The influence of family adaptability and cohesion on anxiety and depression of terminally ill cancer patients
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This study investigated the effect of family members on terminally ill cancer patients by measuring the relationship of the presence of the family caregivers, visiting time by family and friends, and family adaptability and cohesion with patient’s anxiety and depression.
From June, 2016 to March, 2017, 100 terminally ill cancer patients who were admitted to a palliative care unit in Seoul, South Korea, were surveyed, and their medical records were reviewed. The Korean version of the Family Adaptability and Cohesion Evaluation Scales III and Hospital Anxiety-Depression Scale was used. Chi-square and multiple logistic regression analyses were used.
The results of the chi-square analysis showed that the presence of family caregivers and family visit times did not have statistically significant effects on anxiety and depression in terminally ill cancer patients. In multiple logistic regression, when adjusted for age, sex, ECOG PS, and the monthly average income, the odds ratios (ORs) of the low family adaptability to anxiety and depression were 2.4 (1.03–5.83) and 5.4 (1.10–26.87), respectively. The OR of low family cohesion for depression was 5.4 (1.10–27.20) when adjusted for age, sex, ECOG PS, and monthly average household income.
A higher family adaptability resulted in a lower degree of anxiety and depression in terminally ill cancer patients. The higher the family cohesion, the lower the degree of depression in the patient. The presence of the family caregiver and the visiting time by family and friends did not affect the patient’s anxiety and depression.
KeywordsTerminally-ill-cancer Anxiety Depression Family Adaptability Cohesion
This study was supported by a VHS Medical Center Research Grant, Republic of Korea (VHSMC 17009).
Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was approved by the institutional review board of the Veterans Health Service Medical Center (IRB file no. 2016-05-016).
Conflict of interest
The authors declare that there are no conflicts of interest.
Informed consent was obtained from all individual participants included in the study.
- 1.World Health Organization (2015) World report on ageing and health http://apps.who.int/iris/bitstream/10665/186463/1/9789240694811_eng.pdf. Accessed 30 May 2017
- 2.Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C et al (2012) Cancer incidence and mortality worldwide: IARC CancerBase No. 11. International Agency for Research on Cancer, Lyon, France http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx. Accessed 30 May 2017Google Scholar
- 3.World Health Organization (2017) Fact sheets on cancer http://www.who.int/mediacentre/factsheets/fs297/en/. Accessed 30 May 2017
- 6.O’Connor M, White K, Kristjanson LJ, Cousins K, Wilkes L (2010) The prevalence of anxiety and depression in palliative care patient with cancer in Western Australia and New South Wales. Med J Aust 193(5):44Google Scholar
- 9.Goodyer IM, Herbert J, Tamplin A et al (1997) Short-term outcome of major depression: II. Life events, family dysfunction and friendship difficulties as predictors of persistent disorder. J Am Acad Child Adolesc Psychiatry 36(4):474–480. https://doi.org/10.1097/00004583-199704000-00009 CrossRefPubMedGoogle Scholar
- 10.Ullrich A, Ascherfeld L, Marx G, Bokemeyer C, Bergelt C, Oechsle K (2017) Quality of life, psychological burden, needs, and satisfaction during specialized inpatient palliative care in family caregivers of advanced cancer patient. BMC Palliat Care 16:31. https://doi.org/10.1186/s12904-017-0206-z CrossRefPubMedPubMedCentralGoogle Scholar
- 11.Han KH, Jung JG, Oh SK, Kim JS, Kim SS, Kim SY (2005) Depression level among family caregivers of terminal cancer patient. Korean J Fam Med 26(12):752–758Google Scholar
- 13.Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x CrossRefGoogle Scholar
- 14.Oh SM, Min KJ, Park DB (1999) A study on the standardization of the hospital anxiety and depression scale for Koreans: a comparison of normal, depressed and anxious groups. J Korean Neuropsychiatr Assoc 38(2):289–296Google Scholar
- 15.Löwe B, Spitzer RL, Gräfe K, Kroenke K, Quenter A, Zipfel S, Buchholz C, Witte S, Herzog W (2004) Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians’ diagnoses. J Affect Disord 78(2):131–140. https://doi.org/10.1016/S0165-0327(02)00237-9 CrossRefPubMedGoogle Scholar
- 17.Youn BB, Lee HR, Kwak KW, Oh MK, Lim JH, Lee KR (1990) A study on reliability and validity of FACES III. J Korean Acad Fam Med 11(10):8–17Google Scholar
- 23.National Cancer Center (2011) On December 11, 2014, Perception of hospice palliative care http://ncc.re.kr/pr/notice_view.jsp?current_page=1&nws_id=1136
- 24.Du N, Ran MS, Liang SG, SiTu MJ, Huang Y, Mansfield AK, Keitner G (2014) Comparison of family functioning in families of depressed patient and nonclinical control families in China using the Family Assessment Device and the Family Adaptability and Cohesion Evaluation Scales II. Ann Clin Psychiatry 26(1):47–56PubMedGoogle Scholar
- 26.Aamir S, Zuraida N, Loh EC, Beng TS (2012) Correlation between anxiety, depression, family functioning and quality of life, in palliative care cancer patient. Int J Med Med Sci 2(10):204–208Google Scholar
- 31.Ministry of Health and welfare of the republic of Korea (2015) On July 15, 2015, application of health insurance was started for ‘Hospice hospitalization’ in the terminal cancer, and also implementation was started ‘home hospice’ in the year. http://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&BOARD_ID=140&BOARD_FLAG=00&CONT_SEQ=324228&page=1. Accessed 28 May 2017