Simultaneous analysis of the concepts of anxiety and fear: contributions to nursing diagnoses
Análisis simultáneo de los conceptos de ansiedad y temor: contribuciones a los diagnósticos de enfermería
Análise simultânea dos conceitos de ansiedade e medo: contribuições para os diagnósticos de enfermagem
Claudia Angélica Mainenti Ferreira Mercês; Jaqueline da Silva Soares Souto; Priscilla Alfradique de Souza; Marléa Crescêncio Chagas; Carleara Weiss; Andrea Barroso Benevides; Marcos Antônio Gomes Brandão
Abstract
Objectives: To make a simultaneous analysis on the concepts of anxiety and fear.
Method: Simultaneous concept analysis with nine steps proposed by Haase, Leidy, Coward, Britt, and Penn.
Results: A total of 43 articles were included from a search in five literature databases. 51 attributes, 26 antecedents, and 10 consequents were identified from the analysis of these concepts. This analysis revealed that anxiety and fear are subjective, multidimensional concepts with high abstraction degrees.
Conclusion: The simultaneous analysis of anxiety and fear is useful to refine these diagnoses and propose changes in their components.
Implications for practice: The analysis of these concepts enables the precise identification of these effects in the clinical practice, applying greater diagnostic accuracy
Keywords
Resumen
Palabras clave
Resumo
Objetivos: Realizar a análise simultânea dos conceitos de ansiedade e medo.
Método: Análise simultânea de conceitos com base nas nove etapas propostas por Haase, Leidy, Coward, Britt e Penn.
Resultados: 43 artigos foram incluídos a partir de uma busca em cinco bases de dados. 51 atributos, 26 antecedentes e 10 consequentes foram identificados a partir da análise destes conceitos. Esta análise revelou que a ansiedade e o medo são conceitos subjetivos, multidimensionais e com altos graus de abstração.
Conclusão: A análise simultânea da ansiedade e do medo possibilitou o refinamento destes diagnósticos e a proposição de modificações em seus componentes.
Implicações para a prática: A análise destes conceitos possibilitará a identificação precisa destes fenômenos na prática clínica, proporcionando maior acurácia diagnóstica.
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Referências
1 Suriano MLF, Lopes DCDF, Macedo GPDOS, Michel JLM, Barros ALBLD. Identification of the defining characteristics of fear and anxiety in patients scheduled for gynecological surgery. Acta Paul Enferm. 2009;22:928-34.
2 Grisa GH, Monteiro JK. Aspectos emocionais do paciente cardíaco cirúrgico no período pré-operatório. Gerais [Internet]. 2015; [citado 2020 jun 10];8(1):111-30. Disponível em:
3 Bronner MB, Nguyen MH, Smets EM, Van de Ven AW, van Weert JC. Anxiety during cancer diagnosis: Examining the influence of monitoring coping style and treatment plan. Psychooncology. 2018;27(2):661-7.
4 Mehnert A, Brähler E, Faller H, Härter M, Keller M, Schulz H et al. Four-week prevalence of mental disorders in patients with cancer across major tumor entities. J Clin Oncol. 2014;32(31):3540-6.
5 Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12(2):160-74.
6 Vehling S, Koch U, Ladehoff N, Schön G, Wegscheider K, Heckl U et al. Prevalence of affective and anxiety disorders in cancer: systematic literature review and meta-analysis. Psychother Psychosom Med Psychol. 2012;62(7):249-58.
7 Sousa RMD, Santo FHDE, Santana RF, Lopes MVDO. Nursing diagnoses identified in onco-hematologic patients: a cross-mapping study. Esc Anna Nery. 2015;19(1):54-65.
8 Castro MCF, Fuly PDSC, Garcia TR. Santos MLSC. ICNP® terminological subgroup for palliative care patients with malignant tumor wounds. Acta Paul Enferm. 2016;29(3):340-6.
9 Gonçalves MCDS, Brandão MAG, Duran ECM. Validation of the defining characteristics of the nursing diagnosis impaired comfort in oncology. Acta Paul Enferm. 2016;29(1):115-24.
10 LeDoux JE, Pine DS. Using neuroscience to help understand fear and anxiety: a two-system framework. Am J Psychiatry. 2016;173(11):1083-93.
11 Herdman H, Kamitsuru S. Diagnósticos de enfermagem da NANDA-I: definições e classificação - 2018/2020. 11. ed. Porto Alegre: Art Med; 2018
12 Bousso RS, Poles K, Cruz DDALM. Nursing concepts and theories. Rev Esc Enferm USP. 2014;48(1):141-5.
13 Lunney M. Uso do pensamento crítico para o alcance de resultados positivos de saúde. In: Lunney M. Pensamento crítico para o alcance de resultados positivos em saúde: análise e estudos de caso em enfermagem. Porto Alegre: Artmed; 2011. p. 25-55.
14 Craske MG, Stein MB, Eley TC, Milad MR, Holmes A, Rapee RM et al. Correction: anxiety disorders. Nat Rev Dis Primers. 2017;3(1):17100.
