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Instruments to measure anxiety in children, adolescents, and young adults with cancer: a systematic review

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Abstract

Purpose

The primary objective was to describe anxiety measurement instruments used in children and adolescents with cancer or undergoing hematopoietic stem cell transplantation (HSCT) and summarize their content and psychometric properties.

Methods

We conducted searches of MEDLINE, Embase, PsycINFO, HAPI, and CINAHL. We included studies that used at least one instrument to measure anxiety quantitatively in children or adolescents with cancer or undergoing HSCT. Two authors independently identified studies and abstracted study demographics and instrument characteristics.

Results

Twenty-seven instruments, 14 multi-item and 13 single-item, were used between 78 studies. The most commonly used instrument was the State-Trait Anxiety Inventory in 46 studies. Three multi-item instruments (Children’s Manifest Anxiety Scale—Mandarin version, PROMIS Pediatric Anxiety Short Form, and the State-Trait Anxiety Inventory) and two single-item instruments (Faces Pain Scale-Revised and 10-cm Visual Analogue Scale, both adapted for anxiety) were found to be reliable and valid in children with cancer.

Conclusions

We identified 14 different multi-item and 13 different single-item anxiety measurement instruments that have been used in pediatric cancer or HSCT. Only three multi-item and two single-item instruments were identified as being reliable and valid among pediatric cancer or HSCT patients and would therefore be appropriate to measure anxiety in this population.

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Acknowledgements

We would like to thank Cheri Nickel for her excellent support in assisting us with the database searches that were conducted for this study and Dr. Mark Dobrow for his critical review of the protocol for this research.

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Authors and Affiliations

  1. Program in Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada

    Tanya Lazor, Leonie Tigelaar, Deborah Tomlinson & Lillian Sung

  2. Pediatric Oncology Group of Ontario, 480 University Avenue, Toronto, ON, M5G 1V2, Canada

    Jason D. Pole

  3. Department of Psychiatry, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada

    Claire De Souza

  4. Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada

    Lillian Sung

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  1. Tanya Lazor
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  2. Leonie Tigelaar
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  3. Jason D. Pole
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  4. Claire De Souza
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  5. Deborah Tomlinson
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  6. Lillian Sung
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Contributions

All authors contributed to the study conception and design, TL and LT contributed to the acquisition of data, analysis, and interpretation of data, and all authors contributed to the manuscript writing and revisions and have approved the final version for publication.

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Correspondence to Tanya Lazor.

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Conflict of interest

This research is unfunded. The first author (TL) has full control of all primary data and agrees to allow the journal to review the data if requested.

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Lazor, T., Tigelaar, L., Pole, J.D. et al. Instruments to measure anxiety in children, adolescents, and young adults with cancer: a systematic review. Support Care Cancer 25, 2921–2931 (2017). https://doi.org/10.1007/s00520-017-3743-3

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