Trajectories and predictors of state and trait anxiety in patients receiving chemotherapy for breast and colorectal cancer: Results from a longitudinal study

Annegret Schneider, Grigorios Kotronoulas, Constantina Papadopoulou, Lisa McCann, Morven Miller, Jackie McBride, Zoe Polly, Simon Bettles, Alison Whitehouse, Nora Kearney, Roma Maguire

Research output: Contribution to journalArticle

Abstract

PURPOSE: To examine the trajectories and predictors of state and trait anxiety in patients undergoing chemotherapy for breast or colorectal cancer.

METHODS: Secondary analysis of data collected as part of a large multi-site longitudinal study. Patients with breast or colorectal cancer completed validated scales assessing their state and trait anxiety levels (State-Trait Anxiety Inventory) and symptom burden (Rotterdam Symptom Checklist) at the beginning of each chemotherapy cycle. Longitudinal mixed model analyses were performed to test changes of trait and state anxiety over time and the predictive value of symptom burden and patients' demographic (age, gender) and clinical characteristics (cancer type, stage, comorbidities, ECOG performance status).

RESULTS: Data from 137 patients with breast (60%) or colorectal cancer (40%) were analysed. Linear time effects were found for both state (χ(2) = 46.3 [df = 3]; p < 0.001) and trait anxiety (χ(2) = 17.708 [df = 3]; p = 0.001), with anxiety levels being higher at baseline and gradually decreasing over the course of chemotherapy. Symptom burden (β = 0.21; SD = 0.06; p = 0.001) predicted state anxiety throughout treatment, but this effect disappeared when accounting for trait anxiety scores before the start of chemotherapy (β = 0.85; SD = 0.05; p < 0.001). Patients' baseline trait anxiety was the only significant predictor of anxiety throughout treatment.

CONCLUSIONS: Changes in the generally stable characteristic of trait anxiety indicate the profoundly life-altering nature of chemotherapy. The time point before the start of chemotherapy was identified as the most anxiety-provoking, calling for interventions to be delivered as early as possible in the treatment trajectory. Patients with high trait anxiety and symptom burden may benefit from additional support.

LanguageEnglish
Pages1-7
Number of pages7
JournalEuropean Journal of Oncology Nursing
Volume24
Early online date18 Jul 2016
DOIs
Publication statusPublished - 31 Oct 2016
Externally publishedYes

Fingerprint

Longitudinal Studies
Colorectal Neoplasms
Anxiety
Breast Neoplasms
Drug Therapy
Checklist
Comorbidity
Therapeutics
Demography
Equipment and Supplies

Keywords

  • psychological adaptations
  • adult
  • aged
  • antineoplastic agents
  • anxiety disorders
  • breast neoplasms
  • colorectal neoplasms
  • drug-related side effects

Cite this

Schneider, Annegret ; Kotronoulas, Grigorios ; Papadopoulou, Constantina ; McCann, Lisa ; Miller, Morven ; McBride, Jackie ; Polly, Zoe ; Bettles, Simon ; Whitehouse, Alison ; Kearney, Nora ; Maguire, Roma. / Trajectories and predictors of state and trait anxiety in patients receiving chemotherapy for breast and colorectal cancer : Results from a longitudinal study. In: European Journal of Oncology Nursing. 2016 ; Vol. 24. pp. 1-7.
@article{f948f83e81614cefa615c6b403412b07,
title = "Trajectories and predictors of state and trait anxiety in patients receiving chemotherapy for breast and colorectal cancer: Results from a longitudinal study",
abstract = "PURPOSE: To examine the trajectories and predictors of state and trait anxiety in patients undergoing chemotherapy for breast or colorectal cancer.METHODS: Secondary analysis of data collected as part of a large multi-site longitudinal study. Patients with breast or colorectal cancer completed validated scales assessing their state and trait anxiety levels (State-Trait Anxiety Inventory) and symptom burden (Rotterdam Symptom Checklist) at the beginning of each chemotherapy cycle. Longitudinal mixed model analyses were performed to test changes of trait and state anxiety over time and the predictive value of symptom burden and patients' demographic (age, gender) and clinical characteristics (cancer type, stage, comorbidities, ECOG performance status).RESULTS: Data from 137 patients with breast (60{\%}) or colorectal cancer (40{\%}) were analysed. Linear time effects were found for both state (χ(2) = 46.3 [df = 3]; p < 0.001) and trait anxiety (χ(2) = 17.708 [df = 3]; p = 0.001), with anxiety levels being higher at baseline and gradually decreasing over the course of chemotherapy. Symptom burden (β = 0.21; SD = 0.06; p = 0.001) predicted state anxiety throughout treatment, but this effect disappeared when accounting for trait anxiety scores before the start of chemotherapy (β = 0.85; SD = 0.05; p < 0.001). Patients' baseline trait anxiety was the only significant predictor of anxiety throughout treatment.CONCLUSIONS: Changes in the generally stable characteristic of trait anxiety indicate the profoundly life-altering nature of chemotherapy. The time point before the start of chemotherapy was identified as the most anxiety-provoking, calling for interventions to be delivered as early as possible in the treatment trajectory. Patients with high trait anxiety and symptom burden may benefit from additional support.",
keywords = "psychological adaptations, adult, aged, antineoplastic agents, anxiety disorders, breast neoplasms, colorectal neoplasms, drug-related side effects",
author = "Annegret Schneider and Grigorios Kotronoulas and Constantina Papadopoulou and Lisa McCann and Morven Miller and Jackie McBride and Zoe Polly and Simon Bettles and Alison Whitehouse and Nora Kearney and Roma Maguire",
note = "Copyright {\circledC} 2016 Elsevier Ltd. All rights reserved.",
year = "2016",
month = "10",
day = "31",
doi = "10.1016/j.ejon.2016.07.001",
language = "English",
volume = "24",
pages = "1--7",
journal = "European Journal of Oncology Nursing",
issn = "1462-3889",

