Capstone Project Framework

Running head: SPIRITUALITY AND DEPRESSION 1

SPIRITUALITY AND DEPRESSION 1

Providing Spiritual Interventions to Decrease Depression Among Cancer Patients

50-70 Years Old

Tristine Garrido

MSN Family Nurse Practitioner

United States University

MSN 563: Evidence Based Inquiry for Scholarship and Practice

Dr. Marilyn DeRidder

October 5, 2020

Spirituality Improves Depression among Cancer Patients

Cancer patients are likely to suffer from depression due to several factors such as the financial burden of the disease, the impact of the disease on the patients’ health, the stigma that comes with cancer, and the fact that cancer is a terminal illness (Feelings and Cancer, 2020). As a result, some patients turn to spirituality and religiosity to cope with the depression that comes with cancer. Spirituality and religiosity give patients suffering from depression a sense of comfort and hope. Therefore, this project will assess the impact of spiritual support on patients suffering from depression and compare the patient outcomes with their condition prior to receiving spiritual interventions.

PICOt question:

Population—50-70 year-old patients with cancer

Intervention—provision of spiritual support

Comparison—to their level of depression prior to receiving spiritual interventions

Outcome—decreased level of depression by 5% as per the PHQ9 depression scale

Time—Three months

Significance

Depression is quite common among patients suffering from cancer. In a study conducted by Nikbakhsh, Moudi, Abbasian, and Khafri (2014), it was found out that only 20.5% of patients suffering from breast cancer and had no depression at all. This means that out of all the breast cancer patients that took part in this study, 79.5% of them either had mild or symptomatic depression. Out of the 150 patients suffering from different types of cancer that were studied, 48% of them had either mild or symptomatic depression. This makes depression a matter of concern among this group of patients. depression affects the mental wellness of cancer patients. The patients are already suffering from a terminal illness. Therefore, a depression diagnosis means that they have to deal with an additional condition that deserves equal attention as cancer they are already suffering from. cancer treatment requires patience, motivation, and ultimate focus. Therefore, if a cancer patient develops depression during the care and cancer management process, he/she might lose the motivation to remain focused on completing and pursuing the treatment (Gu, Xu, Zhu, and Zhong, 2017). Additionally, considering that depression is a mental disorder that affects the patients’ cognition, the patient might fail to adhere to basic health instructions such as medication instructions, physician appointments, and lifestyle modification guidelines. Therefore, if these basic factors of care are not adhered to, mortalities among cancer patients will keep on increasing. It is estimated that depression increases the mortality rate among cancer patients by 39% (Rosenstein, 2011). Therefore, it is important to address the issue of depression among cancer patients with the urgency it deserves to ensure that the quality of life of the patients improves and better outcomes are realized.

One important approach to depression among cancer patients is spirituality and religiosity. Patients suffering from cancer and depression encounter dilemmas of different types. They are confused between taking medications or praying to receive healing. Others view depression as a punishment from God. A combination of cancer and depression is characterized by hopelessness, self-pity, pessimism, emptiness, and doubts in the existence of God (Bener, Alsulaiman, Doodson, and Agathangelou, 2017). On the other hand, Religiosity and spirituality give patients some sense of fulfillment and emotional comfort. Despite being put through the conventional psychiatric care, cancer patients suffering from depression need to find a balance between conventional care and their spirituality. Apart from depression, these patients are also suffering from terminal illnesses. Therefore, they need answers whose questions cannot be answered by the psychiatric care.

To ensure that patients find a consensus between conventional cancer and psychiatric care and their spiritual wellness, spirituality and religiosity should be properly integrated into the care process. Different religious affiliations are structured in a manner that will give their followers hope and resilience to conquer different challenges that they face in their lives. Different studies have been conducted to ascertain the impact of spirituality and religiosity on patients suffering from depression. According to a study conducted by Vitorino et al. (2018), there was a close relationship between low depression scores and spirituality. The study also established a correlation between high depression scores and lack of spirituality among patients suffering from depression. Using the linear regression model, the study found out that negative spiritual and religious coping was positively correlated with depressive symptoms. Cancer patients who had depressive symptoms were positively correlated with negative spiritual and religious coping at 16.1%. However, cancer patients who had positive spiritual and religious coping did not show any depressive symptoms during the study.

