Psychosocial Predictors of Depression Among Older African American Patients With Cancer

Abstract

Purpose To determine whether psychosocial factors predict depression among older African American cancer patients. Design/Methods A descriptive correlational study. Setting Outpatient oncology clinic of NCI designated Cancer Center in Southeastern U.S. Sample African American cancer patients aged 50 and over. Methods Fisher’s Exact and Wilcoxon Rank Sum tests were used to evaluate differences between patients who were possibly depressed (Geriatric Depression Scale) or not. Multivariate linear regression statistics were used to identify the psychosocial factors that predicted higher depression scores. Education and gender were included as covariates. Main Variables Religiosity, emotional support, collectivism, perceived stigma and depression. Findings African American cancer patients (n=77) were on average a median age of 58 years (IQR = 55–65), a majority were well-educated, insured, religiously affiliated, and currently in treatment. Participants in the lowest income category, not married, and male gender had higher depression scores. The multivariable model consisting of organized religion, emotional support, collectivism, education, and gender explained 52% (adjusted R2) of the variation in depression scores. Stigma became insignificant in the multivariable model. Conclusions Psychosocial factors are important predictors of depression. For these participants, emotional support and organized religious activities may represent protective factors against depression, while collectivism may increase their risk. Implications Nurses need to be especially aware of the potential psychological strain for patients with collectivist values, experienced stigma, disruptions in church attendance and lack of emotional support. Further, these treatment plans for these patients should ensure that family members are knowledgeable about cancer, its treatment and side effects so they are empowered to meet the needs for support of the African American cancer patient.

Who Can I Turn To? Emotional Support Availability in African American Social Networks

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Preoperative Level of Depression is a Predictor of Postoperative Levels of Depression in Patients with Head and Neck Cancer

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