title: Symptoms of depression, sadness and sense of coherence (coping) among cognitively intact older people with cancer living in nursing homes-a mixed-methods study.
abstract: BACKGROUND
  Symptoms of depression are often reported among patients with a cancer diagnosis. Strong sense of coherence (SOC) is shown to be associated with less depression in the general older population and among nursing homes (NH) residents in particular. Knowledge about mixed-methods perspectives that examine symptoms of depression and SOC among cognitively intact NH residents with cancer is scarce.
  
  
  OBJECTIVE
  To investigate symptoms of depression and SOC among NH residents who are cognitively intact and have cancer.
  
  
  METHODS
  We used a quantitatively driven mixed-methods design with sequential supplementary qualitative components. We facilitated the collection of quantitative survey data of 60 NH residents (≥ 65 years) with cancer using the Geriatric Depression Scale (GDS) and SOC scale. The supplementary psychosocial component comprised qualitative research interviews about experiences related to depression with nine respondents from the same cohort.
  
  
  RESULTS
  In fully adjusted multiple regression analysis of the sociodemographic variables, the GDS was significantly correlated with SOC (P < 0.001). The experience of sadness was identified by the following theme: sadness. Coping with the experience of symptoms of depression was dominated by coping with sadness.
  
  
  CONCLUSIONS
  More than half the NH residents reported symptoms of depression, and the SOC was associated with reduced symptoms. A mixed-methods design contributed to nuanced and detailed information about the meaning of depression, and the supplementary component informs and supports the core component. To improve the situation of NH residents with cancer, more attention should be paid to the residents' experience of symptoms of depression and their SOC.
authors.affiliation: Faculity of Health and Social Science, Bergen University College, Bergen, Norway; Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
authors.forename: Jorunn
authors.initials: J
authors.lastname: Drageset
authors.affiliation: Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; Centre for Clinical Research, Western Norway Health Region Authority, Bergen, Norway.
authors.forename: Geir Egil
authors.initials: GE
authors.lastname: Eide
authors.affiliation: Faculty of Health and Social Studies and Centre for Caring Research-Southern Norway, Unversity College of Southeast , Porsgrunn , Norway.
authors.forename: Solveig
authors.initials: S
authors.lastname: Hauge
keywords: Cancer; Coping; Depression; Mix-methods; Nursing home; Sadness