title: Worried together: a qualitative study of shared anxiety in patients with metastatic non-small cell lung cancer and their family caregivers.
abstract: OBJECTIVE
  Anxiety is prevalent, distressing, and understudied among patients with advanced lung cancer and their family caregivers. Preliminary evidence suggests that anxiety is not only present in both patients and caregivers but shared by the dyad. Few studies have examined the nature of shared anxiety and its impact on patient-caregiver dyads.
  
  
  METHODS
  This study was developed to identify shared causes and manifestations of anxiety experienced by patients with stage IV non-small cell lung cancer (NSCLC) and their primary caregivers. Data were collected through in-depth semi-structured interviews with ten matched patient-caregiver dyads and one unmatched patient (N = 21) recruited from two comprehensive cancer care centers.
  
  
  RESULTS
  Using grounded theory, eight themes emerged characterizing shared causes and manifestations of anxiety: (1) uncertainty, (2) loss and impending loss, (3) changing roles, (4) conflict outside the dyad, (5) finances, (6) physical symptoms, (7) fears of decline and dying, and (8) life after the patient's passing. All themes were shared by patients and caregivers.
  
  
  CONCLUSIONS
  Implications for future research include the development and evaluation of interventions to reduce anxiety in cancer patient-caregiver dyads.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, MC: 5718, Stanford, CA, 94305-5718, USA, ehendrik@stanford.edu.
authors.forename: Ellen
authors.initials: E
authors.lastname: Hendriksen
authors.forename: Emma
authors.initials: E
authors.lastname: Williams
authors.forename: Nora
authors.initials: N
authors.lastname: Sporn
authors.forename: Joseph
authors.initials: J
authors.lastname: Greer
authors.forename: Alexandra
authors.initials: A
authors.lastname: DeGrange
authors.forename: Cheryl
authors.initials: C
authors.lastname: Koopman
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000523:psychology*; D001294:Attitude to Health; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D003142:Communication; D005195:Family Relations; D005260:Female; D006801:Humans; D055809:Illness Behavior; D008175:Lung Neoplasms / Q000150:complications / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research