BACKGROUND: Appropriate intervention has not been developed and implemented because depression has been overlooked for older cancer patients. However, because depression is prevalent among this population, the need for the intervention is high. The objective of this study was to verify the effectiveness of the problem-solving therapy program in reducing depression level for older cancer patients. METHODS: The experimental participants were recruited by social workers in five university hospitals in Seoul, Gyeonggi, and Gangwon. Using Patient Health Questionnaire-9 (PHQ-9), older cancer patients who scored between 10–19 points are selected. The subjects were assigned to the experimental group (30 patients) and the control group (30 patients) according to their will, and the experimental group participated in the problem solving therapy program for 6 weeks. The Center for Epidemiological Studies Depression 10 Scale and the Social Problem Solving Ability Scale were used to verify the effectiveness of the problem-solving program. RESULTS: The group homogeneity test indicated that the experimental group and the control group are homogeneous. The results of this study showed that the depression of older cancer patients had a significant positive correlation with the negative attitude toward the problem. The effectiveness of the problem solving program was significantly reduced in the experimental group (Z=−3.534, P < 0.001). And the social problem solving ability of experimental group was significantly improved (Z=−2.908, P=0.003). CONCLUSIONS: The problem-solving therapy program is effective for depression in geriatric cancer patients and this result suggests that it can be implemented as an alternative medical treatment.
Depression ; Epidemiologic Studies ; Gangwon-do ; Gyeonggi-do ; Hospitals, University ; Humans ; Problem Solving ; Seoul ; Social Problems ; Social Work ; Social Workers

BACKGROUND: Appropriate intervention has not been developed and implemented because depression has been overlooked for older cancer patients. However, because depression is prevalent among this population, the need for the intervention is high. The objective of this study was to verify the effectiveness of the problem-solving therapy program in reducing depression level for older cancer patients. METHODS: The experimental participants were recruited by social workers in five university hospitals in Seoul, Gyeonggi, and Gangwon. Using Patient Health Questionnaire-9 (PHQ-9), older cancer patients who scored between 10–19 points are selected. The subjects were assigned to the experimental group (30 patients) and the control group (30 patients) according to their will, and the experimental group participated in the problem solving therapy program for 6 weeks. The Center for Epidemiological Studies Depression 10 Scale and the Social Problem Solving Ability Scale were used to verify the effectiveness of the problem-solving program. RESULTS: The group homogeneity test indicated that the experimental group and the control group are homogeneous. The results of this study showed that the depression of older cancer patients had a significant positive correlation with the negative attitude toward the problem. The effectiveness of the problem solving program was significantly reduced in the experimental group (Z=−3.534, P < 0.001). And the social problem solving ability of experimental group was significantly improved (Z=−2.908, P=0.003). CONCLUSIONS The problem-solving therapy program is effective for depression in geriatric cancer patients and this result suggests that it can be implemented as an alternative medical treatment.

BACKGROUND: Numerous studies have demonstrated that spirituality has protective effects on depression. However, there are only few studies on the theoretical mechanism showing how spirituality effects on depression. Thus, to find mediating variables explaining the relationship between the spirituality and depression may help to develop appropriate program for reducing depression in elderly cancer patients. In this study, we examined the effect of optimism and pessimism as their mediating effects on depression. METHODS: This study is to verify the relationships between spirituality and depression along with the mediating effects of optimism and pessimism among 600 South Korean elderly cancer patients who participated in a community-based study about their mental health. RESULTS: Optimism and pessimism are linked with spirituality and depression. Higher spirituality levels were associated with increased optimistic thinking, and then optimistic thinking is associated with low possibility of depression, whereas lower spirituality levels were associated with more pessimistic thinking, and in turn pessimistic thinking is associated with high depression scores. CONCLUSIONS: Understanding optimism and pessimism affecting depression level is critical for developing spirituality-based programs to reduce depression in elderly cancer patients.
Aged* ; Depression* ; Humans ; Mental Health ; Negotiating* ; Optimism* ; Pessimism* ; Spirituality* ; Thinking

