Comparison of Depression Levelbetween Lung Cancer Patients

and Breast Cancer Patientsthat were hospitalized in

Ospital ng Maynila Medical Center

Presented by:Kimberly O. Bacorro

BSCP III-2

Presented to:Dean Nenita F. Buan

Research I Adviser

TABLE OF CONTENTS

CHAPTER 1: THE PROBLEM AND ITS BACKGROUNDIntroductionBackground of the StudyTheoretical FrameworkConceptual FrameworkStatement of the ProblemHypothesisScope and Limitation of the StudySignificance of the StudyDefinition of Terms

CHAPTER 2: REVIEWS OF RELATED LITERATURE AND STUDIESForeign StudiesForeign LiteratureLocal StudiesLocal LiteratureSynthesis of Reviewed Literature and Studies

CHAPTER 3: RESEARCH METHODOLOGYMethods of ResearchDescription of RespondentsResearch InstrumentData Gathering ProcedureAnalysis of Data

CHAPTER 1THE PROBLEM AND IT’S

BACKGROUND

INTRODUCTION

Cancer is a major source of morbidity, mortality, and economic expense. Not only do people with cancer have a higher risk of developing depression, the rate of depression is much higher than in the general population (ADA, 2010). According to GLOBOCAN 2012, lung cancer was the most commonly diagnosed cancer as well as the leading cause of death in males globally. However, breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females worldwide.

Depression is characterized by a number of common symptoms. These include a persistent sad, anxious, or “empty” mood, and feelings of hopelessness or pessimism. A person who is depressed also often has feelings of guilt, worthlessness, and helplessness. They no longer take interest or pleasure in hobbies and activities that were once enjoyed; this may include things like going out with friends or even sex. Insomnia, early-morning awakening, and oversleeping are all common. (Grohol, 2014)

BACKGROUND OF THE STUDY

This study aims to measure the depression level among lung cancer patients compared with breast cancer patients that were hospitalized in Ospital ng Maynila Medical Center. The researcher is going to conduct this study in Ospital ng Maynila Medical Center in accordance to her topic the level of depression among lung cancer patients compared with breast cancer patients in the said institution.

The Ospital ng Maynila Medical Center is a 300-bed non-profit tertiary, general and training hospital in Malate, Manila, Philippines. It is the laboratory hospital of health science students (students of medicine, nursing and physical therapy) enrolled at the Pamantasan ng Lungsod ng Maynila, one of the Philippines' most prestigious universities.

As hospital operated and maintained through taxes paid by Manila residents, OMMC has for its primary concern the admission and treatment of patients who are bonafide residents of the city. Furthermore, it is responsible for the provision of an integrated community health program and in the promotion of scientific excellence through research activities.

THEORETICAL FRAMEWORK

Beck’s model of depression. In particular, Beck (1967) suggests that thinking negatively about oneself, the world, and the future (i.e., the negative triad), may be a primary risk factor associated with depression.

Ellis also noted the presence of information processing biases in depressed people's cognitions. Like Beck he noted that depressed people tend to: ignore positive information, pay exaggerated attention to negative information, and to engage in overgeneralization, which occurs when people assume that because some local and isolated event has turned out badly, that this means that all events will turn out badly.

THEORETICAL FRAMEWORK

Bandura pointed out that depressed people's self-concepts are different from non-depressed people's self-concepts. Depressed people tend to hold themselves solely responsible for bad things in their lives and are full of self-recrimination and self-blame. In contrast, successes tend to get viewed as having been caused by external factors outside of the depressed person's control. In addition, depressed people tend to have low levels of self-efficacy.

Learned Helplessness. According to Seligman, depressed people have learned to be helpless. In other words, depressed people feel that whatever they do will be futile, and that they have no control over their environments. With further study, Seligman modified the learned helplessness theory to incorporate a person's thinking style as a factor determining whether learned helplessness would occur. He suggested that depressed people tended to use a more pessimistic explanatory style when thinking about stressful events than did non-depressed people, who tended to be more optimistic in nature.

People diagnosed with lung cancer and breast cancer tend to have depression. People with few positive reinforcements in their lives tend to become depressed. In the diagram, it stresses that depressed people often lack the social skills needed to obtain reinforcement, such as asking neighbor or friend for help with a problem.

CONCEPTUAL FRAMEWORK

STATEMENT OF THE PROBLEM

This study attempts to determine the Depression Level among Lung Cancer Patients compared with Breast Cancer Patients that were hospitalized in Ospital ng Maynila Medical Center.

