Intervention for depression among palliative care patients and their families: A study protocol for evaluation of a training program for professional care staff

Abstract

BackgroundClinical depression is highly prevalent yet under-detected and under-treated in palliative care settings and is associated with a number of adverse medical and psychological outcomes for patients and their family members. This article presents a study protocol to evaluate a training intervention for non-physician palliative care staff to improve the recognition of depression and provide support for depressed patients and their family members. Details of the hypotheses and expected outcomes, study design, training program development and evaluation measures are described.Methods and DesignA randomised controlled trial will be implemented across two palliative care services to evaluate the "Training program for professional carers to recognise and manage depression in palliative care settings". Pre-, post- and three-month follow-up data will be collected to assess: the impact of the training on the knowledge, attitudes, self-efficacy and perceived barriers of palliative care staff when working with depression; referral rates for depression; and changes to staff practices. Quantitative and qualitative methods, in the form of self-report questionnaires and interviews with staff and family members, will be used to evaluate the effectiveness of the intervention.DiscussionThis study will determine the effectiveness of an intervention that aims to respond to the urgent need for innovative programs to target depression in the palliative care setting. The expected outcome of this study is the validation of an evidence-based training program to improve staff recognition and appropriate referrals for depression, as well as improve psychosocial support for depressed patients and their family members.Trial RegistrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610000183088

Detecting and Managing Depressed Patients: Palliative Care Nurses' Self-Efficacy and Perceived Barriers to Care

“…Questionnaires incorporating these reported items and measures of self-efficacy and perceived barriers to care were distributed to palliative care nurses to complete as part of the baseline measures of another study. 15 No incentives were offered for participatation.…”

“…12 Despite these nurses recognizing depression as a common issue and identifying the need for further training, 13 a minority of nurses actually receive specialized training in working with depressed patients and their families, 13,14 and there exist few evaluated training interventions. 15 If these training interventions within palliative services are to be effective, they must target areas in which nurses have difficulty, and provide education or training relating to specific barriers to care. To date, several factors that relate to nurses' confidence and skills in working with depressed patients, and barriers to providing pathways to treatment, have been recognized.…”

“…Questionnaires evaluating these variables were developed and distributed to palliative care nurses as part of a larger study designed to implement and evaluate a training program for professional carers working in palliative care settings. For a study protocol see Hallford et al 15 The current study reports these nurses' responses relating to their perceived confidence in areas pertaining to the detection and provision of care for depressed patients, and issues they identified as barriers to this process.…”

The influence of sense of control and cognitive functioning in older cancer patients' depression

“…Expert working groups around the world have noted the poor corresponding levels of recognition and treatment of depression in this setting and have identified the need of more effective pathways to treatment and increased provision of care . Although depression is a significant problem among patients receiving palliative care , nevertheless, older people have not been specifically investigated in current cancer studies .…”

Evaluation of A Training Program to Assist Care Staff to Better Recognize and Manage Depression among Palliative Care Patients and Their Families

“…The program was developed from a depression training program for the aged care sector (33,34) and adapted to address palliative care needs identified through both an extensive literature review and the needs analysis outlined earlier. For a description of the program development, please refer to Hallford and colleagues (35).…”