Symptoms of depression, sadness and sense of coherence (coping) among cognitively intact older people with cancer living in nursing homes-a mixed-methods study.

Jorunn Drageset,Geir Egil Eide,Solveig Hauge

doi:10.7717/peerj.2096

Abstract

Background: Symptoms of depression are often reported among patients with a cancer diagnosis. Strong sense of coherence (SOC) is shown to be associated with less depression in the general older population and among nursing homes (NH) residents in particular. Knowledge about mixed-methods perspectives that examine symptoms of depression and SOC among cognitively intact NH residents with cancer is scarce.Aim: To investigate symptoms of depression and SOC among NH residents who are cognitively intact and have cancer.Methods: We used a quantitatively driven mixed-methods design with sequential supplementary qualitative components. We facilitated the collection of quantitative survey data of 60 NH residents (≥ 65 years) with cancer using the Geriatric Depression Scale (GDS) and SOC scale. The supplementary psychosocial component comprised qualitative research interviews about experiences related to depression with nine respondents from the same cohort.Results: In fully adjusted multiple regression analysis of the sociodemographic variables, the GDS was significantly correlated with SOC (P < 0.001). The experience of sadness was identified by the following theme: sadness. Coping with the experience of symptoms of depression was dominated by coping with sadness.Conclusion: More than half the NH residents reported symptoms of depression, and the SOC was associated with reduced symptoms. A mixed-methods design contributed to nuanced and detailed information about the meaning of depression, and the supplementary component informs and supports the core component. To improve the situation of NH residents with cancer, more attention should be paid to the residents’ experience of symptoms of depression and their SOC.

Highlights

Nursing home (NH) residents with cancer are given little attention (Duncan, ForbesThompson & Bott, 2008)
The quantitative core component initially comprised 60 respondents with cancer, and we facilitated the collection of the survey data using the Geriatric Depression Scale (GDS) and sense of coherence (SOC) questionnaire
GDS was significantly negatively associated with SOC in simple linear regression (b = -0.157, 95% confidence intervals (CI): -0.185 to -0.128, P < 0.001, R2 = 0.34) (Table 2)

Summary

Introduction

Nursing home (NH) residents with cancer are given little attention (Duncan, ForbesThompson & Bott, 2008). Since the incidence of cancer increases with age, more people will be diagnosed with cancer in the years ahead as the number of older people is growing (Bourbonniere & Van Cleave, 2006; International Agency for Research on Cancer, 2012) Many of these older people will live in NH (Clement, Bradley & Lin, 2009). At admission to a NH, 10–26% of the residents have a diagnosis of cancer (Drageset, Eide & Ranhoff, 2012; Rodin, 2008), and some develop cancer while living in the NH (Clement, Bradley & Lin, 2009) Because of their actual condition and treatment, many of these NH residents with cancer experience distressing symptoms such as fatigue, anorexia, nausea, vomiting and pain (Drageset et al, 2014; Pimentel et al, 2015) and have unstable health (Bourbonniere & Van Cleave, 2006; Buchanan et al, 2005). To improve the situation of NH residents with cancer, more attention should be paid to the residents’ experience of symptoms of depression and their SOC

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Results

Conclusion