15 Taylor-Loughran AE, O’Brien ME, LaChapelle R, Rangel S. Defining characteristics of the nursing diagnoses fear and anxiety: A validation study. Appl Nurs Res. 1989;2(4):178-86.
16 Whitley GG, Tousman SA. A multivariate approach for validation of anxiety and fear. Int J Nurs Terminol Classif. 1996;7(3):116-24.
17 Suriano MLF, Michel JM, Zeitoun SS, Herdman TH, Barros ALBL. Consensual validation of the nursing diagnoses fear and anxiety identified at the immediate preoperative period in patients undergoing elective surgery. Int J Nurs Terminol Classif. 2011;22(3):133-41.
18 Bay EJ, Algase DL. Fear and anxiety: a simultaneous concept analysis. Int J Nurs Knowl. 1999;10(3):103-11.
19 Whitley GG. Concept analysis of fear. Int J Nurs Terminol Classif. 1992;3(4):155-61.
20 Letho RH, Stein KF. Death anxiety: an analysis of an evolving concept: research and theory for nursing practice. Int J. 2009;23(1):23-41.
21 Costa JN, Lopes MVO, Moraes MHB. Simultaneous concept analysis of diagnoses related to urinary incontinence. Int J Nurs Knowl. 2019;31(2):109-23.
22 Haase JE, Britt T, Coward DD, Leidy NK, Penn PE. Simultaneous concept analysis of spiritual perspective, hope, acceptance and self‐transcendence. Image J Nurs Sch. 1992;24(2):141-7.
23 Lopes MVO, Silva VM. Métodos avançados de validação de diagnósticos de enfermagem. In Herdman TH, organizador. PRONANDA Programa de atualização em diagnósticos de enfermagem: conceitos básicos. Porto Alegre: Artmed Panamericana; 2016. p. 87-132.
24 Mendes KDS, Silveira RCDCP, Galvão CM. Integrative literature review: a research method to incorporate evidence in health care and nursing. Texto Contexto Enferm. 2008;17(4):758-64.
25 Galica J, Brennenstuhl S, Maheu C, Townsley C, Metcalfe K. Examining the dimensionality of the Fear of Cancer Recurrence Inventory. Psychooncology. 2018;27(11):2602-8.
26 Walker LO, Avant KC. Strategies for theory construction in nursing (6th ed.). Upper Saddle River: Pearson/Prentice Hall; 2018.
27 Martin P. The epidemiology of anxiety disorders: a review. Dialogues Clin Neurosci. 2003;5(3):281-98. PMid:22034470.
28 Oliveira N, Chianca T, Rassool GH. A validation study of the nursing diagnosis anxiety in Brazil. Int J Nurs Terminol Classif. 2008;19(3):102-10.
29 Wein S, Sulkes A, Stemmer S. The oncologist’s role in managing depression, anxiety, and demoralization with advanced cancer. Cancer J. 2010;16(5):493-9.
30 Stoklosa J, Patterson K, Rosielle D, Arnold RM. Anxiety in palliative care: causes and diagnosis# 186. J Palliat Med. 2011;14(10):1173-4.
31 Castillo ARG, Recondo R, Asbahr FR, Manfro GG. Transtornos de ansiedade. Br J Psychiatry. 2000;22(suppl 2):20-3.
32 Locker D. Psychosocial consequences of dental fear and anxiety. Community Dent Oral Epidemiol. 2003;31(2):144-51.
33 Finks K. Symptoms and treatment of anxiety disorders. NASN Sch Nurse. 2012;27(5):251-3.
34 Gomes GLL, Nóbrega MML. Anxiety in children following hospitalization: a proposal for a nursing diagnosis. Rev Lat Am Enfermagem. 2015;23(5):963-70.
35 Gomes GLL, Fernandes MGM, Nóbrega MML. Hospitalization anxiety in children: conceptual analysis. Rev Bras Enferm. 2016;69(5):940-5.
36 Goyal AR, Bergh S, Engedal K, Kirkevold M, Kirkevold Ø. Anxiety, anxiety symptoms, and their correlates in persons with dementia in Norwegian nursing homes: a cause for concern. Dement Geriatr Cogn Disord. 2017;43(5-6):294-305.
37 Humble M. Aetiology and mechanisms of anxiety disorders. Acta Psychiatr Scand. 1987;76(S335):15-30.
38 Frederickson K. Using a nursing model to manage symptoms: anxiety and the Roy adaptation model. Holist Nurs Pract. 1993;7(2):36-43.
39 Hilliard KM, Iwamasa GY. The conceptualization of anxiety: an exploratory study of Japanese American older adults. J Clin Geropsychol. 2001;7(1):53-65.
40 Koivula M, Paunonen-Ilmonen M, Tarkka MT, Tarkka M, Laippala P. Fear and anxiety in patients awaiting coronary artery bypass grafting. Heart Lung. 2001;30(4):302-11.
