Skip to main content Accessibility help

Family caregivers' perceptions of depression in patients with advanced cancer: A qualitative study

  • Wadih Rhondali (a1) (a2) (a3), Anne Chirac (a1) (a4), Angélique Laurent (a4), Jean-Louis Terra (a4) (a5) and Marilène Filbet (a1)...



Depression is a serious issue for cancer patients, resulting in impaired quality of life and probably shorter survival. However, many cancer patients with depression are not treated because of the difficulties in identifying depression within this population. Our study aimed to examine caregivers' perceptions of depression among advanced cancer patients.


This qualitative study employed semistructured interviews, and we analyzed data using grounded theory and qualitative methods. We recruited caregivers from our palliative care unit (PCU) at an academic medical center.


We interviewed a total of 15 caregivers. Cancer patients' caregivers had a good theoretical knowledge of depression but also acknowledged that, in the context of cancer and because of their relationship with the patient, identification of depressive symptoms could be challenging. They considered themselves as partners in the patient's care with a supportive role. However, by assuming the role of partner in patient care, caregivers exposed themselves to emotional difficulties and an increased need for support and information.

Significance of Results:

Our results suggest a significant impact of depression in advanced cancer caregivers, and it is therefore crucial that healthcare professionals develop educational programs targeting cancer patients' families as well as specific interventions to minimize the impact of the burden of patient care on caregivers.


Corresponding author

Address correspondence and reprint requests to: Wadih Rhondali, Department of Palliative Care, Centre Hospitalier Lyon-Sud, Hospices civils de Lyon. 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France. E-mail:


Hide All

Both authors contributed equally to this paper.



