Author Affiliations: Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center (Drs McClintock and Howe-Martin), Dallas, Texas; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine (Dr McClintock), Durham, North Carolina; College of Nursing, University of South Carolina (Dr Dail), Columbia, South Carolina; Moncrief Cancer Institute, UT Southwestern Medical Center (Dr Howe-Martin); Duke Clinical Research Institute (Dr Mann), Durham, North Carolina; and Duke University School of Nursing (Dr Bailey), Durham, North Carolina.
Cancer Nurs. 2023;46(3):E146-E158. doi: 10.1097/NCC.0000000000001056. Epub 2022 Jan 27.
High-dose interleukin-2 is a therapy available for individuals with renal cell carcinoma; however, it can produce adverse effects, specifically depressive symptoms. There is limited information regarding the trajectory of depressive symptoms and measurement-based care assessment of depressive symptoms.
The purpose was to describe the trajectory of depressive symptoms and compare 2 depression measures.
A descriptive, mixed-method case study approach was used to describe the longitudinal trajectory of depressive symptoms The qualitative assessment included a journal entry and an interview. The quantitative depression symptom severity measures included the 8-item self-report Patient-Reported Outcomes Measurement Information System Depression and the 30-item Inventory of Depressive Symptomatology-Clinician Rated (IDS-C).
Ten cases were enrolled. The maximum number of interleukin-2 doses that any patient received within a single hospitalization ranged from 4 to 12. Mean scores on the 8-item Patient-Reported Outcomes Measurement Information System Depression showed no changes in depressive symptoms from pretreatment to posttreatment, nor across hospitalizations. Mean total scores on the IDS-C increased from "normal" to "mild severity" depressive symptom range across all treatment cycles, suggesting transient depressive symptoms within hospitalizations. Qualitative data from the case supported the IDS-C increase, suggesting that the patient developed depressive symptoms pretreatment to posttreatment.
Understanding the trajectory of depressive symptoms allows for the identification of critical time points when depressive symptoms present and change across treatment. It is critical to use measurement-based care using validated measures to assess for the presence and changes in depressive symptoms.
Validated self-report or clinician-rated depression symptom measures should be used to document the presence or absence of depressive symptoms in this population.
高剂量白细胞介素-2 是一种可用于治疗肾细胞癌患者的疗法；然而，它会产生不良反应，特别是抑郁症状。关于抑郁症状的轨迹和基于测量的抑郁症状护理评估的信息有限。
描述抑郁症状的轨迹并比较两种抑郁测量方法。
采用描述性、混合方法的病例研究方法来描述抑郁症状的纵向轨迹。定性评估包括日记条目和访谈。定量抑郁症状严重程度的测量方法包括 8 项自评患者报告的结局测量信息系统抑郁量表和 30 项抑郁症状清单-临床医生评定（IDS-C）。
共纳入 10 例病例。任何患者在单次住院期间接受白细胞介素-2 剂量的最大值范围从 4 到 12。8 项自评患者报告的结局测量信息系统抑郁量表的平均得分表明，从治疗前到治疗后，以及在整个住院期间，抑郁症状均无变化。IDS-C 的总平均得分从所有治疗周期的“正常”到“轻度严重”抑郁症状范围增加，表明住院期间存在短暂的抑郁症状。病例的定性数据支持 IDS-C 的增加，表明患者在治疗前到治疗后出现了抑郁症状。
了解抑郁症状的轨迹可以识别出治疗过程中出现和变化的关键时间点。使用基于测量的护理并使用经过验证的测量方法来评估抑郁症状的存在和变化至关重要。
应使用经过验证的自评或临床医生评定的抑郁症状测量方法来记录该人群中抑郁症状的存在或不存在。