41 Kilbride L, Smith G, Grant R. The frequency and cause of anxiety and depression amongst patients with malignant brain tumours between surgery and radiotherapy. J Neurooncol. 2007;84(3):297-304.
42 Fardell JE, Thewes B, Turner J, Gilchrist J, Sharpe L, Smith A et al. Fear of cancer recurrence: a theoretical review and novel cognitive processing formulation. J Cancer Surviv. 2016;10(4):663-73.
43 Bayrampour H, Ali E, McNeil DA, Benzies K, MacQueen G, Tough S. Pregnancy-related anxiety: a concept analysis. Int J Nurs Stud. 2016;55:115-30.
44 McNaughton N. What is anxiety and how should we treat it?'. N Z J Psychol [Internet]. 1996; [citado 2020 jun 10];25(1):51-61. Disponível em:
45 Skaali T, Fosså SD, Bremnes R, Dahl O, Haaland CF, Hauge ER et al. Fear of recurrence in long‐term testicular cancer survivors. Psychooncology. 2009;18(6):580-8.
46 Vasconcelos ADS, Costa C, Barbosa LNF. Do transtorno de ansiedade ao câncer. Rev SBPH [Internet]. 2008; [citado 2020 jun 10];11(2):51-71. Disponível em:
47 Bergamasco EC, Rossi LA, Carvalho EC, Dalri MCB. Diagnósticos de medo e ansiedade: validação de conteúdo para o paciente queimado. Rev Bras Enferm. 2004;57(2):170-7.
48 Rapee RM. Generalized anxiety disorder: a review of clinical features and theoretical concepts. Clin Psychol Rev. 1991;11(4):419-40.
49 Ziner KW, Sledge Jr GW, Bell CJ, Johns S, Miller KD, Champion VL. Predicting fear of breast cancer recurrence and self-efficacy in survivors by age at diagnosis. Oncol Nurs Forum. 2012;39(3):287-95.
50 Shay LA, Carpentier MY, Vernon SW. Prevalence and correlates of fear of recurrence among adolescent and young adult versus older adult post-treatment cancer survivors. Support Care Cancer. 2016;24(11):4689-96.
51 Moser DK. “The rust of life”: impact of anxiety on cardiac patients. Am J Crit Care. 2007;16(4):361-9.
52 Tramonti F, Maestri M, Gronchi A, Fabbrini M, Di Coscio E, Carnicelli L et al. Psychological well-being of patients with insomnia and its relationship with anxiety and depression. Psychol Health Med. 2016;21(3):309-16.
53 Taylor C, Richardson A, Cowley S. Surviving cancer treatment: an investigation of the experience of fear about, and monitoring for, recurrence in patients following treatment for colorectal cancer. Eur J Oncol Nurs. 2011;15(3):243-9.
54 Armfield JM. Cognitive vulnerability: a model of the etiology of fear. Clin Psychol Rev. 2006;26(6):746-68.
55 Gomes ET, Souza Melo RLA, Vasconcelos EMR, Alencar EN. Uso dos diagnósticos de enfermagem ansiedade e medo nas clínicas médica e cirúrgica de um hospital universitário.
56 Calhoon GG, Tye KM. Resolving the neural circuits of anxiety. Nat Neurosci. 2015;18(10):1394-404.
57 Whitley GG. Expert validation and differentiation of the nursing diagnoses anxiety and fear. Int J Nurs Terminol Classif. 1994;5(4):143-50.
58 Fulton CL. The physical and psychological symptoms experienced by patients with metastatic breast cancer before death. Eur J Cancer Care. 1997;6(4):262-6.
59 Lebel S, Ozakinci G, Humphris G, Mutsaers B, Thewes B, Prins J et al. From normal response to clinical problem: definition and clinical features of fear of cancer recurrence. Support Care Cancer. 2016;24(8):3265-8.
60 Sharpley CF, Christie DR. ‘How I was then and how I am now’: current and retrospective self-reports of anxiety and depression in Australian women with breast cancer. Psychooncology. 2007;16(8):752-62.
61 Holanda VN, Bezerra AS, Tavares AR, Lima CIR, Mamede LTS, Araújo RLQ et al. As bases biológicas do medo: uma revisão sistemática da literatura. Rev Interfaces [Internet]. 2013; [citado 2020 jun 10];1(3):1-15. Disponível em:
62 Esperidião-Antonio V, Majeski-Colombo M, Toledo-Monteverde D, Moraes-Martins G, Fernandes JJ, Assis MBD et al. Neurobiologia das emoções. Archives of Clinical Psychiatry. 2008;35(2):55-65.
63 Brandão ML. As bases biológicas do comportamento: introdução à neurociência. Rev Inst Med Trop São Paulo. 2005;47(3):124.
64 Menezes GB, Fontenelle LF, Mululo S, Versiani M. Treatment-resistant anxiety disorders: social phobia, generalized anxiety disorder and panic disorder. Rev Bras Psiquiatr. 2007;29(2, Suppl 2):S55-60.
Submetido em:
10/06/2020
Aceito em:
25/08/2020