cancer, depression, hospice, symptom distress



  1. McMillan, Susan C. PhD, ARNP, FAAN
  2. Rivera, Henry R. Jr MS, ARNP, AOCNP


The purpose of this project was to evaluate the relationship between depressive symptoms and symptom distress experienced by hospice patients with cancer. A total of 275 hospice patients with cancer were evaluated using the Memorial Symptom Assessment Scale (MSAS), the Center for Epidemiological Study-Depression (CES-D) Scale and a Demographic Data Form. Patients in the sample were mostly white and Christian with a variety of types of cancer with lung cancer being most common. Patients reported an average of 10 symptoms with fatigue, pain, dry mouth, drowsiness, loss of appetite and shortness of breath being reported most frequently. Among the most common symptoms, those with the highest intensity scores were pain and fatigue and with the highest distress scores were fatigue, pain, and shortness of breath. Depressive symptoms reached the cut-off score of 4 for 38% of patients indicating a likelihood of clinical depression. A moderate significant correlation (r = 0.45; P = .000) was found between CES-D scores and total number of symptoms reported and with total symptom distress (r = 0.49; P = .000). Results underscore the continued need for a focus on symptoms in cancer patients, and further delineates the need to ameliorate depressive symptoms in order to enhance quality of life near the end of life.