title: Palliative medicine practitioners' views on the concept of depression in the palliative care setting.
abstract: BACKGROUND
  Despite its clinical importance in palliative care, depression remains an ambiguous concept.
  
  
  OBJECTIVE
  The purpose of this study was to explore how medical practitioners working in palliative care conceptualize depression in that setting.
  
  
  METHODS
  Medical practitioners who attended a palliative medicine conference (N=185) were invited to respond to a questionnaire, which explored their views on the concept of depression in the palliative care context. Descriptive statistics were used to summarize responses, and comparison between groups was conducted using nonparametric statistics. Themes in free-text comments were identified.
  
  
  RESULTS
  Seventy-nine responses were obtained (response rate 43%). Depression was not a unified concept, but was generally considered to be an illness with psychological, spiritual, and existential causes. Respondents were more uncertain about depression being an illness in the palliative care setting compared with other settings, and were ambivalent about its causality. Treatment preferences leaned towards psychological interventions. Depression being different in the palliative care setting was a theme. It was considered to be more prevalent, different in quality, harder to define, and associated with greater barriers to diagnosis and treatment. Conceptual differences were associated with the respondents' area of work, work position, duration of practice, and previous mental health training.
  
  
  CONCLUSIONS
  Depression in the palliative care setting is a variable concept for palliative medicine practitioners. The conceptual diversity and complexities of depression in this setting must be acknowledged and further explored in order to develop nuanced approaches in clinical practice and in research.
authors.affiliation: Discipline of Psychiatry, University of Adelaide, Adelaide, Australia. felicity.ng@adelaide.edu.au
authors.forename: Felicity
authors.initials: F
authors.lastname: Ng
authors.forename: Gregory B
authors.initials: GB
authors.lastname: Crawford
authors.forename: Anna
authors.initials: A
authors.lastname: Chur-Hansen
mesh_terms: D001291:Attitude of Health Personnel; D001315:Australia; D003863:Depression / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D009520:New Zealand; D010166:Palliative Care / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D019452:Terminally Ill / Q000523:psychology*; D000078329:Workforce