1344P - Increasing clinical depression over the dying process is not inevitable but is associated with mounting disease burden, tangible social support, an...

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Psychosocial Aspects of Cancer
Palliative Care
Presenter Siew Tzuh Tang
Citation Annals of Oncology (2014) 25 (suppl_4): iv471-iv477. 10.1093/annonc/mdu350
Authors S.T. Tang1, J. Chen2, W. Chou2, K. Lin3
  • 1School Of Nursing, Chang Gung University, 333 - Tao-Yuan/TW
  • 2Division Of Hematology-oncology, Chang Gung Memorial Hospital, Tao Yun/TW
  • 3Department Of Health Care And Management, National Taipei University of Nursing and Health Science, Taipei/TW



Terminally ill cancer patients experience progressive functional decline, accelerating symptom severity, deteriorating social support, and perceived sense of burden to others (SPB), predisposing them to suffer from depressive symptoms. However, changes in the prevalence of clinical depression over the dying process and the unique roles of these four variables have not often been studied together. The purposes of this study were to explore the longitudinal changes in and the impact of symptom distress, functional dependence, social support, and SPB on the prevalence of clinical depression over the dying process.


A convenience sample of 323 cancer patients was followed until death. Prevalence of clinical depression was identified as scoring >11 on the depression subscale of the Hospital Anxiety and Depression Scale. Longitudinal changes in and determinants of clinical depression were examined by a multivariate logistic regression model with the generalized estimating equation.


The prevalence of clinical depression increased as death approached. However, clinical depression over the dying process was not determined by time proximity to patient death after confounding factors were controlled. In contrast, the likelihood of experiencing clinical depression was significantly higher in patients who had a higher level of symptom distress and functional dependence, received greater tangible support, and reported high SPB, but lower for patients reporting a higher level of affectionate support and positive social interaction with their supportive network.


Conclusion: Increasing clinical depression as death approaches is not inevitable but is associated with accelerating disease burden, greater tangible social support, and increased SPB.


All authors have declared no conflicts of interest.