A literature review on screening, assessing, and managing of depression in patients with cancer was summarized and the researchers’ recommendations were presented in a recent report in the Clinical Journal of Oncology Nursing.
“Depression is not a typical part of surviving cancer and is often amenable to pharmacologic and nonpharmacologic interventions,” the researchers explained in their report.
To perform the literature review, the researchers searched several databases, including the Applied Science and Technology Source, CINAHL®, the Cochrane Database of Systematic Reviews, MEDLINE®, and PsycINFO®. The database searchers used terms such as cancer, depression, nonpharmacological interventions, mindfulness, psychotherapy, and spirituality, with the goal of identifying patterns in screening, nursing assessment, and nonpharmacologic treatment in patients with cancer who had depression.
A total of 248 unique articles were identified in through searches; of these, 13 were selected for further review. Publication dates ranged from 2015 through 2020. Insights into practices for screening, assessment, and nonpharmacologic management were extracted from the articles.
Patients with cancer can display a wide range of emotions and behaviors related to their diagnosis, but the researchers determined that cancer severity itself was not a predictor of a patient’s reaction to the cancer diagnosis. However, severity of symptoms identified in self-reporting of depression symptoms was found to be a significant predictor of depression.
The researchers recommended oncology nurses display openness to discussing emotional concerns and symptom severity, including by employing reflective listening. The Patient Health Questionnaire and Center for Epidemiological Studies — Depression scale also was recommended as an aid that can assist with monitoring depression in patients.
Following any patient screening that suggests depression, the researchers emphasized the importance of assessing depression severity. “The story of a patient’s cancer prognosis, physical symptoms, concurrent life stressors, personal relationships, and support structures becomes the basis for assessing depression,” the researchers explained.
Some depression symptoms, such as appetite, fatigue, and difficulty concentrating, may stem from cancer treatment. In turn, these symptoms may be enhanced by depression. Treating these symptoms, they indicated, may help with mood and a sense of well-being.
Cognitive behavioral therapy, mindfulness-based stress reduction, yoga, and strategies incorporating education are potential nonpharmacologic treatment approaches for patients with mild depression. In cases involving more concerning depression symptoms or history, prompt psychological referral and intervention are advised.
“Although some of the interventions described in the current article may not be practical because of time limitations or the need for specialized training, many can occur while nurses are performing other tasks, such as talking with patients about their feelings and emotions during chemotherapy administration,” the researchers wrote. They recommended that oncology nurses familiarize themselves with tools and approaches involved in reducing the impact of depression in patients with cancer.
Decker VB, Tofthagen C. Depression: screening, assessment, and interventions in oncology nursing. Clin J Oncol Nurs. 2021;25(4):413-421. doi:10.1188/21.CJON.413-421