Warning: mkdir(): Permission denied in /home/virtual/lib/view_data.php on line 81

Warning: fopen(upload/ip_log/ip_log_2024-11.txt): failed to open stream: No such file or directory in /home/virtual/lib/view_data.php on line 83

Warning: fwrite() expects parameter 1 to be resource, boolean given in /home/virtual/lib/view_data.php on line 84
The Effectiveness of Problem-Solving Therapy Program Intervention in Reducing Depression of Older Cancer Patients

The Effectiveness of Problem-Solving Therapy Program Intervention in Reducing Depression of Older Cancer Patients

Article information

Korean J Health Promot. 2018;18(1):60-70
Publication date (electronic) : 2018 March 31
doi : https://doi.org/10.15384/kjhp.2018.18.1.60
1Department of Social Welfare, Hallym University, Chuncheon, Korea.
2Hallym University Institute of Aging, Hallym University, Chuncheon, Korea.
3Department of Social Welfare, Sungkonghoe University, Seoul, Korea.
Corresponding author: Yojin Kim, PhD. Department of Social Welfare, Hallym University, 1 Hallimdaehak-gil, Chuncheon 24252, Korea. Tel: +82-33-248-1336, Fax: +82-33-248-1776, k96jin@hallym.ac.kr
Received 2017 May 16; Accepted 2018 February 08.

Abstract

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.

Notes

This work was supported by the National Research Foundation of Korea Grant funded by the Korean Government (NRF-2014-S1A5B6A02048942).

References

1. Oh CM, Won YJ, Jung KW, Kong HJ, Cho H, Lee JK, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2013. Cancer Res Treat 2016;48(2):436–450.
2. Kolva E, Rosenfeld B, Pessin H, Breitbart W, Brescia R. Anxiety in terminally ill cancer patients. J Pain Symptom Manage 2011;42(5):691–701.
3. Derogatis LR, Morrow GR, Fetting J, Penman D, Piasetsky S, Schmale AM, et al. The prevalence of psychiatric disorders among cancer patients. JAMA 1983;249(6):751–757.
4. de Jonge P, Ormel J, Slaets JP, Kempen GI, Ranchor AV, van Jaarsveld CH, et al. Depressive symptoms in elderly patients predict poor adjustment after somatic events. Am J Geriatr Psychiatry 2004;12(1):57–64.
5. Cho J, Choi EK, Kim SY, Shin DW, Cho BL, Kim CH, et al. Association between cancer stigma and depression among cancer survivors: a nationwide survey in Korea. Psychooncology 2013;22(10):2372–2378.
6. Yang YL, Liu L, Wang Y, Wu H, Yang XS, Wang JN, et al. The prevalence of depression and anxiety among Chinese adults with cancer: a systematic review and meta-analysis. BMC Cancer 2013;13:393.
7. Jorm AF. History of depression as a risk factor for dementia: an updated review. Aust N Z J Psychiatry 2001;35(6):776–781.
8. Ell K, Xie B, Wells A, Nedjat-Haiem F, Lee PJ, Vourlekis B. Economic stress among low-income women with cancer: effects on quality of life. Cancer 2008;112(3):616–625.
9. Lim YO, Yoon HS, Nam IS, Kim YJ, Lee HJ, Choi KW. Stress process of older cancer patient's depression undergoing Chemotherapy: focus on spirituality, optimism, and family support. J Korean Gerontol Soc 2014;34(4):821–842.
10. Park KS, Choi ES. Problem-Solving Therapy: A Positive Approach to Clinical Intervention. Seoul: HAKJISA corp; 2008. p. 139–143. .
11. Zhang AY, Cooper GS. Recognition of depression and anxiety among elderly colorectal cancer patients. Nurs Res Pract 2010;2010:693961.
12. Gellis ZD, Bruce ML. Problem solving therapy for subthreshold depression in home healthcare patients with cardiovascular disease. Am J Geriatr Psychiatry 2010;18(6):464–474.
13. Areán PA, Raue P, Mackin RS, Kanellopoulos D, McCulloch C, Alexopoulos GS. Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction. Am J Psychiatry 2010;167(11):1391–1398.
14. Nezu AM, Nezu CM, Houts PS, Friedman SH, Faddis S. Relevance of problem-solving therapy to psychosocial oncology. J Psychosoc Oncol 1999;16(3-4):5–26.
15. Nezu AM, Nezu CM, Felgoise SH, McClure KS, Houts PS. Project Genesis: assessing the efficacy of problem-solving therapy for distressed adult cancer patients. J Consult Clin Psychol 2003;71(6):1036–1048.
16. Hopko DR, Armento ME, Robertson SM, Ryba MM, Carvalho JP, Colman LK, et al. Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: randomized trial. J Consult Clin Psychol 2011;79(6):834–849.
17. Fann JR, Fan MY, Unützer J. Improving primary care for older adults with cancer and depression. J Gen Intern Med 2009;24Suppl 2. :S417–S424.
18. Malouff JM, Thorsteinsson EB, Schutte NS. The efficacy of problem solving therapy in reducing mental and physical health problems: a meta-analysis. Clin Psychol Rev 2007;27(1):46–57.
19. Bell AC, D'Zurilla TJ. Problem-solving therapy for depression: a meta-analysis. Clin Psychol Rev 2009;29(4):348–353.
20. Nezu AM, D'Zurilla TJ. Problem-solving therapy : a positive approach to clinical intervention New York: Springer Publishing Company; 2006.
21. Advancing Integrated Mental Health Solutions (AIMS) CENTER. IMPACT: Improving Mood -- Promoting Access to Collaborative Treatment [Internet] Seattle: AIMS CENTER; Mar 15, 2017. Available from: http://aims.uw.edu/impact-improving-mood-promoting-access-collaborative-treatment.
22. Yoon HS, Koo BM, Lee K, Lee JY. The effectiveness of problem-solving treatment on geriatric depression. J Korean Gerontol Soc 2010;30(3):871–894.
23. Lee HK. Handbook of Positive psychology Seoul: HAKJISA corp; 2008.
24. Irwin M, Artin KH, Oxman MN. Screening for depression in the older adult: criterion validity of the 10-item center for epidemiological studies depression scale (CES-D). Arch Intern Med 1999;159(15):1701–1704.
25. Kim HS, Park SM, Jang SN, Kwon S. Depressive symptoms, chronic medical illness, and health care utilization: findings from the Korean Longitudinal Study of Ageing (KLoSA). Int Psychogeriatr 2011;23(8):1285–1293.
26. D'Zurilla TJ, Nezu AM, Maydeu-Olivares Cancer. Social problem-solving inventory Revised (SPSI-R): Technical manual North Tonawanda: Multi-Health Systems; 2002.
27. Kim SY. Statistical analysis based on experimental studies In : Survey Research Spring Conference; June 9, 2007; Seoul National University. Seoul: The Korean Association for Survey Research; 2007.
28. Baer RA. Mindfulness training as a clinical intervention: a conceptual and empirical review. CLIN PSYCHOL-SCI PR 2003;10(2):125–143.
29. Panza F, Frisardi V, Capurso C, D'Introno A, Colacicco AM, Imbimbo BP, et al. Late-life depression, mild cognitive impairment, and dementia: possible continuum? Am J Geriatr Psychiatry 2010;18(2):98–116.
30. Richard E, Reitz C, Honig LH, Schupf N, Tang MX, Manly JJ, et al. Late-life depression, mild cognitive impairment, and dementia. JAMA Neurol 2013;70(3):374–382.

