Predictors of depression among patients with cervical cancer in Bali Indonesia

Introduction: Mental distress has been highlighted as one of the biggest concerns, particularly for people with chronic diseases, such as cervical cancer. To date, it is unknown what the prevalence and predictors of depression in patients with cervical cancer are in Bali, Indonesia. This study assessed the proportion of depression and its predictors among patients with cervical cancer who were treated at the largest referral hospital, Prof. dr. I.G.N.G Ngoerah Hospital, in Bali, Indonesia. Methods: This is a cross-sectional analytic study, which was conducted from March to December 2018 at the Gynecology Policlinic of Prof. dr. I.G.N.G Ngoerah Hospital Bali. A consecutive sampling technique was applied to select 121 patients with cervical cancer at the center. All patients who agreed to participate were interviewed to collect data on sociodemographic and clinical characteristics. They were then screened for the presence of depression symptoms using the Hospital-based Anxiety and Depression Scale (HADS) questionnaire which has been translated into Bahasa Indonesia. Based on the scale, depression was categorized into depression, borderline case, and normal. Predictors of depression were identified using a chi-square test followed by logistic regression using SPSS 2.0. Results: This study found that 24% of the respondents had probable depression and 9% had depression. This is significantly higher than the depression rate in the general population. Factors that were significantly associated with probable depression and depression were lower education levels (p=0.017). Other variables: age, occupation, marital status, level of knowledge toward cervical cancer, type of therapy, and co-existing disease were not significantly associated with depression among cervical cancer patients. Conclusions: Depression and probable depression were quite prevalent among patients with cervical cancer. Mental health care responses targeting patients with cervical cancer, particularly those with low education levels should therefore be prioritized, especially during their intensive chemotherapy or radiotherapy.