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Supportive Care in Cancer

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01-01-2016 | Original Article

An interdisciplinary palliative rehabilitation intervention bolstering general self-efficacy to attenuate symptoms of depression in patients living with advanced cancer

Authors: A. Feldstain, S. Lebel, M. R. Chasen

Published in: Supportive Care in Cancer | Issue 1/2016

Abstract

Purpose

Patients with advanced cancer, post-anticancer treatment, are living longer than 10–20 years ago. This emerging population of survivors has unique palliative and rehabilitation needs. A particular concern is depression, which can impair functioning, quality of life, and survival. The interdisciplinary Palliative Rehabilitation Program offers holistic palliative rehabilitation for this population using a self-efficacy framework. The current study examined the unique impact of three program factors that have been shown to improve depression: inflammation, exercise, and self-efficacy.

Method

Patients underwent a 2-month interdisciplinary intervention (up to six disciplines) and thorough pre-post assessments. Measures included serum C-reactive protein, 6-min walk test, General Self-efficacy Scale, and Hospital Anxiety and Depression Scale (depression subscale). Paired t tests analyzed pre-post changes in each variable, and a hierarchical linear regression analyzed the predictors’ unique contributions of changes in depression in this quasi-experimental design.

Results

The sample included 80 patients (52.5 % females), with stages 3/4 heterogeneous cancers. Results revealed that C-reactive protein (CRP) did not significantly change pre-post, from 7.39 (SD = 11.99) to 9.47 mg/L (SD = 16.41), p = 0.110, exercise significantly increased, from 372.55 (SD = 137.71) to 412.64 m (SD = 144.31), p < 0.001, self-efficacy significantly increased from 27.86 (SD = 6.16) to 31.23 units (SD = 5.77), p < 0.001, and depression scores significantly decreased, from 7.14 (SD = 3.91) to 5.95 units (SD = 3.51), p = 0.002. A hierarchical linear regression revealed that this model explained 15 % of variance in changes in depression scores, p = 0.006. Change in self-efficacy accounted for 11 % of change in depression scores (p < 0.001). Change in CRP and exercise did not make a significant contribution.

Conclusions

A self-efficacy framework may be a helpful ingredient in interdisciplinary intervention to decrease depressive symptomatology.

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Title: An interdisciplinary palliative rehabilitation intervention bolstering general self-efficacy to attenuate symptoms of depression in patients living with advanced cancer
Authors: A. Feldstain
S. Lebel
M. R. Chasen
Publication date: 01-01-2016
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 1/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-015-2751-4

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Abstract

Purpose

Method

Results

Conclusions

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