Parameters of anxiety in children with cancer vary according to instrument used
The severity, patterns over time and predictors of anxiety in children and adolescents undergoing chemotherapy or haematopoietic stem cell transplantation (HSCT) change with different instruments used, a new study has found.
Seventy-seven paediatric patients (median age 13.2 years; 35.1 percent female) participated, in whom self-reported anxiety at chemotherapy or HSCT initiation was measured using three instruments: the Paediatric Quality of Life Inventory (PedsQL) 3.0 Acute Cancer Module, the Paediatric Patient-Reported Outcomes Measurement Information System (PROMIS) Paediatric Short-Form (SF) and the Multidimensional Anxiety Scale for Children (MASC).
At baseline, the percentage of participants who had severe anxiety ranged from 13.0–28.6 percent and varied according to the instrument used. When the PedsQL (procedural anxiety subscale: p=0.037) and PROMIS (p=0.013) instruments were used, significant improvements in anxiety were observed. No such change was recorded by the MASC.
There also seemed to be a variation among instruments regarding predictive factors. Univariate linear regression analysis showed that in the PedsQL instrument, age was a significant risk factor for anxiety, such that children aged 16–18 years reported more worries than those aged 8–11 years (p=0.036).
In comparison, the MASC instrument reported that lower annual household income was also a significant risk factor for anxiety in the participants (p=0.028).
The present findings highlight the heterogeneous nature of childhood anxiety and the need for careful consideration when choosing a measurement instrument, said researchers. Future studies about anxiety in paediatric cancer should focus on a particular facet of anxiety.