European Journal of Oncology Nursing
Volume 16, Issue 1 , Pages 1-9, February 2012

Trajectories of anxiety in oncology patients and family caregivers during and after radiation therapy

  • Laura B. Dunn

      Affiliations

    • School of Medicine, University of California, San Francisco, CA, USA
    • ,
  • Bradley E. Aouizerat

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • Institute for Human Genetics, University of California, San Francisco, CA, USA
    • ,
  • Bruce A. Cooper

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • ,
  • Marylin Dodd

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • ,
  • Kathryn Lee

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • ,
  • Claudia West

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • ,
  • Steven M. Paul

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • ,
  • William Wara

      Affiliations

    • Kaiser Permanente, San Francisco, CA, USA
    • ,
  • Patrick Swift

      Affiliations

    • Alta Bates Comprehensive Cancer Center, Berkeley, CA, USA
    • ,
  • Christine Miaskowski

      Affiliations

    • School of Nursing, University of California, San Francisco, CA, USA
    • Corresponding Author InformationCorresponding author. Department of Physiological Nursing, School of Nursing, University of California, 2 Koret Way, Box 0610, San Francisco, CA 94143-0610, USA. Tel.: +1 415 476 9407; fax: +1 415 476 8899.

published online 15 February 2011.

Abstract 

Purpose

Anxiety is common in patients undergoing radiation therapy (RT) and in their family caregivers (FCs). Little is known about individual differences in anxiety trajectories during and after RT. This study aimed to identify distinct latent classes of oncology patients and their FCs based on self-reported anxiety symptoms from the beginning to four months after the completion of RT.

Method

Using growth mixture modeling (GMM), longitudinal changes in Spielberger State Anxiety Inventory (STAI-S) scores among 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 FCs were evaluated to determine distinct anxiety symptom profiles. STAI-S scores were assessed just prior to, throughout the course of, and for four months following RT (total of 7 assessments). Baseline trait anxiety and depressive symptoms (during and after RT) were also assessed.

Results

The GMM analysis identified three latent classes of oncology patients and FCs with distinct trajectories of state anxiety: Low Stable (n = 93, 36.9%), Intermediate Decelerating (n = 82, 32.5%), and High (n = 77, 30.6%) classes. Younger participants, women, ethnic minorities, and those with children at home were more likely to be classified in the High anxiety class. Higher levels of trait anxiety and depressive symptoms, at the initiation of RT, were associated with being in the High anxiety class.

Conclusions

Subgroups of patients and FCs with high, intermediate, and low mean levels of anxiety during and after RT were identified with GMM. Additional research is needed to better understand the heterogeneity of symptom experiences as well as comorbid symptoms in patients and FCs.

Keywords: Psycho-oncology, Anxiety, Radiation therapy, Family caregivers, Growth mixture modeling, Depression

 

PII: S1462-3889(11)00007-X

doi:10.1016/j.ejon.2011.01.003

European Journal of Oncology Nursing
Volume 16, Issue 1 , Pages 1-9, February 2012

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