title: Determinants of anxiety in patients with advanced somatic disease: differences and similarities between patients undergoing renal replacement therapies and patients suffering from cancer.
abstract: OBJECTIVE
  Anxiety is the most frequent emotional reaction to the chronic somatic disease. However, little is known about anxiety and coping strategies in patients with end-stage renal disease (ESRD) undergoing renal replacement therapies (RRTs). The purpose of the study was to assess the intensity and determinants of anxiety in patients treated with different RRTs in comparison with end-stage breast cancer patients and healthy controls.
  
  
  METHODS
  The study involved (1) ESRD patients undergoing different RRTs: 32 renal transplant recipients, 31 maintenance haemodialysis and 21 chronic peritoneal dialysis patients, (2) women with end-stage breast cancer (n = 25) and (3) healthy persons (n = 55). We used State-Trait Anxiety Inventory, Scale of Personal Religiousness, Mental Adjustment to Cancer Scale, Rotterdam Symptom Checklist with reference to medical history. The data thus obtained were analysed using the analysis of variance, the Tukey's HSD post hoc test and Spearman's rank correlation coefficient.
  
  
  RESULTS
  Both ESRD and breast cancer patients revealed higher level of anxiety state and trait than healthy controls; however, there was no statistically significant difference found between both findings. There was a tendency towards higher levels of anxiety state in breast cancer patients when compared to ESRD patients undergoing the RRT treatment and for both groups non-constructive coping strategies correlated with the levels of anxiety state. With ESRD patients undergoing RRTs, the intensity of anxiety state did not depend on the mode of treatment but on the correlation between the levels of anxiety and the general quality of their life, psychological condition and social activity.
  
  
  CONCLUSIONS
  In patients with advanced somatic disease (ESRD and end-stage breast cancer), non-constructive strategies of coping with the disease require further evaluation and possibly psychological support.
authors.affiliation: Department of Palliative Medicine, Medical University of Gdansk, Dębinki 2, 80-211, Gdańsk, Poland, jjaniszewska@gumed.edu.pl.
authors.forename: Justyna
authors.initials: J
authors.lastname: Janiszewska
authors.forename: Monika
authors.initials: M
authors.lastname: Lichodziejewska-Niemierko
authors.forename: Justyna
authors.initials: J
authors.lastname: Gołębiewska
authors.forename: Mikołaj
authors.initials: M
authors.lastname: Majkowicz
authors.forename: Bolesław
authors.initials: B
authors.lastname: Rutkowski
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000523:psychology*; D001943:Breast Neoplasms / Q000523:psychology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology; D017582:Renal Replacement Therapy; D012720:Severity of Illness Index; D058992:Social Participation; D055815:Young Adult