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Nursing assessment of anxiety and mood disturbance in a palliative patient
  1. Sarah Combes1,2
  1. 1Inpatient Unit, St Christopher's Hospice, London, UK
  2. 2Florence Nightingale School of Nursing and Midwifery, King's College, London, UK
  1. Correspondence to Sarah Combes, sarah.combes{at}

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Anxiety can be described as a feeling of worry or apprehension about uncertain future events; it is a normal sensation that everyone experiences at times (Stevenson 2010). Feeling anxious can be beneficial as it stimulates the fight or flight response, and helps us adapt to minor stressors such as sitting for an examination or attending an interview (Clancy and McVicar 2009). However, if anxiety becomes persistent and severe, it can develop into a mood disturbance and significantly impact quality of life (Wilson et al 2007, Watson et al 2010).

Anxiety is prevalent in chronic disease as people are attempting to adjust to the additional stressors and challenges their health conditions bring (Yohannes et al 2010). Anxiety has also been shown to be prevalent in palliative patients, particularly those nearing the end of life (Wilson et al 2007). A recent meta-analysis (Mitchell et al 2011), including 24 studies throughout seven countries, established a prevalence of 9.8% (6.8–13.2%) anxiety as a single mood disturbance in palliative settings, and 29.0% (10.1–52.9%) for all types of mood disorders, including anxiety, depression and adjustment disorder. Palliative patients are also trying to adjust to additional stressors, such as functional decline, as well as trying to come to terms with concerns including the dying process, unresolved physical pain, and worry about those they are leaving behind (Spencer et al 2010).

However, while anxiety is known to be common in palliative patients, it is underdiagnosed and undertreated (Wilson et al 2007). Therefore, to manage the symptoms of anxiety appropriately, it is imperative that nurses are able to assess its symptoms and work as part of the multidisciplinary team (MDT). Using a case study approach, this paper critically evaluates the author's experience of assessing and managing the anxiety of a patient in her care. By reflecting …

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