title: Assessment of anxiety in advanced cancer patients: a mixed methods study.
abstract: Anxiety is a risk for reduced quality of life in advanced cancer patients. However, it is an overlooked symptom without routine use of instruments to assess anxiety.
  
  
  
  To gain insight into the use of instruments by nurses to assess anxiety in advanced cancer patients and the rationale behind it.
  
  
  
  Data with regard to nurses' use of instruments were collected from medical records of 154 patients in three settings. Additionally, 12 nurses were interviewed.
  
  
  
  Four instruments were used to assess anxiety. The frequency of assessed anxiety differed among settings. The application of instruments guided patient care and improved communication. Lack of knowledge was the main reason not to use instruments.
  
  
  
  Application was influenced by patient and environmental factors, knowledge, attitudes and beliefs of nurses. Multifaceted strategies, leadership and education of nurses in the assessment and analysis of anxiety are needed to improve symptom management in advanced cancer patients.
authors.affiliation: Staff Nurse, Lung Diseases and Tubercolosis Department, Diakonessenhuis, Utrecht, Netherlands.
authors.forename: Hanneke
authors.initials: H
authors.lastname: Veldhuisen
authors.affiliation: Registered Nurse, Julius Center for Health Sciences and Primary Care Department of General Practice, Utrecht, Netherlands.
authors.forename: Danielle
authors.initials: D
authors.lastname: Zweers
authors.affiliation: Registered Nurse, Julius Center for Health Sciences and Primary Care Department of General Practice, Utrecht, Netherlands.
authors.forename: Everlien
authors.initials: E
authors.lastname: de Graaf
authors.affiliation: Professor, Palliative Care and Hospice, Julius Center for Health Sciences and Primary Care Department of General Practice, Utrecht, Netherlands.
authors.forename: Saskia
authors.initials: S
authors.lastname: Teunissen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000451:nursing* / Q000523:psychology*; D005069:Evaluation Studies as Topic; D005260:Female; D064946:Hospice and Palliative Care Nursing; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology*; D009426:Netherlands; D009730:Nursing Assessment / Q000379:methods*; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Advanced cancer; Anxiety; Methods; Nurses; Palliative care; Symptom assessment