Nurse-delivered Therapy Improves Depression Among Cancer Patients
Therapy delivered to cancer patients by oncology nurses improves cancer-related depression compared with standard therapies. These results were recently published in the Lancet.
Depression is common among patients with cancer, whether newly diagnosed, undergoing treatment, or following completion of therapy. Depression may be mild or severe and, at any degree, may significantly reduce quality of life. Severe depression can become so debilitating that individuals avoid common daily activities and may even experience suicidal thoughts.
Standard therapies for patients with depression typically consist of anti-depressant agents and/or counseling, depending upon the severity and individual situation.
Oncology nurses have the unique position of spending time with patients and their families and often understand ongoing issues of the patient’s life that may extend beyond immediate treatment for their cancer. With such insight, nurses can often offer support in ways that are not commonly provided by other healthcare providers.
Researchers from the University of Edinburgh in Scotland recently conducted a clinical study to explore the potential effects of offering counseling sessions provided by oncology nurses to cancer patients dealing with depression. The study included nearly 200 patients whose cancer was in remission; one group of patients received the usual care of antidepressants and/or counseling (psychotherapy), while the other group received the usual care plus 10 one-on-one sessions with an oncology nurse. The oncology nurses had no prior psychiatric nursing experience but were trained for this specific intervention. The 45-minute, one-on-one counseling sessions were delivered either in person or over the phone during a three-month period. Patients were then contacted by telephone for three months following the sessions to monitor their depression. Those who developed worsening signs of depression during this time were offered one or two more sessions of nurse-delivered therapy. The sessions included: “problem-solving therapy to help patients overcome feelings of helplessness; education about depression and the available treatments; and counseling on talking about depression with oncologists and primary-care physicians. “
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- The group of patients who received counseling with a nurse suffered from less depression than those who received standard therapy for depression.
- The advantage from nurse-delivered therapy was maintained for at least one full year.
- Secondary effects associated with depression, such as fatigue and anxiety, were also improved as depression improved.
- There were no differences in pain or other physical effects among the two groups of patients.
The researchers concluded that the addition of oncology nurse-delivered counseling sessions to usual care for depression significantly improves depression, with lasting effects, among patients with cancer, and that integration of nurse-delivered therapy provides an effective way to aid depression in patients with cancer.
Reference: Strong V, et al. Strong V, et al. Management of depression for people with cancer (SMaRT oncology 1): a randomised trial. Lancet. 2008; 372: 40-48. Lancet. 2008; 372: 40-48.
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