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An interdisciplinary palliative rehabilitation intervention bolstering general self-efficacy to attenuate symptoms of depression in patients living with advanced cancer

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Abstract

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.

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Acknowledgments

The authors thank the clinical, administrative, and research members of the PRP team for their respective contributions; the Bruyère Continuing Care and Research Institute for their support; Dwayne Schindler for his statistical guidance; and the Ottawa Regional Cancer Foundation for their financial contributions to the PRP.

Conflict of interest

Authors declare that they have no conflicts of interest. The authors have full control of all primary data and agree to allow the journal to review their data if requested.

Funding

This work was supported by the Ottawa Regional Cancer Foundation, Bruyère Continuing Care, The Bruyère Research Institute, and the Bruyère Foundation.

Author information

Authors and Affiliations

  1. School of Psychology, University of Ottawa, Ottawa, ON, Canada

    A. Feldstain & S. Lebel

  2. Bruyère Research Institute, Bruyère Continuing Care, Ottawa, ON, Canada

    A. Feldstain & M. R. Chasen

  3. Department of Palliative Medicine, Bruyère Continuing Care, Ottawa, ON, Canada

    M. R. Chasen

  4. Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada

    M. R. Chasen

Authors
  1. A. Feldstain
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  2. S. Lebel
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  3. M. R. Chasen
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Correspondence to A. Feldstain.

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Feldstain, A., Lebel, S. & Chasen, M.R. An interdisciplinary palliative rehabilitation intervention bolstering general self-efficacy to attenuate symptoms of depression in patients living with advanced cancer. Support Care Cancer 24, 109–117 (2016). https://doi.org/10.1007/s00520-015-2751-4

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