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

01-01-2016 | Original Article

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

Authors: Siew Tzuh Tang, Jen-Shi Chen, Wen-Chi Chou, Kuan-Chia Lin, Wen-Cheng Chang, Chia-Hsun Hsieh, Chiao-En Wu

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

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Abstract

Purpose

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.

Methods

A convenience sample of 325 cancer patients was longitudinally followed until death. Prevalence of severe depressive symptoms (score ≥11 on the depression subscale of the Hospital Anxiety and Depression Scale) was examined by multivariate logistic regression modeling with the generalized estimating equation.

Results

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.

Conclusion

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.
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Metadata
Title
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
Authors
Siew Tzuh Tang
Jen-Shi Chen
Wen-Chi Chou
Kuan-Chia Lin
Wen-Cheng Chang
Chia-Hsun Hsieh
Chiao-En Wu
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/s00520-015-2747-0

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