The meaning of anxiety for patients with a malignant glioma: a grounded theory design

Two percent of all new cancer patients have a primary intracerebral tumor.
Approximately 70% of these patients have a malignant glioma. Due to a lack of
curative treatment of malignant gliomas, both therapy and care are focused on
palliation. In the palliative phase, symptoms are present which negatively
affect the quality of life. One of those symptoms is anxiety. There is no
scientific knowledge available about what being anxious means for patients
with a malignant glioma. It is necessary to understand this unique, indivual en
concrete experience of the patient, because early identification and symptom
mangement requires knowledge, competence and clinical experience of the nurse.
By understanding the meaning of anxiety and the specific needs of these
patienten, nurses can more focused intervene with knowledge, understanding and
empathy.

The aim of this study is to understand what it means to be anxious for adults
with a malignant glioma. This study focuses on the lived experience and the
underlying processes of the meaning of anxiety.

Main question: "What does it mean for patients with a malignant glioma when
they are anxious?"

This qualitative study is based on the principles of Grounded Theory. The study
takes place in the home situation of the patient. The initial sample is
purposive, aiming for maximum variation. Thereafter, patients are selected
purposeful with respect to the emerging theory, until conceptual saturation is
reached. To reach conceptual saturation, 10-15 patients are needed. Patients
are recruited from a neurological outpatient clinic in the south of the
Netherlands.
During three months (January-May 2011) data are collected by one-time,
individual semi-structured in-depth interviews, document analysis and a
demographic questionnaire. The data are analyzed according to the three phases
of GT: open, axial and selective coding. During the data analysis, memos are
written.

The study has no risks.

The strain for the patient consists of:
- A single in-depth interview of 1 hour
- Completing a demographic questionnaire
- The investigation has no benefits or disadvantages. It is possible that the
patient feels comfortable to talk about his illness and related fears.
However, there is a chance that patients have trouble afterwards, because they
suddenly have spoken of their fears.
In that case, patients are referred to a social worker.