Prevalence of Depression in Cancer Patients

My topic of interest is the prevalence of depression in cancer patients. Prior to analyzing

any literature my understanding was that cancer patients have a higher incidence of depression

compared to the general population due to the decline in their health. My belief is shaped by a

personal experience with a family member who had cancer and suffered from depression.

This is significant to nursing because approximately 10-25 percent of cancer patients

develop depression (Traeger, 2010). As depression develops within a cancer patient it can cause

poorer treatment tolerance, decreased quality of life and an increased desire for death for patients

with cancer (Traeger, 2010). These factors can result in reduced treatment effectiveness,

treatment refusal, and disease management costs (Traeger, 2010). Furthermore, patients may

have difficulty accepting their prognosis which can cause conflict between appropriate and

compassionate end of life care causing distress in decision making (Traeger, 2010). Therefore, as

health care professionals it is important that we are aware of this and offer the appropriate

management and treatment options or interventions to increase the quality of life as well as help

prevent the development of depression (Yang et al., 2013) (Neilson et al., 2012).

During my preliminary search two articles were found; “The Prevalence of Depression

and Anxiety among Chinese Adults with Cancer: A Systematic Review and Meta-analysis” and

“A Longitudinal Study of Distress (depression and anxiety) up to 18 Months after Radiotherapy

for Head and Neck Cancer.” Both articles were found by searching depression in cancer patients.

I choose Yang et al. (2013) article because the article focused solely on the prevalence of

depression in cancer patients. Furthermore, this article supported the importance of identifying

and treating depression as it is critical for decreased disease progression and medical costs,

increased survival rates and quality of life. Lastly, interventions can be generated through the

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findings of this article for optimal care for cancer patients experiencing depression. Neilson et al.

(2012) article was chosen because the study conducted explored and identified factors that

predict depression which can help aid nurses in preventing depression from developing or

escalading. The articles findings stated that if depression is untreated there is a decrease in

quality of life, increased complications with treatment and compliance, and extended hospital

stays. Lastly this article found that if the predictive factors are addressed we are able to

determine vulnerable groups and this can allow nurses to target these groups and intervene to

prevent or decreased the symptoms of depression and aid in the recovery process.

The purpose of Yang et al. (2013) article was designed to analyze depression and

anxiety in Chinese adults with cancer as well as evaluate the commonalities and differences of

depression and anxiety among those without cancer. The purpose of Neilson et al. (2012) article

is to conduct a study following the course of head and neck cancer of an Australian population

up to 18 months after receiving radiotherapy and evaluate the symptoms of depression and

After conducting a literature review for both articles, my original understanding of

the topic is supported because Yang et. al., (2013) concluded that in fact Chinese adults with

cancer had higher prevalence rates of depression compared to the control group. These findings

support that these patients should receive more attention. Furthermore Neilson et. al. (2012)

also concluded that patients with head and neck cancer have increased rates of depression due

to the symptoms related to the treatments. These findings support that interventions need to be

developed in order to meet the changing needs of these patients as treatment proceeds.

Ontology is defined by the nature of knowledge, what exists, and what is true (Bailey,

1997). It is broken up into two paradigms, relativist and realism (Bailey, 1997). After conducting

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an analysis on Yang et. al. (2013) and Neilson et. al. (2012) article it was evident that the

ontological approach is realism. Realism is demonstrated in Yang et. al. (2013) article because

the findings support that patients with cancers have a higher prevalence of depression compared

to the general population, concluding that there is one reality that exists and was proven by their

experiment. Neilson et. al. (2012) article demonstrated realism by a common conclusion that

their study results indicated significant increase in the development of depression for those with

head and neck cancer. Epistemology is determined by how knowledge is acquired and the

relationship between the researcher and what is known (Bailey, 1997). This paradigm is known

to be dependent on the ontological approach (Bailey, 1997). Therefore, Yang et. al. (2013)

article supports the quantitative research and uses experimentation to verify their hypotheses and

lead to decontextualize results. This is demonstrated by the use of screening tools such as the

DSM-IV (diagnostic and statistical manual of mental disorders, fourth edition), CCMD (Chinese

classification of mental disorders), HRSD (Hamilton rating scale for depression), the ratio of

odds, and by the use of self-report questionnaires. In Neilson et. al. (2012) article the quantitative

paradigm is apparent due to the use of the data collection tools such as the anxiety and

depression scale, addition concerns subscale of the functional assessment, and 101 subjects

participated. Theoretical approach is based on or uses the ideas and abstract principles that relate

to a particular subject. Both articles suggest that cancer is a serious and life threatening illness

and that the treatments can be very distressing. From this the articles based there knowledge and

experimental methods on that principle. The theoretical approach revealed that in their studies

cancer patients do have a higher prevalence of depression compared to the general population.

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References

Bailey, P. H. (1997). Finding your way around qualitative methods in nursing research. Journal

of Advanced Nursing, 25, 18-22.

Neilson, K., Pollard, A., Boonzaier, A., Corry, J., Castle, D., Smith, D.,...Couper, J. (2012). A

longitudinal study of distress (depression and anxiety) up to 18 months after radiotherapy

for head and neck cancer. Psycho-Oncology, 22, 1843-1848.

Traeger, L. (2010). Approaching the treatment of depression in elderly cancer patients. Aging

Health, 6(3), 393-403.

Yang, Y., Liu, L., Wang, Y., Wu, H., Yang, X., Wang, J., & Wang, L. (2013). The prevalence of

depression and anxiety among Chinese adults with cancer: a systematic review and meta- analysis. BMC Cancer, 13(393), 1-15. doi:10.1186/1471-2407-13-393