BACKGROUND: The study examined the correlations among the results of the European Organization for Research and Treatment of Cancer (EORTC)-Quality of Life Questionnaire, Core 30 (QLQ-C30) completed by elderly cancer patients and their family caregivers and the Eastern Cooperative Oncology Group (ECOG)-performance status (PS) evaluated by medical doctors. METHODS: The study sample included 269 persons with cancer aged 55 years or older and their family caregivers recruited from hospitals located in Seoul and Gyeonggi-do. The results of the ECOG-PS evaluated by medical doctors were obtained from medical records. Intra-class correlation analysis was used to assess rater reliability between the elderly cancer patients and their family caregivers. Correlations among the EORTC QLQ-C30 and the ECOG-PS were tested using the Kruskal-Wallis test and Spearmen's correlation. RESULTS: The results showed that four subscales of quality of life (physical functioning, emotional functioning, social functioning, and global health status) and three items under symptoms (fatigue, pain, and financial difficulties) in the EORTC QLQ-C30 were highly consistent between patients and their family caregivers. From the EORTC QLQ-C30 results, social functioning, role functioning, health status, fatigue, pain, and appetite loss (patients results) and physical functioning (family caregivers results) were highly consistent with the results of the ECOG-PS by the physicians. CONCLUSIONS: The findings suggest that when the older persons with cancer have difficulty expressing their own thoughts or feelings, the EORTC QLQ-C30 completed by their family caregivers and the results of the ECOG-PS completed by the physicians could be used as substitutes.
Aged ; Appetite ; Caregivers* ; Fatigue ; Gyeonggi-do ; Humans ; Medical Records ; Medical Staff* ; Quality of Life* ; Seoul

BACKGROUND: This research is an exploratory study that is based on previous studies focusing on relationship between the doctors and the elderly cancer patients; moreover, the research focuses on the doctors' negative attitudes and discriminative behaviors towards the elderly cancer patients so that we may be able to suggest the ways to decrease the ageism. METHODS: Qualitative method and quantitative method were applied sequently. In this research, we practiced in-depth interviews with 8 doctors and then the surveys with 274 doctors. The in-depth interview questions were categorized depending on meaningful testimonies and the survey data were analyzed in the descriptive statistic analysis and paired t-test using PASW statistics 18. RESULTS: Through the in-depth interviews, the following is observed: the doctors rarely notify the elderly cancer patients directly; the family members of patients avoids the doctors to do so; and the doctors even show different attitudes or discriminatory actions to the elderly. Based on the in-depth interview results, the questions on notifying methods of the diagnosis and how to explain for treatment were developed and performed as a survey. Through the survey, only 8.4% of the doctors reported they directly notify the elderly cancer patient; moreover, they also reported they provide less information on treatment, side-effects, prognosis, and medical cost to the elderly than the middle-aged. CONCLUSIONS: This research not only discovered the presence of discrimination towards the elderly cancer patients but also suggested the causes of it. In order to resolve the phenomenon, doctors must consider individualized difference and variability of physiological function and should be aware of the psychological change after the cancer diagnosis to better communicate with them. Additionally, the social family culture which overprotects the elderly must be changed.
Aged* ; Ageism* ; Diagnosis* ; Disclosure* ; Discrimination (Psychology) ; Humans ; Methods ; Prognosis

BACKGROUND: This study examined moderating effects of optimism and family support on the depression of family caregivers of cancer patients aged 55 and over by adopting stress process model. METHODS: 359 family caregivers who accompanied with cancer patients to out-patient clinics were recruited and completed questionnaire at three university hospitals located in Seoul and Gyeonggi province. Exploratory factor analysis was applied to test validity of the construction of the scale. Hierarchical multiple regression analysis was used to determine moderating effects of optimism and family support on depression after making mean centering of each variable. RESULTS: Results showed that spouse caregivers have more depression than do adult children as the nursing period gets longer. Education and income status were significant variables affecting depression of family caregivers. Optimism and family support for family caregivers have moderating effects on the association between stressors (emotional functioning of cancer patients and role overload of family caregivers) and depression of family caregivers. CONCLUSIONS: The findings suggest that more attentions are needed to the depression of spouse caregivers. Interventions are strongly recommended for health professionals to provide cancer patients and their family caregivers with "holding environments" caring for emotions and facilitating adjustment.
Adult Children ; Attention ; Caregivers* ; Depression* ; Education ; Gyeonggi-do ; Health Occupations ; Hospitals, University ; Humans ; Nursing ; Optimism* ; Outpatients ; Seoul