Abstract
BackgroundClinical depression is highly prevalent yet under-detected and under-treated in palliative care settings and is associated with a number of adverse medical and psychological outcomes for patients and their family members. This article presents a study protocol to evaluate a training intervention for non-physician palliative care staff to improve the recognition of depression and provide support for depressed patients and their family members. Details of the hypotheses and expected outcomes, study design, training program development and evaluation measures are described.Methods and DesignA randomised controlled trial will be implemented across two palliative care services to evaluate the "Training program for professional carers to recognise and manage depression in palliative care settings". Pre-, post- and three-month follow-up data will be collected to assess: the impact of the training on the knowledge, attitudes, self-efficacy and perceived barriers of palliative care staff when working with depression; referral rates for depression; and changes to staff practices. Quantitative and qualitative methods, in the form of self-report questionnaires and interviews with staff and family members, will be used to evaluate the effectiveness of the intervention.DiscussionThis study will determine the effectiveness of an intervention that aims to respond to the urgent need for innovative programs to target depression in the palliative care setting. The expected outcome of this study is the validation of an evidence-based training program to improve staff recognition and appropriate referrals for depression, as well as improve psychosocial support for depressed patients and their family members.Trial RegistrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610000183088
Highlights
Clinical depression is highly prevalent yet under-detected and under-treated in palliative care settings and is associated with a number of adverse medical and psychological outcomes for patients and their family members
This study will determine the effectiveness of an intervention that aims to respond to the urgent need for innovative programs to target depression in the palliative care setting
The expected outcome of this study is the validation of an evidence-based training program to improve staff recognition and appropriate referrals for depression, as well as improve psychosocial support for depressed patients and their family members
Summary
Clinical depression is highly prevalent yet under-detected and under-treated in palliative care settings and is associated with a number of adverse medical and psychological outcomes for patients and their family members. Despite awareness of the high prevalence of depression in this population, rates of detection and treatment are reported to be comparatively low, with only 50 per cent of depressed patients being recognised as depressed and subsequently referred for treatment [11,12] These low rates of detection strongly indicate the need for improved pathways to care for this vulnerable population. Members of palliative care patients represent a high-risk group for psychiatric disorders [13]; yet research indicates they too often do not receive the support needed from professional care services [14,15] Due to their high level of day-to-day contact with patients, non-physician palliative care staff are in an ideal position to both improve the pathways to care and provide support for depressed patients and their family members. No training program of this type has been evaluated and reported in the scientific literature
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