}

Trajectories and predictors of state and trait anxiety in patients receiving chemotherapy for breast and colorectal cancer : Results from a longitudinal study. / Schneider, Annegret; Kotronoulas, Grigorios; Papadopoulou, Constantina; McCann, Lisa; Miller, Morven; McBride, Jackie; Polly, Zoe; Bettles, Simon; Whitehouse, Alison; Kearney, Nora; Maguire, Roma.

In: European Journal of Oncology Nursing, Vol. 24, 31.10.2016, p. 1-7.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Trajectories and predictors of state and trait anxiety in patients receiving chemotherapy for breast and colorectal cancer

T2 - European Journal of Oncology Nursing

AU - Schneider, Annegret

AU - Kotronoulas, Grigorios

AU - Papadopoulou, Constantina

AU - McCann, Lisa

AU - Miller, Morven

AU - McBride, Jackie

AU - Polly, Zoe

AU - Bettles, Simon

AU - Whitehouse, Alison

AU - Kearney, Nora

AU - Maguire, Roma

N1 - Copyright © 2016 Elsevier Ltd. All rights reserved.

PY - 2016/10/31

Y1 - 2016/10/31

N2 - PURPOSE: To examine the trajectories and predictors of state and trait anxiety in patients undergoing chemotherapy for breast or colorectal cancer.METHODS: Secondary analysis of data collected as part of a large multi-site longitudinal study. Patients with breast or colorectal cancer completed validated scales assessing their state and trait anxiety levels (State-Trait Anxiety Inventory) and symptom burden (Rotterdam Symptom Checklist) at the beginning of each chemotherapy cycle. Longitudinal mixed model analyses were performed to test changes of trait and state anxiety over time and the predictive value of symptom burden and patients' demographic (age, gender) and clinical characteristics (cancer type, stage, comorbidities, ECOG performance status).RESULTS: Data from 137 patients with breast (60%) or colorectal cancer (40%) were analysed. Linear time effects were found for both state (χ(2) = 46.3 [df = 3]; p < 0.001) and trait anxiety (χ(2) = 17.708 [df = 3]; p = 0.001), with anxiety levels being higher at baseline and gradually decreasing over the course of chemotherapy. Symptom burden (β = 0.21; SD = 0.06; p = 0.001) predicted state anxiety throughout treatment, but this effect disappeared when accounting for trait anxiety scores before the start of chemotherapy (β = 0.85; SD = 0.05; p < 0.001). Patients' baseline trait anxiety was the only significant predictor of anxiety throughout treatment.CONCLUSIONS: Changes in the generally stable characteristic of trait anxiety indicate the profoundly life-altering nature of chemotherapy. The time point before the start of chemotherapy was identified as the most anxiety-provoking, calling for interventions to be delivered as early as possible in the treatment trajectory. Patients with high trait anxiety and symptom burden may benefit from additional support.

AB - PURPOSE: To examine the trajectories and predictors of state and trait anxiety in patients undergoing chemotherapy for breast or colorectal cancer.METHODS: Secondary analysis of data collected as part of a large multi-site longitudinal study. Patients with breast or colorectal cancer completed validated scales assessing their state and trait anxiety levels (State-Trait Anxiety Inventory) and symptom burden (Rotterdam Symptom Checklist) at the beginning of each chemotherapy cycle. Longitudinal mixed model analyses were performed to test changes of trait and state anxiety over time and the predictive value of symptom burden and patients' demographic (age, gender) and clinical characteristics (cancer type, stage, comorbidities, ECOG performance status).RESULTS: Data from 137 patients with breast (60%) or colorectal cancer (40%) were analysed. Linear time effects were found for both state (χ(2) = 46.3 [df = 3]; p < 0.001) and trait anxiety (χ(2) = 17.708 [df = 3]; p = 0.001), with anxiety levels being higher at baseline and gradually decreasing over the course of chemotherapy. Symptom burden (β = 0.21; SD = 0.06; p = 0.001) predicted state anxiety throughout treatment, but this effect disappeared when accounting for trait anxiety scores before the start of chemotherapy (β = 0.85; SD = 0.05; p < 0.001). Patients' baseline trait anxiety was the only significant predictor of anxiety throughout treatment.CONCLUSIONS: Changes in the generally stable characteristic of trait anxiety indicate the profoundly life-altering nature of chemotherapy. The time point before the start of chemotherapy was identified as the most anxiety-provoking, calling for interventions to be delivered as early as possible in the treatment trajectory. Patients with high trait anxiety and symptom burden may benefit from additional support.

KW - psychological adaptations

KW - adult

KW - aged

KW - antineoplastic agents

KW - anxiety disorders

KW - breast neoplasms

KW - colorectal neoplasms

KW - drug-related side effects

UR - http://www.sciencedirect.com/science/article/pii/S1462388916300527

U2 - 10.1016/j.ejon.2016.07.001

DO - 10.1016/j.ejon.2016.07.001

M3 - Article

VL - 24

SP - 1

EP - 7

JO - European Journal of Oncology Nursing

JF - European Journal of Oncology Nursing

SN - 1462-3889

ER -