Erna W (2007) Patients and carer experiences of care provision after a diagnosis of lung cancer in Scotland. Support Care Cancer 15(3):327–332. doi:10.1007/s00520-006-0129-3

    Article  Google Scholar 

  32. Montazeri A, Milroy R, Hole D, McEwen J, Gillis CR (1998) Anxiety and depression in patients with lung cancer before and after diagnosis: findings from a population in Glasgow, Scotland. J Epidemiol Community Health 52(3):203–204. doi:10.1136/jech.52.3.203

    Article  CAS  PubMed  Google Scholar 

  33. Murray S, Kendall M, Boyd K, Sheikh A (2005) Illness trajectories and palliative care. BMJ 330(7498):1007–1011. doi:10.1136/bmj.330.7498.1007

    Article  PubMed  Google Scholar 

  34. Oken M, Creech R, Tormey D et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655. doi:10.1097/00000421-198212000-00014

    Article  CAS  PubMed  Google Scholar 

  35. ONS (2007) Mortality statistics: cancer incidence and mortality in the United Kingdom 2001–03. Office for National Statistics, Edinburgh

    Google Scholar 

  36. Parkin D (2001) Global cancer statistics in the year 2000. Lancet Oncol 2(9):533–543. doi:10.1016/S1470-2045(01)00486-7

    Article  CAS  PubMed  Google Scholar 

  37. Podnos YD, Borneman TR, Koczywas M, Uman G, Ferrell BR (2007) Symptom concerns and resource utilization in patients with lung cancer. J Palliat Med 10(4):899–903. doi:10.1089/jpm.2006.0232

    Article  PubMed  Google Scholar 

  38. Richardson A, Plant H, Moore S, Medina J, Cornwall A, Ream E (2007) Developing supportive care for family members of people with lung cancer: a feasibility study. Support Care Cancer 15(11):1259–1269. doi:10.1007/s00520-007-0233-z

    Article  PubMed  Google Scholar 

  39. Roth AJ, Massie MJ (2007) Anxiety and its management in advanced cancer. Curr Opin Supportive Palliat Care 1(1):50–56. doi:10.1097/SPC.0b013e32813aeb23

    Article  Google Scholar 

  40. Smith EL, Hann DM, Ahles TA et al (2001) Dyspnea, anxiety, body consciousness, and quality of life in patients with lung cancer. J Pain Symptom Manage 21(4):323–329. doi:10.1016/S0885-3924(01)00255-X

    Article  CAS  PubMed  Google Scholar 

  41. Spiegel D, Barlow D (2000) Anxiety disorders. In: Gelder M, Lopez-Ibor J, Andreasen N (eds) New Oxford textbook of psychiatry. Oxford University Press, Oxford

    Google Scholar 

  42. Stark DPH, House A (2000) Anxiety in cancer patients. Br J Cancer 83(10):1261. doi:10.1054/bjoc.2000.1405

    Article  CAS  PubMed  Google Scholar 

  43. Stevens A, Gwilliam B, A'Hern R, Broadley K, Hardy J (2005) Experience in the use of the palliative care outcome scale. Support Care Cancer 13:1027–1034. doi:10.1007/s00520-005-0815-6

    Article  PubMed  Google Scholar 

  44. Tishelman C, Degner LF, Rudman A et al (2005) Symptoms in patients with lung carcinoma. Cancer 104:2013–2021

    Article  PubMed  Google Scholar 

  45. Tishelman C, Gustavsson JP, Degner LF et al (2001) Symptom distress and quality of life in patients with inoperable lung cancer: perceptions of patients, staff and family caregivers. Eur J Cancer 37(Supplement 6):S436–S583. doi:doi:10.1016/S0959-8049(01)82071-2

    Article  Google Scholar 

  46. Tyrer P (1984) Classification of anxiety. Br J Psychiatry 144:78–83. doi:doi:10.1192/bjp.144.1.78

    Article  CAS  PubMed  Google Scholar 

  47. Wennman-Larsen A, Tishelman C, Wengstrom Y, Gustavsson P (2007) Factors influencing agreement in symptom ratings by lung cancer patients and their significant others. J Pain Symptom Manage 33(2):146–155. doi:doi:10.1016/j.jpainsymman.2006.07.019

    Article  PubMed  Google Scholar 

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Acknowledgements

We would like to thank all the patients who participated in this study. We would also like to acknowledge the support of staff of the out-patient clinic and medical records. Particular thanks to Jasminder Singh. POS was developed by Professor Irene Higginson and the POS Development team, King’s College, London, UK.

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Correspondence to D. Buchanan.

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Buchanan, D., Milroy, R., Baker, L. et al. Perceptions of anxiety in lung cancer patients and their support network. Support Care Cancer 18, 29–36 (2010). https://doi.org/10.1007/s00520-009-0626-2

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