Holistic perspective of depression and anxiety among a community palliative care population

Palliative care patients can experience a wide range of physical and psychological symptoms. Depression and anxiety are two psychological problems reported to occur in palliative care patients (Massie, 1989). With the increasing trend towards community care, approaches to identify and explore psychological symptoms are necessary. This study set out to explore and describe the extent and associated risk factors which contribute to the development of depression and anxiety among a community palliative care population. The impact of depression and anxiety as experienced by seven community palliative care patients was explored. The findings from this research highlight the fact that depression and anxiety were a significant symptom among 75 community palliative care patients, with the extent of depression reported at two periods as 19% and 25% and anxiety reported as 16% and 17%. Logistic regression analysis revealed a previous history of depression and a family history of anxiety were the risk factors identified as predictors of future psychological distress. The experience of depression and anxiety among the seven participants was described using unstructured interviews as a reduction in their quality of life and their fear of living with an uncertain future. Despite the hardships faced by these participants, descriptions of how they were able to ""hold on' to their remaining life was revealed. Implications for clinical nursmg practice identified in this research include the importance of psychological assessment, the importance of using screening tools, the importance for nurses to include the family/carers in the on-going assessment and for nurses to incorporate a holistic approach to management of concerns voiced by their patients.

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