Purpose-To assess the prevalence of depression among low-income, ethnic minority women with breast or gynecological cancer, receipt of antidepressant medications or counseling services, and correlates of depression.Patients and Methods-Study patients were 472 women receiving cancer care in an urban public medical center. Women had a primary diagnosis of breast (Stage 0-III) or gynecological cancer (FIGO 0-3B). A diagnostic depression screen and baseline questionnaire was administered prior to or during active treatment or during active follow-up. Self-report data was collected on receipt of depression treatment, use of supportive counseling, pain and receipt of pain medication, functional status and well-being, and perceived barriers to cancer care.Results-Twenty-four percent of women reported moderate to severe levels of depressive disorder, 30% of breast cancer patients and 17% of gynecological cancer patients. Only 12% of women meeting criteria for major depression reported currently receiving medications for depression and only 5% of women reported seeing a counselor or participating in a cancer support group. Neither cancer stage or treatment status was correlated with depression. Primary diagnosis of breast cancer, younger age, greater functional impairment, poorer social/family well-being, anxiety, comorbid arthritis, and fears about treatment side effects were correlated with depression.Conclusion-Findings indicate that depressive disorder among ethnic minority, low-income women with breast or gynecological cancer is prevalent and is correlated with pain, anxiety and health-related quality of life (HRQL). Because these women are unlikely to receive depression treatment or supportive counseling, there is a need for routine screening, evaluation and treatment in this population.
This study aimed to examine: the prevalence and correlates of depression among adults age 65 and over on admission to diverse home health care programs; nurse compliance with routine screening using the PHQ-9; and concordance between the number of depressed individuals identified by the PHQ-9 and Medicare-mandated nursing assessment following targeted nurse training in identifying depression among the elderly using a standard diagnostic screen. Data are drawn from routine screening of 9,178 patients (a 77% screening compliance rate). Of all patients screened, 782 (8.5%) met criteria for probable major depression and 148 (1.6%) for mild depression. Concordance between nurse identified depression via PHQ-9 and OASIS depression assessment improved over that reported in previous studies. Findings suggest that the use of a routine screening tool for depression can be implemented with minimal in-house training and improves detection of depression among older adults with significant physical and functional impairment.
During the past 15 years, the number of colorectal cancer survivors has risen dramatically. While it is unclear how many colorectal cancer survivors were employed at the time of diagnosis, it is reasonable to expect a significant proportion of these survivors were temporarily displaced from the work force. This article describes the return to work experiences of 250 colorecta1 cancer survivors. The majority (80%) of the survivors were employed at diagnosis and 89% returned to work. Of those who returned to work, 81% sustained employment 5 years postdiagnosis. Results indicate survivors were successful in their attempt to return to work and sustain employment. However, 34% of survivors delayed their return beyond 2 months pestdiagnosis. After controlling for ethnicity, education, and disease severity, the reason for delay was related to chemotherapy treatment. Prospective studies of colorectal cancer survivors to document' barriers to work return can guide interventions and occupational services to keep survivors healthy and in the workplace.
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