COSMIN database

Instruments to measure anxiety in children, adolescents, and young adults with cancer: a systematic review

Lazor, T., Tigelaar, L., Pole, J. D., De Souza, C., Tomlinson, D., and Sung, L.
PURPOSE: The primary objective was to describe anxiety measurement instruments used in children and adolescents with cancer or undergoing hematopoietic stem cell transplantation (HSCT) and summarize their content and psychometric properties.

METHODS: We conducted searches of MEDLINE, Embase, PsycINFO, HAPI, and CINAHL. We included studies that used at least one instrument to measure anxiety quantitatively in children or adolescents with cancer or undergoing HSCT. Two authors independently identified studies and abstracted study demographics and instrument characteristics.

RESULTS: Twenty-seven instruments, 14 multi-item and 13 single-item, were used between 78 studies. The most commonly used instrument was the State-Trait Anxiety Inventory in 46 studies. Three multi-item instruments (Children's Manifest Anxiety Scale-Mandarin version, PROMIS Pediatric Anxiety Short Form, and the State-Trait Anxiety Inventory) and two single-item instruments (Faces Pain Scale-Revised and 10-cm Visual Analogue Scale, both adapted for anxiety) were found to be reliable and valid in children with cancer.

CONCLUSIONS: We identified 14 different multi-item and 13 different single-item anxiety measurement instruments that have been used in pediatric cancer or HSCT. Only three multi-item and two single-item instruments were identified as being reliable and valid among pediatric cancer or HSCT patients and would therefore be appropriate to measure anxiety in this population.
Support Care Cancer
Publication year:
Symptom status:
Cognitive/mental state
Emotional state
Adults (18-65)
Children (0-18)
Neoplasms and related symptoms
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
Anxiety Distress Response Rating Scale
Anxiety Observer Rating Scale
Anxiety Pictorial Self-Rating Scale
BAI - Beck Anxiety Inventory (versions: BAI-Youth)
Clinical Global Anxiety Scale
CMFS - Child Medical Fear Scale
Colored Analogue Scale
FACES - Faces Anxiety Scale
FACES - Wong-Baker FACES Pain Rating Scale (ook: WBFPRS, WBF, WBS)
Fear faces scale
FPS-R - Faces Pain Scale-Revised (versions: FPS; FPS-6; FPS-7)   
HARS - Hamilton Anxiety Rating Scale [alias: HAM-A]
Hospital fears rating scale
MAS - Manifest Anxiety Scale (versions: MAS-sf; CMAS; RCMAS; RCMAS-2; AMAS; AMAS-e)
Multi-dimensional Anxiety Scale (versions: Child version)
PARS - Pediatric Anxiety Rating Scale
Procedural Anxiety Rating Scale
PROMIS Paediatric Anxiety
SASC - Social Anxiety Scale Child (versions: SASC-R - SASC-revised;
SAS - Zung Self-rated Anxiety Scale [alias: ZAS] (versions: SAS-ID - SAS-Intellectual Disabilities)
SCARED - Screen for Child Anxiety Related Emotional Disorders (versions: SCARED-R)
STAIC - State Trait Anxiety Inventory for Children
VAS Anxiety - Visual Analog Scale anxiety
Visual Analogue Thermometer for anxiety
Yale Preoperative Anxiety Scale (versions: Modified)