Perceptions of anxiety in lung cancer patients and their support network

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.

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.

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.

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).

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.