An interdisciplinary palliative rehabilitation intervention bolstering general self-efficacy to attenuate symptoms of depression in patients living with advanced cancer
Menée au Canada auprès de 80 patients atteints d'un cancer de stade avancé, cette étude analyse l'efficacité d'une intervention pluridisciplinaire destinée à atténuer les symptômes de la dépression et améliorer la survie
Purpose : Patients with advanced cancer, post-anticancer treatment, are living longer than 10–20 years ago. This emerging population of survivors has unique palliative and rehabilitation needs. A particular concern is depression, which can impair functioning, quality of life, and survival. The interdisciplinary Palliative Rehabilitation Program offers holistic palliative rehabilitation for this population using a self-efficacy framework. The current study examined the unique impact of three program factors that have been shown to improve depression: inflammation, exercise, and self-efficacy. Method : Patients underwent a 2-month interdisciplinary intervention (up to six disciplines) and thorough pre-post assessments. Measures included serum C-reactive protein, 6-min walk test, General Self-efficacy Scale, and Hospital Anxiety and Depression Scale (depression subscale). Paired t tests analyzed pre-post changes in each variable, and a hierarchical linear regression analyzed the predictors’ unique contributions of changes in depression in this quasi-experimental design. Results : The sample included 80 patients (52.5 % females), with stages 3/4 heterogeneous cancers. Results revealed that C-reactive protein (CRP) did not significantly change pre-post, from 7.39 (SD = 11.99) to 9.47 mg/L (SD = 16.41), p = 0.110, exercise significantly increased, from 372.55 (SD = 137.71) to 412.64 m (SD = 144.31), p < 0.001, self-efficacy significantly increased from 27.86 (SD = 6.16) to 31.23 units (SD = 5.77), p < 0.001, and depression scores significantly decreased, from 7.14 (SD = 3.91) to 5.95 units (SD = 3.51), p = 0.002. A hierarchical linear regression revealed that this model explained 15 % of variance in changes in depression scores, p = 0.006. Change in self-efficacy accounted for 11 % of change in depression scores (p < 0.001). Change in CRP and exercise did not make a significant contribution. Conclusions : A self-efficacy framework may be a helpful ingredient in interdisciplinary intervention to decrease depressive symptomatology.