Improving palliative care through psychosocial intervention

Researchers from the University’s Institute of Psychology, Health and Society have found a psychosocial interventions with palliative care patients can help to reduce depression.

Depression in palliative care patients is common, difficult to assess, and treatment is complex. There are several known risk factors for depression in those with cancer, including younger age and a history of receiving psychological treatment.

Depression impairs quality of life and can cause earlier mortality in palliative care populations.

Focused interventions

A ‘psychosocial intervention’ is a broad term used to describe different ways to support people to overcome challenges and maintain good mental health. These interventions do not involve the use of medication.

Researchers, led by Professor Mari Lloyd-Williams, who leads the Academic Palliative and Supportive Care Studies Group  conducted a pilot trial (DISCERN) to determine the effect a focused psychosocial intervention had on depression in palliative care patients when used in addition to usual care.

Palliative care patients are often asked to fill in a multiple-choice self-report questionnaire (Patient Health Questionnaire-9 (PHQ-9)) that is used as a screening and diagnostic tool for mental health disorders.

Greater reduction

Researchers examined the initial and follow-up results of 57 palliative care patients aged over 18 recruited from hospice day care services.

Out of 57 participating patients (71% female), with mean age 65.1 years (range 36–88 years), 33 patients were randomised to the intervention and 24 to usual care only.

Patients receiving intervention had greater reduction in PHQ-9 score indicating depression at six-week follow-up. On average patients who received intervention lived longer than those in the control group (157 days compared to 102 days).

Longer survival

Professor Lloyd-Williams, said: “This study suggests a focused narrative intervention in palliative care patients with moderate to severe depression can reduce depression scores more than usual care alone.

“Patients receiving intervention also appeared to have longer survival. These results support the need for a fully powered trial.”

The full study, entitled ‘Pilot randomised controlled trial of focused narrative intervention for moderate to severe depression in palliative care patients: DISCERN trial’, can be found here.

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