Management of major depression in outpatients attending a cancer centre: a preliminary evaluation of a multicomponent cancer nurse-delivered intervention

Sharpe, Michael; Strong, Vanessa; Allen, Katherine A.; Rush, Robert; Maguire, Peter; House, Allan; Ramirez, Amanda-Jane; Cull, Ann

doi:10.1038/sj.bjc.6601546

Cited by 46 publications

(57 citation statements)

References 21 publications

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“…Ethnic minority patients' preference for receiving depression care within the general health sector [66] suggests a need to integrate depression care within the oncology care system. Nurses and social workers might be trained to provide depression care for cancer patients [72][73]. In a pilot randomized study of 55 depressed, low-income, Latina breast or cervical cancer patients in public sector oncology clinics, onsite depression care management by a medical social worker that included Problem Solving Treatment and medication follow-up and psychiatric consultation significantly reduced depression symptoms over usual care [74].…”

Section: Discussionmentioning

confidence: 99%

Depression, Correlates of Depression, and Receipt of Depression Care Among Low-Income Women With Breast or Gynecologic Cancer

Ell

Sanchez

Vourlekis

et al. 2005

JCO

277

209

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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.

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Section: Discussionmentioning

confidence: 99%

Depression, Correlates of Depression, and Receipt of Depression Care Among Low-Income Women With Breast or Gynecologic Cancer

Ell

Sanchez

Vourlekis

et al. 2005

JCO

277

209

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“…Eight studies matched criterion 1 or 2; among them, three were randomized controlled trials (RCTs) (17 -19) and five were non-randomized trials (20 -24). Six studies matched criterion 3 or 4; among them, four were RCTs (25 -27, 28) and two were non-randomized trials (29,30) (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…One study targeted breast cancer patients (17), while another examined breast and lung cancer patients (19); the others, however, examined mixed populations of cancer patients, and the sample sizes ranged from 60 (29) to 998 (24). Five studies used the Distress Thermometer (DT) (19,22) or the Distress and Impact Thermometer (20,23,24), which is a modified version of the DT (31), as a screening instrument; four studies (30) were also used in one study each.…”

Section: Resultsmentioning

confidence: 99%

Effects of Integrated Psychosocial Care for Distress in Cancer Patients

Shimizu

2013

Japanese Journal of Clinical Oncology

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Background: Despite some clinical guidelines for incorporating integrated psychosocial care (combining psychological screening and psychological intervention, including adequate collaboration with mental health specialists) into routine oncology practice, definitive empirical evidence regarding the effectiveness of such care remains unavailable. Here the findings of recent experimental studies are reviewed to provide guidance regarding this issue. Methods: Comparative studies examining integrated psychosocial care were reviewed. Results: Studies examining interventions that include both screening and psychological care have produced contradictory results regarding effectiveness, but all the studies that have examined the effect of psychological care after the identification of distress using systematic screening have shown positive results. Conclusions: Integrated psychosocial care may affect patients with significant distress, but the adequacy of introducing such care into routine oncology practice remains debatable.

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“…Several reports have suggested the usefulness of integrated screening programs in clinical oncology settings. Those programs provide pharmacotherapy by oncologists using antidepressant algorithms 31,32 or psychologic intervention delivered by cancer nurses under the supervision of a consultant psychiatrist 33 to patients who screened positive. Simple intervention, meaning feeding back the results of the screening alone, however, does not seem to be useful.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of the nurse‐assisted screening and psychiatric referral program

Shimizu

Akechi

Okamura

et al. 2005

Cancer

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BACKGROUNDMajor depression and adjustment disorders are common psychiatric disorders in patients with cancer, but they are often overlooked in clinical oncology settings. The nurse‐assisted screening and psychiatric referral program (NASPRP) has been introduced in clinical practice to facilitate psychiatric treatment for major depression and adjustment disorders. This study assessed the usefulness of the NASPRP and compared it with usual practice.METHODSThe program consists of two stages. In the first stage, consecutive patients newly admitted to the Oncology/Hematology Unit are administered the Distress and Impact Thermometer (DIT) by nurses as a brief screening tool for major depression and adjustment disorders. In the second stage, the nurses recommend psychiatric referral to patients with scores above the cutoff point. Patients' records were reviewed for a 3‐month period before the start of the program and during the 3‐month period after the start of the program. These records were then compared.RESULTSOf 157 patients newly admitted during the program period, 86.0% (135/157) completed the DIT and results were positive in 49.6% (67/135), but only 28.2% (19/67) accepted psychiatric referral. Ultimately, 11.5% (18/157) of patients newly admitted were diagnosed with major depression or adjustment disorders and treated by psychiatric service, a significantly higher proportion than during the preceding 3‐month period, before the program was begun (2.5%; P = 0.001).CONCLUSIONThe NASPRP enabled identification of major depression and adjustment disorders in patients with cancer and introduced them to psychiatric treatment. Nevertheless, there is room for improvement in the program. Cancer 2005. © 2005 American Cancer Society.

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Management of major depression in outpatients attending a cancer centre: a preliminary evaluation of a multicomponent cancer nurse-delivered intervention

Cited by 46 publications

References 21 publications

Depression, Correlates of Depression, and Receipt of Depression Care Among Low-Income Women With Breast or Gynecologic Cancer

Depression, Correlates of Depression, and Receipt of Depression Care Among Low-Income Women With Breast or Gynecologic Cancer

Effects of Integrated Psychosocial Care for Distress in Cancer Patients

Usefulness of the nurse‐assisted screening and psychiatric referral program

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