Assessing anxiety and depression in cancer patients

Abstract

Background: empirical evidence suggests that anxiety and depression in cancer patients is underdiagnosed and subsequently this patient population receives little or no support or intervention to address their psychosocial needs. It is often difficult to distinguish between normal emotional distress experienced following a cancer diagnosis and anxiety and depression, which can have a significant impact on coping mechanisms and subsequent outcomes.

Aim: a qualitative study using the Hospital Anxiety and Depression Scale (HADS) was undertaken in the National Centre for Cancer Care and Research in Qatar. The driver for change was to provide evidence of the need for an assessment to be incorporated into the nursing admission process as a means of early detection and onward referral for more formal interventions if required. The sample size was 57.

Findings: the evidence from the outcome data supported the hypothesis that anxiety and depression were present in a significant number of the sample group. This would support the proposal of early screening and onward referral. A number of patients surveyed expressed moderate to severe depression, which may impact negatively on outcomes.

Conclusion: screening for anxiety and depression in adult cancer patients should form part of an early nursing assessment to identify those who may benefit from more structured interventions. HADS is a useful screening tool; however, further research is required on validating tools used to screen for anxiety and depression in cancer and chronic disease in different cultures to ensure validity and reliability of outcome data.

Keywords: Anxiety; Cancer; Depression; Hospital Anxiety and Depression Scale; Qatar.