Prevalence of severe depressive symptoms increases as death approaches and is associated with disease burden, tangible social support, and high self-perceived burden to others

被引:21
作者
Tang, Siew Tzuh [1 ]
Chen, Jen-Shi [2 ]
Chou, Wen-Chi [3 ]
Lin, Kuan-Chia [4 ]
Chang, Wen-Cheng [2 ]
Hsieh, Chia-Hsun [3 ]
Wu, Chiao-En [3 ]
机构
[1] Chang Gung Univ, Sch Nursing, Taoyuan 333, Taiwan
[2] Chang Gung Univ, Coll Med, Chang Gung Mem Hosp Linkou, Div Hematol Oncol, Taoyuan 333, Taiwan
[3] Chang Gung Mem Hosp Linkou, Div Hematol Oncol, Taoyuan, Taiwan
[4] Natl Taipei Univ Nursing & Hlth Sci, Dept Hlth Care & Management, Taipei, Taiwan
关键词
Clinical depression; Depressive symptoms; Sense of burden to others; Symptom distress; Functional dependence; Social support; End-of-life care; QUALITY-OF-LIFE; CANCER-PATIENTS; HOSPITAL ANXIETY; BINARY OUTCOMES; SCALE; CARE; METAANALYSIS; BREAST; VALIDATION; DISTRESS;
D O I
10.1007/s00520-015-2747-0
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Terminally ill cancer patients experience progressive functional decline, accelerating symptom severity, deteriorating social support, and self-perceived burden to others (SPB), predisposing them to depressive symptoms. However, changes in the prevalence of severe depressive symptoms as death approaches and the unique roles of these four variables have not been adequately studied. This study explored longitudinal changes in and associations of symptom distress, functional dependence, social support, and SPB with prevalence of severe depressive symptoms in the last year of life. A convenience sample of 325 cancer patients was longitudinally followed until death. Prevalence of severe depressive symptoms (score a parts per thousand yen11 on the depression subscale of the Hospital Anxiety and Depression Scale) was examined by multivariate logistic regression modeling with the generalized estimating equation. The prevalence of severe depressive symptoms increased as death approached. The likelihood of severe depressive symptoms was significantly higher in patients who had higher levels of symptom distress and functional dependence, received greater tangible support, and reported high SPB, but lower for patients reporting a higher level of affectionate support and positive social interactions with their supportive network. Prevalence of severe depressive symptoms increased as death approached and was associated with several modifiable factors. Healthcare professionals should become familiar with these factors to identify vulnerable patients. To decrease the likelihood of terminally ill cancer patients' severe depressive symptoms, they should receive effective interventions to manage their symptoms, appropriately foster social support to restore their fragile self-esteem due to depending on others, and lighten their SPB.
引用
收藏
页码:83 / 91
页数:9
相关论文
共 45 条
  • [1] [Anonymous], NHPCOS FACTS FIG HOS
  • [2] DEVELOPMENT OF A SOCIAL DEPENDENCY SCALE
    BENOLIEL, JQ
    MCCORKLE, R
    YOUNG, K
    [J]. RESEARCH IN NURSING & HEALTH, 1980, 3 (01) : 3 - 10
  • [3] Psychological distress and pain significantly increase before death in metastatic breast cancer patients
    Butler, LD
    Koopman, C
    Cordova, MJ
    Garlan, RW
    DiMiceli, S
    Spiegel, D
    [J]. PSYCHOSOMATIC MEDICINE, 2003, 65 (03): : 416 - 426
  • [4] Identifying psychological morbidity among people with cancer using the Hospital Anxiety and Depression Scale: time to revisit first principles?
    Carey, Mariko
    Noble, Natasha
    Sanson-Fisher, Robert
    Mackenzie, Lisa
    [J]. PSYCHO-ONCOLOGY, 2012, 21 (03) : 229 - 238
  • [5] Burden to others and the terminally Ill
    Chochinov, Harvey Max
    Kristjanson, Linda J.
    Hack, Thomas F.
    Hassard, Thomas
    McClement, Susan
    Harlos, Mike
    [J]. JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2007, 34 (05) : 463 - 471
  • [6] Survival of Medicare patients after enrollment in hospice programs
    Christakis, NA
    Escarce, JJ
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1996, 335 (03) : 172 - 178
  • [7] Surviving cancer or other serious illness: A review of individual and community resources
    Coughlin, Steven S.
    [J]. CA-A CANCER JOURNAL FOR CLINICIANS, 2008, 58 (01) : 60 - 64
  • [8] Measuring chronic patients' feelings of being a burden to their caregivers -: Development and preliminary validation of a scale
    Cousineau, N
    McDowell, I
    Hotz, S
    Hébert, P
    [J]. MEDICAL CARE, 2003, 41 (01) : 110 - 118
  • [9] Health-related quality of life during the last three months of life in patients with advanced cancer
    Elmqvist, Marianne Ahlner
    Jordhoy, Marit S.
    Bjordal, Kristin
    Kaasa, Stein
    Jannert, Magnus
    [J]. SUPPORTIVE CARE IN CANCER, 2009, 17 (02) : 191 - 198
  • [10] Meta-Analysis of Efficacy of Interventions for Elevated Depressive Symptoms in Adults Diagnosed With Cancer
    Hart, Stacey L.
    Hoyt, Michael A.
    Diefenbach, Michael
    Anderson, Derek R.
    Kilbourn, Kristin M.
    Craft, Lynette L.
    Steel, Jennifer L.
    Cuijpers, Pim
    Mohr, David C.
    Berendsen, Mark
    Spring, Bonnie
    Stanton, Annette L.
    [J]. JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2012, 104 (13): : 990 - 1004