Details

Autor(en) / Beteiligte

• Feldstain, A.
• Lebel, S.
• Chasen, M. R.

Titel

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

Ist Teil von

• Supportive care in cancer, 2016-01, Vol.24 (1), p.109-117

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• 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.