| Objective：Mental crisis may occur in each period such as diagnosis, treatment, recovery, dying etc.[1]. The prevalence of depression symptoms was much higher than that in nornal and otherpopulation with other diseases. Especially in the palliative care cancer patients, the prevalenceof depression diorder and depression symptoms is becoming higher, as well as a higherlevel[2]. Not only does depression weaken the confidence of being treated, but decreases theadvance cancer patients’ quality of life. In order to impove the effect of treatment in cancerand help the patients with advanced cancer live with quality, it is necessary to reliefdepression. However, current researches mainly qualitatively or quantitatively focus on thefeatures and influencial factors of depression, which leads to current psychological nursingstrategies or models for intervention lacked. Main points of psychological treatment are notprominent, resulting in the lack of antidepressant effect. In this study a qualitative researchand a quatitative research were integratedly used to determine some important factorsassociated with depression and establish a path model. Based on the results, a psychologicalnursing theory model for depression was proposed to provide a theoretical basis for clinicalpractice of psychological nursing care in the palliative care cancer patients.Subjects and Methods：(1) Two doctors, two nurses and two cancer patients were randomly selected andinterviewed in open-ended condition. And a semi-structured questionnaire was formed.(2) A semi-structured interview for5doctors,5nurses，15patients with cancer and5relatives was conducted. The qualitative characteristics in the patients with cancer were gotthrough the united method for many times and code analysis.(3) Beck Depression Iventory, General Condition Questionnaire, Quality of Life Questionnaire and Coping Style Questionnair were adopted to test the patients withadvanced-stage cancer, in order to discuss the relationship between depression and the factorsof the quality of life and the coping style by using Pearson correlation method.(4) A path model was established according to the factors influencing depression in thepalliative care cancer patients.(5) The content of psychological nursing assessment, procedure, method and evaluationof depression were determined, as well as the treatment mode of psychological nursing in thepalliative care cancer patients in this study.Results：(1) Five types of negative emotions and behavior mainly exist in the palliative care cancerpatients in this study. They were depression, anxiety, anger, avoidance and dependence, ofwhich depression was the mostly common.(2) The number of the palliative care cancer patients with the symptoms of majordepression accounted for74.2%in this study, which was significantly larger than that of thepatients with symptoms of moderate depression while comparing different ages（χ2=8.194，χ2=7.323，p<0.05）.(3) BDI scores was negatively related to those in Problem-solving factor andHelp-seeking factor（P<0.01）, positively related to those in Self-blaming factor（P<0.01）in the Coping Style Questionnaire. Compared to female patients, depression was highlyrelated to problem-solving, help-seeking and self-blaming.(4) BDI scores was positively related to those in the role function, the emotional function,the cognitive function, the social function, fatigue, nausea and vomiting, pain, short-breathing,appetite for food, diarrhea（P<0.01）, body and insomnia（P<0.05）,negatively related togeneral health（P<0.01）.The sign of depression was associated with the defficiency of theemotional function, the cognitive function and the physical discomfort in both male andfemale patients. The role function and the social function also decreased in male patients,while female patients often worried about their economy influenced by their own treatment.Radiotherapy and chemotherapy both brought much physical pain to the patients.(5) Self-blaming factor, Problem-solving factor and Help-seeking factor included in thecoping style, the emotional function, the cognitive function, nausea and vomiting, short-breathing, diarrhea included in the quality of life all became the main factors heavilyinfluencing depression.(6) Coping style and quality of life affected the onset of depression both through negativecognition.(7) A psychological nursing theory model for depression was established aiming atrecovering the cognitive function and the emotional function in the palliative care cancerpatients.Conclusion：In this study a variety of methods such as qualitative research, psychologicalmeasurement etc.were integratedly used to determine the mental features and some importantfactors associated with depression in the palliative care cancer patients. Based on thepsychological nursing program, a psychological nursing theory model for depression wasestablished aiming at changing the negative cognition of depression and recovering thecognitive function and the emotional function, which showed a good theoretical and practicalsignificance. |
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