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The predictive value of symptoms for anxiety in hospice inpatients with advanced cancer

Published online by Cambridge University Press:  25 September 2017

Danielle Zweers ,
Everlien de Graaf ,
Alexander de Graeff ,
Rebecca K. Stellato ,
Petronella O. Witteveen  and
Saskia C.C.M. Teunissen
Danielle Zweers*
Affiliation:
Center of Expertise in Palliative Care–Utrecht, Julius Center for Healthcare Sciences and Primary Care, Department of General Practice and the Cancer Center University Medical Center, and Department of Medical Oncology, University of Utrecht, Utrecht, The Netherlands
Everlien de Graaf
Affiliation:
Center of Expertise in Palliative Care–Utrecht, Julius Center for Healthcare Sciences and Primary Care, Department of General Practice, University of Utrecht, Utrecht, The Netherlands
Alexander de Graeff
Affiliation:
Cancer Center University Medical Center–Utrecht, Department of Medical Oncology, University of Utrecht, Utrecht, The Netherlands
Rebecca K. Stellato
Affiliation:
Julius Center for Healthcare Sciences and Primary Care, Department of Biostatistics and Research Support, University of Utrecht, Utrecht, The Netherlands
Petronella O. Witteveen
Affiliation:
Cancer Center University Medical Center–Utrecht, Department of Medical Oncology, University of Utrecht, Utrecht, The Netherlands
Saskia C.C.M. Teunissen
Affiliation:
Center of Expertise in Palliative Care–Utrecht, Julius Center for Healthcare Sciences and Primary Care, Department of General Practice, University of Utrecht, Utrecht, The Netherlands
*
Address correspondence and reprint requests to: Danielle Zweers, P.O. 85500, 3508 GA Utrecht, The Netherlands. E-mail: d.zweers@umcutrecht.nl.
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Abstract

Objective:

Insight into symptoms as predictors for anxiety may help to foster early identification of anxiety and to ameliorate anxiety management. The aim of this study was to determine which frequently occurring symptoms are predictors for anxiety in advanced cancer patients recently admitted to a hospice.

Method:

Symptom burden was measured in patients admitted to a hospice who died ≤3 month after admission using the Utrecht Symptom Diary. This is a Dutch-translated and adapted version of the Edmonton Symptom Assessment System to self-assess the 11 most prevalent symptoms and overall well-being on a 0–10 numerical rating scale. Multiple linear regression analysis was employed to analyze the predictive value of fatigue, nausea, pain, dyspnea, depressed mood, insomnia, and well-being on anxiety.

Results:

A total of 211 patients were included, 42% of whom were men, and the median age was 71 years (range = 31–95). Anxiety was uncommon and rarely severe: 25% had a score ≥1, and 14% had a score >3. After correction for age, gender, and marital status, depressed mood (p = 0.00) and dyspnea (p = 0.01) were independent predictors for anxiety and explained 23% of the variance in anxiety.

Significance of results:

Hospice inpatients with advanced cancer who suffer from dyspnea and/or depressed mood are at increased risk for anxiety. Treatment of dyspnea and depressed mood may contribute to adequate anxiety management. Further research should explore other factors associated with anxiety, especially in the psychological, social, and spiritual domains.

Keywords

AnxietySymptomsAdvanced cancerHospice carePalliative care
Type
Original Article
Information
Palliative & Supportive Care , Volume 16 , Issue 5 , October 2018 , pp. 602 - 607
Copyright
Copyright © Cambridge University Press 2017 

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