Use of brief, simple anxiety assessment tools in palliative care - yes, we can: a cross-sectional observational study of anxiety visual analog scale and numeric rating scale.
Adrien Evin, Jean-François Huon, Aurelie Le Thuaut, Patricia Jego, Pierre Nizet, Caroline Victorri-Vigneau, Marianne Bourdon
{"title":"Use of brief, simple anxiety assessment tools in palliative care - yes, we can: a cross-sectional observational study of anxiety visual analog scale and numeric rating scale.","authors":"Adrien Evin, Jean-François Huon, Aurelie Le Thuaut, Patricia Jego, Pierre Nizet, Caroline Victorri-Vigneau, Marianne Bourdon","doi":"10.1186/s12904-025-01814-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Given the high prevalence of anxiety in palliative care and its frequent underestimation by healthcare professionals, it is important to use simplified tools to facilitate the evaluation of anxiety. The State-Trait Anxiety Inventory-State scale is a reference 20-item questionnaire that has been validated in this population, but is too long for some patients. The visual analog scale (VAS) and the numeric rating scale (NRS) are two short instruments that have been validated to assess pain, but not anxiety in palliative care.</p><p><strong>Aim: </strong>This study sought to investigate the correlation between anxiety VAS and NRS and State-Trait Anxiety Inventory-State scale for assessing anxiety in palliative care patients.</p><p><strong>Methods: </strong>A single-center cross-sectional observational study was conducted over 2 years. All palliative care patients followed by the palliative care team of a French university hospital were eligible. Each patient completed the State-Trait Anxiety Inventory-State scale and rated their perceived anxiety using the NRS and VAS. Pearson's correlation test between the scales and receiver operating characteristic (ROC) curve analysis were performed to determine diagnostic cut-offs.</p><p><strong>Results: </strong>A total of 186 patients were included (89.8% with cancer), 20.4% of whom had severe or very severe anxiety. The NRS/ State-Trait Anxiety Inventory-State scale and VAS/ State-Trait Anxiety Inventory-State scale correlations were 0.62 and 0.70, respectively. The NRS and VAS showed good discrimination, with an area under the ROC curve of 0.81 and 0.88, respectively. Cut-offs of 5 (NRS) and 49 millimeters (VAS) yielded sensitivities of 89.5% and 89.2%, respectively, for the detection of severe or very severe anxiety, with specificities of 60.1% and 70.3%, respectively.</p><p><strong>Conclusion: </strong>Cut-offs of 5 for the NRS and 49 millimeters for the VAS showed excellent sensitivity for detecting anxiety in palliative care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"173"},"PeriodicalIF":2.5000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211726/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Palliative Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12904-025-01814-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Given the high prevalence of anxiety in palliative care and its frequent underestimation by healthcare professionals, it is important to use simplified tools to facilitate the evaluation of anxiety. The State-Trait Anxiety Inventory-State scale is a reference 20-item questionnaire that has been validated in this population, but is too long for some patients. The visual analog scale (VAS) and the numeric rating scale (NRS) are two short instruments that have been validated to assess pain, but not anxiety in palliative care.
Aim: This study sought to investigate the correlation between anxiety VAS and NRS and State-Trait Anxiety Inventory-State scale for assessing anxiety in palliative care patients.
Methods: A single-center cross-sectional observational study was conducted over 2 years. All palliative care patients followed by the palliative care team of a French university hospital were eligible. Each patient completed the State-Trait Anxiety Inventory-State scale and rated their perceived anxiety using the NRS and VAS. Pearson's correlation test between the scales and receiver operating characteristic (ROC) curve analysis were performed to determine diagnostic cut-offs.
Results: A total of 186 patients were included (89.8% with cancer), 20.4% of whom had severe or very severe anxiety. The NRS/ State-Trait Anxiety Inventory-State scale and VAS/ State-Trait Anxiety Inventory-State scale correlations were 0.62 and 0.70, respectively. The NRS and VAS showed good discrimination, with an area under the ROC curve of 0.81 and 0.88, respectively. Cut-offs of 5 (NRS) and 49 millimeters (VAS) yielded sensitivities of 89.5% and 89.2%, respectively, for the detection of severe or very severe anxiety, with specificities of 60.1% and 70.3%, respectively.
Conclusion: Cut-offs of 5 for the NRS and 49 millimeters for the VAS showed excellent sensitivity for detecting anxiety in palliative care.
期刊介绍：
BMC Palliative Care is an open access journal publishing original peer-reviewed research articles in the clinical, scientific, ethical and policy issues, local and international, regarding all aspects of hospice and palliative care for the dying and for those with profound suffering related to chronic illness.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
