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The longitudinal course of depression symptomatology following a palliative rehabilitation program

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Abstract

Purpose

Patients with advanced cancer have increased life expectancy but suffer from ongoing burden. Depressive symptomatology is their most common mental health concern. The Ottawa Palliative Rehabilitation Program (PRP) offers rehabilitation for this population. It offers 8 weeks of individualized interdisciplinary rehabilitation, post cancer treatment. Interventions include medical (physician and nurse), physiotherapy, occupational therapy, dietary, and social work using a general self-efficacy framework. Pilot data suggest benefits in a range of domains, including ratings of feeling “depressed.” We examined whether reduced symptomatology was maintained 3 months after PRP completion.

Methods

Participants with advanced heterogeneous cancers who completed the PRP were mailed the Hospital Anxiety and Depression Scale (among others) 3-month post-PRP (n = 44). Demographic and medical information were obtained from patient files.

Results

There was a significant linear trend (mean T1: 6.79 ± 2.29; T2: 5.23 ± 3.06; T3: 4.59 ± 3.34; p = 0.007) with statistically and clinically significant decreases in reported depressive symptomatology between T1 and T2 (p = 0.042) and T1 and T3 (p = 0.007). There was a significant decreases in number of cases reporting symptomatology scores in the clinical range from T1 to T3 (p = 0.038).

Conclusion

Patients who undergo a palliative rehabilitation program may experience relief of mild depressive symptomatology, maintainable 3-month post-PRP. The sample was exhibiting mild symptomatology and these results may not be generalizable to those with higher scores; a lack of specialized psychosocial clinician may have affected the acquired sample. Experimental designs are needed to more thoroughly compare these findings to independent rehabilitation interventions.

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Acknowledgements

We thank the members of the Palliative Rehabilitation team: Dr. Paula Enright, Debbie Gravelle, Teresa Lee, Lisa Savage-Larose, Caroline Richardson, Cecelia Cranston, Anne-Marie Burns, Rita Finnigan, Maria Delgadillo for their clinical contributions; Josée Desjardins, Samantha Zinkie, Danielle Sinden, and Sylvie Bisaillon for their administrative support; Dr. Neil MacDonald and Dr. Ravi Bhargava for their academic contributions; and Dr. Catherine Bielajew, Dr. Keith Wilson, Dr. Mary Egan, and Dr. Nicole Culos-Reed who provided their feedback on this manuscript as evaluators of author AF’s doctoral thesis. This research was funded by contributions to the Palliative Rehabilitation Program from Bruyère Continuing Care, The Bruyère Research Institute, and the Bruyère Foundation. Author AF is currently funded through a post-doctoral clinical Fellowship from the Alberta Cancer Foundation, the Department of Oncology, CancerControl Alberta, and Alberta Health Services.

Funding

This research was funded by contributions to the Palliative Rehabilitation Program from Bruyère Continuing Care, The Bruyère Research Institute, and the Bruyère Foundation. Author AF is currently funded through a clinical Fellowship from the Alberta Cancer Foundation, the Department of Oncology, CancerControl Alberta, and Alberta Health Services.

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Authors and Affiliations

  1. Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, 2202 2nd st. SW, Calgary, AB, T2S 3C1, Canada

    Andrea Feldstain

  2. School of Psychology, Faculty of Social Sciences, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall Ottawa, Ottawa, ON, K1N 6N5, Canada

    Andrea Feldstain & Sophie Lebel

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

    Andrea Feldstain & Martin R. Chasen

  4. Medical Oncologist/Medical Director of Palliative Care, William Osler Health System, 2100 Bovaird Dr E, Brampton, ON, L6R 3J7, Canada

    Martin R. Chasen

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

    Martin R. Chasen

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  1. Andrea Feldstain
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Correspondence to Andrea Feldstain.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Feldstain, A., Lebel, S. & Chasen, M.R. The longitudinal course of depression symptomatology following a palliative rehabilitation program. Qual Life Res 26, 1809–1818 (2017). https://doi.org/10.1007/s11136-017-1531-7

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