Article information Continued

Funded by : National Research Foundation of Koreahttp://dx.doi.org/10.13039/501100003725
Award ID : NRF-2014-S1A5B6A02048942

Table 1

Organization and contents of sessions

Table 1

Table 2

General and disease characteristicsa

Table 2

Abbreviations: GIST, gastrointestinal stromal tumor; GB, gallbladder.

Values are presented as number (%) unless otherwise indicated.

aP-values using the results of the fisher's exact test.

Table 3

Normality test in experimental and control group

Table 3

Abbreviations: W, Shapiro-Wilk's W statistic; CES-D10, Center for Epidemiological Studies Depression 10 Scale.

The normality test was performed using the Shapiro-Wilk test.

Table 4

Pre-homogeneity test of experimental and control group

Table 4

Abbreviations: CES-D10, Center for Epidemiological Studies Depression 10 Scale.

Table 5

Correlation between major variables, depression and social problem solving ability

Table 5

Abbreviations: CES-D10, Center for Epidemiological Studies Depression 10 Scale; SPS, social problem solving; PPO, positive problem orientation; NPO, negative problem orientation; RPS, rational problem solving style; ICS, impulsive careless style.

Analysis was used to Spearman's correlation sign ranked.

aP<0.01, bP<0.05.

Table 6

Pre and post-ranking analysis of CES-D10 (depression) and social problem solving ability

Table 6

Abbreviations: CES-D10, Center for Epidemiological Studies Depression 10 Scale; N, number; Exp., experimental group; Cont., control group. When comparing pretest and posttest of experimental and control group was used for nonparametric statistics of Wilcoxon signed rank test (posttest-pretest).

aPosttest<pretest.

bPosttest=pretest.

cPosttest>pretest.

dBased on positive ranks.

eBased on negative ranks.