Specifically, this research study seeks to answer the following questions:1. What is the profile of the respondents with respect to the following personal dimensions:

1.1 Name1.2 Age1.3 Gender1.4 Specify if lung cancer patient or breast cancer patient1.5 Diagnosis Date

2. What are the levels of depression?3. Which of the lung cancer patients and breast cancer patients have the higher level of depression?4. What are the precipitating factors that cause the depression of the lung cancer patients and breast cancer patients that were hospitalized in Ospital ng Maynila Medical Center?

HYPOTHESES 1. There is no significant difference between depression level of lung cancer patients and breast cancer patients that were hospitalized in Ospital ng Maynila Medical Center. 2. There is no significant difference between having a lung cancer and breast cancer to depression.

SCOPE AND LIMITATION OF THE STUDY

This study delves on the depression level among lung cancer patients compared with breast cancer patients hospitalized in Ospital ng Maynila Medical Center.

This study is however limited to 100 lung cancer patients and 100 breast cancer patients in Ospital ng Maynila Medical Center.

SIGNIFICANCE OF THE STUDY

The researchers aim to seek the importance of Depression Level among Lung Cancer Patients compared with Breast Cancer Patients hospitalized in Ospital ng Maynila Medical Center. This study will be a significant endeavor to the following:

• For the researchers themselves, the study will serve as their guide when they got the chance to work on the same institution and it will serve as stepping stones toward future studies regarding Depression Level among Lung Cancer patients and Breast Cancer patients.

• To the students who wants to conduct and continue the study for further clarifications.

• For the professors who will direct their students who want to conduct the same study.

• To Polytechnic University of the Philippines, this study will give pride and honor in the University because the students will once again prove their acquired wisdom to conduct this kind of study.

• Finally, to the society, this study will enlighten each and everyone not to judge easily those lung cancer patients and breast cancer patients who deal with their everyday stresses.

DEFINITION OF TERMS Depression – is a state of low mood and aversion to activity that can affect a person’s thoughts, behavior, feelings and sense of well-being. Assessment – is the systematic process of collecting relevant patient data for the purpose of determining actual or potential health problems and functional status. Methods used to obtain data include interviews, observations, physical examinations, review of records, and collaboration with colleagues. Breast cancer – is a type of cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Lung cancer (also known as carcinoma of the lung) – is a disease characterized by uncontrolled cell growth in tissues of the lung.

CHAPTER 2REVIEW OF RELATED

LITERATURES & STUDIES

In Buda and Tsuang’s 1990 study (as cited in DeLisle, 2007), it has been shown that women are more likely than men to present with depression and to attempt suicide, while men are more likely to die by suicide due to their choice of more violent means, such as firearms, explosives or hanging. In Carroll and Ryan’s 2005 study (as cited in Oluwafunmilola, 2012) International students normally face a lot of difficulties and this kind of problems are common among international student studying abroad includes: language problem, financial problem, cultural shock, adapting to a new weather, being lonely and accommodation problem. High proportions of students are being depressed while they study abroad.

FOREIGN STUDY

When depressed, men tend to blame others while women blame themselves. Men feel angry, irritable, and ego inflated when depressed while women feel sad, apathetic, and worthless. Men also feel suspicious and guarded; restless and agitated while women feel anxious and scared; slowed down and nervous. Men create conflicts when depressed while women avoid conflicts at all costs. Men need to feel in control at all cost when depressed while women have trouble setting boundaries. Men also find it “weak” to admit self-doubt or despair while women find it easy to talk about self-doubt and despair. When depressed, men tend to use alcohol, TV, sports, and sex to self-medicate while women use food, friends, and “love” to self-medicate. (Diamond, 1997)

FOREIGN LITEREATURE

A study about Prevalence of Depression among the Elderly Population in Rizal Province using the Geriatric Depression Scale stated that depression in the elderly is an important public health concern worldwide. It is the most common psychiatric disorder among the elderly yet unrecognized and under treated because attention is often focused on the physical medical conditions that are apparent during clinic visits. In community practice case reports of elderly suffering from depression were regarded as consequences of the aging process. Contrary to this belief depression in the elderly is not physiologic. It is a pathologic condition that is reversible with prompt and appropriate treatment. Failure to recognize and treat depression increases the risk of a prolonged course of depressive illness as well as other conditions like malnutrition, significant metabolic illnesses, and a greater chance of dying. (Josef, Dela Cruz, and Salandanan, 2011)

