Family anxiety in advanced cancer: a multicentre prospective study in Ireland

Six home care services in Southern Ireland collected data on a total of 757 patients over a 6-month period. Patient and family well-being were measured using the staff-rated Support Team Assessment Schedule and Karnofsky Index. Five hundred and eight patients died while in care, 75% of whom died at home. At referral, 32% of families were rated as having severe or overwhelming anxiety. During the last week of care, anxiety remained severe for 26% of family members. Patient and family well-being were inter-related, and there were significant interactions between family anxiety and patient physical and psychological symptoms, and communication. Discriminant analysis produced two predictive models. In model 1, family anxiety at referral strongly predicts family anxiety in the last week of life. In model 2, family anxiety at referral is excluded from the analysis, and the significant predictor factors at referral for family anxiety in the last 4 weeks of life are patient symptom control, sex of patient, diagnosis and patient age.