In another study conducted by Santos et al. (2017), 27.3% of the participants had depression. The study further found out that patients with higher spiritual and religious coping had a negative correlation with symptomatic depression. There was a negative correlation coefficient of -0.200 between depression and spiritual and religious coping among patients with high spiritual and religious coping. Additionally, this study established a negative correlation between negative religious and spiritual coping scores and the social health of the patients. furthermore, a negative correlation of r=0.214 was identified between religious and spiritual coping and mental health. This shows that religious and spiritual coping not only improves the depression among cancer patients but also improves other health domains of the patients such as their social skills.

Finally, a study conducted by Safavi, Yahyavi, Narab, and Yahyavi (2019) to investigate the association between spiritual intelligence and depression coping among cancer patients, there was an inverse correlation between spiritual intelligence and depression. According to the study, the correlation coefficient between depression and spiritual intelligence was -0.307. These studies show the close relationship between religious and spiritual coping and the wellbeing of patients suffering from depression resulting from cancer. However, spiritual and religious coping not only apply to cancer patients with depression. Coupling psychotherapy with spiritual interventions will ensure that cancer patients suffering from both mild or symptomatic depression find comfort, consolation, and hope beyond the therapy sessions. Through this intervention, patients can gain self-esteem, confidence, and improve their self-control. Furthermore, they can navigate grieving and suffering through different motivating aspects of spirituality and religiosity. Also, they can establish a better relationship with God and fellow humans hence eliminating negative factors such as hopelessness and doubts (Cassella, 2019).

References

Bener, A., Alsulaiman, R., Doodson, L., and Agathangelou, T., 2017. Depression, Hopelessness, and Social Support among Breast Cancer Patients: in Highly Endogamous Population. Asian Pac J Cancer Prev, 18(7).

Cassella, C., 2019. Spiritual Beliefs Are Linked To A 'Protective' Effect Against Depression In The Brain. [online] ScienceAlert. Available at: <https://www.sciencealert.com/spiritual-or-religious-beliefs-may-act-like-a-buffer-against-depression-in-the-brain> [Accessed 30 September 2020].

Gu, W., Xu, Y., Zhu, J. and Zhong, B., 2017. Depression and its impact on health-related quality of life among Chinese in patients with lung cancer. Gu, W., Xu, Y. M., Zhu, J. H., & Zhong, B. L. (2017). Depression and its impact on health-related quality of life among Chinese inpatients with lung cancer. Oncotarget, 8(62), 104806–104812. https://doi.org/10.18632/oncotarget.21001, 8(62).

National Cancer Institute. 2020. Feelings And Cancer. [online] Available at: <https://www.cancer.gov/about-cancer/coping/feelings> [Accessed 30 September 2020].

Nikbakhsh, N., Moudi, S., Abbasian, S. and Khafri, S., 2014. Prevalence of depression and anxiety among cancer patients. Caspian Journal of Internal Medicine, 5(3).

Rosenstein, D., 2011. Depression and end-of-life care for patients with cancer. Dialogues in Clinical Neuroscience, 13(1).

Safavi, M., Yahyavi, S., Narab, H. and Yahyavi, S., 2019. Association between spiritual intelligence and stress, anxiety, and depression coping styles in patients with cancer receiving chemotherapy in university hospitals of Tehran University of medical science. Journal of Cancer Research and Therapeutics, 15(5).

Santos, P., Capote Júnior, J., Filho, J., Ferreira, T., Filho, J. and Oliveira, S., 2017. Religious coping methods predict depression and quality of life among end-stage renal disease patients undergoing hemodialysis: a cross-sectional study. BMC Nephrol, 18(127).

Vitorino, L., Lopes-Júnior, L., Oliveira, G., Tenaglia, M., Brunheroto, A., Cortez, P. and Lucchetti, G., 2018. Spiritual and religious coping and depression among family caregivers of pediatric cancer patients in Latin America. Psychooncology, 27(8).