LOCAL STUDY

As stated to Philippine Daily Inquirer on November 16, 2012, “Teenagers can’t handle their feelings very well. They either keep them, or become a walking beacon filled with feelings. Many things that make us sad, depressed or emotional have to do with family, friends or relationship issues. Other issues that can cause depression include identity crises, peer pressure and society. Of course, depression affects each person differently, and it’s up to that person to respond accordingly. We always look for answers to questions, and, sometimes, the silence is deafening.” Family issues are a main cause of sadness. Sometimes, we get so pressured to excel and succeed that we become numb to all else. To walk into a crowded hallway and know that people are talking about you and laughing at you is probably one of the worst feelings ever. (Evaristo, 2012)

LOCAL LITERATURE

SYNTHESIS OF REVIEWED LITERATURE AND STUDIES

Depression is a major social phenomenon and known to be a mental health problem. It has been portrayed as the leading global cause of disability. Depression can affect people as many as possible such as students, female, male, adolescents, elderly.

Sadness or downswings in mood are normal reactions to life’s struggles, setbacks, and disappointments. Many people use the word “depression” to explain these kinds of feelings, but depression is much more than just sadness. Some people describe depression as “living in a black hole” or having a feeling of impending doom. However, some depressed people don't feel sad at all—they may feel lifeless, empty, and apathetic, or men in particular may even feel angry, aggressive, and restless.

Whatever the symptoms, depression is different from normal sadness in that it engulfs your day-to-day life, interfering with your ability to work, study, eat, sleep, and have fun. The feelings of helplessness, hopelessness, and worthlessness are intense and unrelenting, with little, if any, relief.

Depression affects each person differently, and it’s up to that person to respond accordingly. Other people are likely to spend less time interacting with their peers and are prone to relate with them aggressively. Some have smoked or taken alcohol as an escape route from the burdens of psychosocial difficults.

CHAPTER 3RESEARCH

METHODOLOGY

METHODS OF RESEARCH

This study will use both quantitative and qualitative type of research. The researcher will use qualitative research to gain an understanding of underlying reasons and motivation. However, the researcher will also use quantitative research to quantify data and generalized results from a sample to the population of interest.

The researcher will also use descriptive correlational method to determine whether or not there is a relationship that exist between the history of depression and development of cancer, and if there is, to what extent or degree the relationship is determined.

DESCRIPTION OF RESPONDENTSThe target population of this study are the lung

cancer patients and the breast cancer patients that were hospitalized in Ospital ng Maynila Medical Center. The eligibility criteria for the study were:

1.) ≥ eighteen (18) years of age2.) able to understand, speak, and read English3.) no history of other cancers4.) able to provide informed consent

RESEARCH INSTRUMENTS

The researcher will use Beck’s Depression Inventory, a 21- question multiple-choice self-report inventory. The BDI (Beck & Steer, 1987) assesses depression severity in adolescents and adults. Participants are asked to respond based on their experience over the past week including the day of testing. Responses are coded on a 4-point scale on which symptoms increase in severity from 0 to 3. The test can be administered in individual or group format and takes approximately 15 minutes to complete. The BDI has generally demonstrated adequate reliability, with alpha reliability coefficients ranging from .73 to .95 and test-retest reliabilities ranging from .62 (4-month interval) to .90 (2-week interval) (Beck, Steer, & Garbin, 1988). The concurrent validity of the BDI has also been established in psychiatric and nonpsychiatric samples (Beck et al.; Spreen & Strauss, 1991), and BDI scores have also been found to correlate with self-rated suicide risk in college students (Liddell, 1994). The researcher will also use individual depth interview or group discussion after the testing.

DATA GATHERING PROCEDUREThe researcher will personally administer the

research instrument to the respondents. She will conferred and discussed the significance of the study and accomplished the distribution of the instruments properly. The respondents will be given enough time (approximately 15 minutes) to accomplish the questionnaires to prevent them from giving hasty responses.

After the questionnaires have been accomplished, the results will be tallied and tabulated. These data will be the basis of analysis and interpretation. The researcher will also interview the respondents about their insight regarding with their condition.

ANALYSIS OF DATA

The researcher will use the ANOVA (Analysis of Variance) to answer the question whether there is significant difference between depression level of lung cancer patients and breast cancer patients. Mean scores and standard deviations are given as descriptive statistics. The relationship between the scale scores was tested using Spearman correlation co-efficient.

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