Nurses' recognition of depression in their patients with cancer.
OBJECTIVE
To determine the degree to which nurses recognize levels of depressive symptoms in their patients with cancer and to describe patient characteristics that influence the accuracy of nurses' perceptions of depressive symptoms.


METHODS
Descriptive, prospective correlational design.


METHODS
25 community-based ambulatory oncology clinics affiliated with Community Cancer Care of Indiana.


METHODS
40 clinic nurses rated the depression levels of 1,109 patients.


METHODS
Patients completed the Zung Self-Rating Depression Scale (ZSDS) prior to their medical oncology clinic appointment. Nurses rated their patients' level of depressive symptoms, anxiety, and pain on a 0-10 numerical scale along with determining a performance status score.


METHODS
Patient-rated depression and the nurse depression rating.


RESULTS
The most frequent agreement between nurses and patients was observed when patients reported little or no depressive symptoms. They were only concordant 29% and 14% of the time in the mild and moderate/severe ranges, respectively. Nurses' ratings were influenced most by patients' endorsement of frequent and obvious mood symptoms and nurse ratings of patients' anxiety and pain.


CONCLUSIONS
A marked tendency existed to underestimate the level of depressive symptoms in patients who were more severely depressed. Nurses' ratings were most influenced by symptoms such as crying, depressed mood, and medical factors that are useful but perhaps not the most reliable indicators of depression in this population.


CONCLUSIONS
Nurse assessment of depression might be improved if greater emphasis were placed on the more diagnostically reliable symptoms of depression and if screening tools for depression were incorporated into nursing practice.
McDonald
M V
MV
Community Cancer Care, Inc., Indianapolis, IN, USA.
Passik
S D
SD
Dugan
W
W
Rosenfeld
B
B
Theobald
D E
DE
Edgerton
S
S
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003863:Depression / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007196:Indiana; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology*; D009733:Nursing Diagnosis; D015588:Observer Variation; D011446:Prospective Studies; D012720:Severity of Illness Index