The longitudinal course of depression symptomatology following a palliative rehabilitation program.

Andrea Feldstain, Sophie Lebel, Martin R Chasen

Journal: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 2018;26(7):1809-1818

PMID: 28236265

Abstract

PURPOSE

Patients with advanced cancer have increased life expectancy but suffer from ongoing burden. Depressive symptomatology is their most common mental health concern. The Ottawa Palliative Rehabilitation Program (PRP) offers rehabilitation for this population. It offers 8 weeks of individualized interdisciplinary rehabilitation, post cancer treatment. Interventions include medical (physician and nurse), physiotherapy, occupational therapy, dietary, and social work using a general self-efficacy framework. Pilot data suggest benefits in a range of domains, including ratings of feeling "depressed." We examined whether reduced symptomatology was maintained 3 months after PRP completion.

METHODS

Participants with advanced heterogeneous cancers who completed the PRP were mailed the Hospital Anxiety and Depression Scale (among others) 3-month post-PRP (n = 44). Demographic and medical information were obtained from patient files.

RESULTS

There was a significant linear trend (mean T1: 6.79 ± 2.29; T2: 5.23 ± 3.06; T3: 4.59 ± 3.34; p = 0.007) with statistically and clinically significant decreases in reported depressive symptomatology between T1 and T2 (p = 0.042) and T1 and T3 (p = 0.007). There was a significant decreases in number of cases reporting symptomatology scores in the clinical range from T1 to T3 (p = 0.038).

CONCLUSION

Patients who undergo a palliative rehabilitation program may experience relief of mild depressive symptomatology, maintainable 3-month post-PRP. The sample was exhibiting mild symptomatology and these results may not be generalizable to those with higher scores; a lack of specialized psychosocial clinician may have affected the acquired sample. Experimental designs are needed to more thoroughly compare these findings to independent rehabilitation interventions.

Address: Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, 2202 2nd st. SW, Calgary, AB, T2S 3C1, Canada. [email protected].; School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall Ottawa, Ottawa, ON, K1N 6N5, Canada. [email protected].; Bruyère Research Institute, Bruyère Continuing Care, Ottawa, ON, Canada. [email protected].; School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall Ottawa, Ottawa, ON, K1N 6N5, Canada.; Bruyère Research Institute, Bruyère Continuing Care, Ottawa, ON, Canada.; Medical Oncologist/Medical Director of Palliative Care, William Osler Health System, 2100 Bovaird Dr E, Brampton, ON, L6R 3J7, Canada.; Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.

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