Hide All
Ahmedzai, S.H., Costa, A., Blengini, C., et al. (2004). A new international framework for palliative care. European Journal of Cancer, 40(15), 21922200.
Alexander, P. (2004). An investigation of inpatient referrals to a clinical psychologist in a hospice. European Journal of Cancer Care (England), 13(1), 3644.
Breitbart, W. (1995). Identifying patients at risk for, and treatment of, major psychiatric complications of cancer. Supportive Care in Cancer, 3, 4560.10.1007/BF00343921
Brenne, E., Loge, J.H., Kaasa, S., et al. (2013). Depressed patients with incurable cancer: Which depressive symptoms do they experience? Palliative & Supportive Care, 7, 111.
Bruera, E. & Hui, D. (2010). Integrating supportive and palliative care in the trajectory of cancer: Establishing goals and models of care. Journal of Clinical Oncology, 28(25), 40134017.
Chesebro, J.W. & Borisoff, D.J. (2007). What makes qualitative research qualitative? Qualitative Research Reports in Communication, 8(1), 314.
Clayton, P. (1974). Mourning and depression: Their similarities and differences. Canadian Journal of Psychiatry, 1, 309312.
Cohen, S., O'Leary, K.D. & Foran, H. (2010). A randomized clinical trial of a brief, problem-focused couple therapy for depression. Behavioral Therapy, 41(4), 433446.
Delgado-Guay, M., Parsons, H.A., Li, Z., et al. (2009). Symptom distress in advanced cancer patients with anxiety and depression in the palliative care setting. Supportive Care in Cancer, 17(5), 573579.
Epiphaniou, E., Hamilton, D., Bridger, S., et al. (2012). Adjusting to the caregiving role: The importance of coping and support. International Journal of Palliative Nursing, 18(11), 541545.
Geka, M. & Dargentas, M. (2010). L'apport du logiciel Alceste à l'analyse des représentations sociales: L'exemple de deux études diachroniques. Les cahiers internationaux de psychologie sociale, 1(85), 111136.10.3917/cips.085.0111
Girgis, A., Lambert, S., Johnson, C., et al. (2013). Physical, psychosocial, relationship, and economic burden of caring for people with cancer: A review. Journal of Oncology Practice, 9(4), 197202.
Goodwin, L., Lee, W., Price, A., et al. (2012). Predictors of non-remission of depression in a palliative care population. Palliative Medicine, 26(5), 683695.10.1177/0269216311412230
Libert, Y., Merckaert, I., Slachmuylder, J.L., et al. (2013). The ability of informal primary caregivers to accurately report cancer patients' difficulties. Psycho-Oncology, 22(12), 28402847.
Lindlof, T.R. & Taylor, B.C. (2002). Qualitative communication research methods. Thousand Oaks, CA: Sage.
Lloyd-Williams, M. & Friedman, T. (2001). Depression in palliative care patients: A prospective study. European Journal of Cancer Care (England), 10(4), 270274.
Lloyd-Williams, M., Dennis, M. & Taylor, F. (2004). A prospective study to determine the association between physical symptoms and depression in patients with advanced cancer. Palliative Medicine, 18(6), 558563.
Lloyd-Williams, M., Shiels, C., Taylor, F., et al. (2009). Depression: An independent predictor of early death in patients with advanced cancer. Journal of Affective Disorders, 113(1–2), 127132.
Mazzotti, E., Sebastiani, C., Antonini Cappellini, et al. (2013). Predictors of mood disorders in cancer patients' caregivers. Supportive Care in Cancer, 21(2), 643647.10.1007/s00520-012-1663-9
Mellor, D., McCabe, M.P., Davison, T.E., et al. (2013). Barriers to the detection and management of depression by palliative care professional carers among their patients: Perspectives from professional carers and patients' family members. American Journal of Hospice & Palliative Care, 30(1), 1220.10.1177/1049909112438705
Meyer, H.A., Sinnott, C. & Seed, P.T. (2003). Depressive symptoms in advanced cancer, part 1. Assessing depression: The Mood Evaluation Questionnaire. Palliative Medicine, 17(7), 596603.10.1191/0269216303pm812oa
Mitchell, A.J., Chan, M., Bhatti, H., et al. (2011). Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: A meta-analysis of 94 interview-based studies. The Lancet Oncology, 12(2), 160174.10.1016/S1470-2045(11)70002-X
Newell, S., Sanson-Fisher, R.W., Girgis, A., et al. (1998). How well do medical oncologists' perceptions reflect their patients' reported physical and psychosocial problems? Data from a survey of five oncologists. Cancer, 83(8), 16401651.10.1002/(SICI)1097-0142(19981015)83:8<1640::AID-CNCR21>3.0.CO;2-#
Newell, S.A., Sanson-Fisher, R.W. & Savolainen, N.J. (2002). Systematic review of psychological therapies for cancer patients: Overview and recommendations for future research. Journal of the National Cancer Institute, 94(8), 558584.
Noorani, N.H. & Montagnini, M. (2007). Recognizing depression in palliative care patients. Journal of Palliative Medicine, 10(2), 458464.
O'Connor, M. & Payne, S. (2006). Discourse analysis: Examining the potential for research in palliative care. Palliative Medicine, 20(8), 829834.
Pascoe, S., Edelman, S. & Kidman, A. (2000). Prevalence of psychological distress and use of support services by cancer patients at Sydney hospitals. The Australian and New Zealand Journal of Psychiatry, 34(5), 785791.
Rayner, L., Loge, J.H., Wasteson, E., et al. (2009). The detection of depression in palliative care. Current Opinions in Supportive and Palliative Care, 3(1), 5560.
Rayner, L., Price, A., Evans, A., et al. (2011). Antidepressants for the treatment of depression in palliative care: systematic review and meta-analysis. Palliative Medicine, 25(1), 3651.
Reinert, M. (1983). Une méthode de classification descendante hiérarchique: Application à l'analyse lexicale par contexte. Cahiers de l'analyse des données, 8(2), 187198.
Rhondali, W., Perceau, E., Berthiller, J., et al. (2012). Frequency of depression among oncology outpatients and association with other symptoms. Supportive Care in Cancer, 20(11), 27952802.10.1007/s00520-012-1401-3
Rodin, G., Lloyd, N., Katz, M., et al. (2007). The treatment of depression in cancer patients: A systematic review. Supportive Care in Cancer, 15(2), 123136.
Satin, J.R., Linden, W. & Phillips, M.J. (2009). Depression as a predictor of disease progression and mortality in cancer patients: A meta-analysis. Cancer, 115(22), 53495361.
Skalla, K.A., Smith, E.M., Li, Z., et al. (2013). Multidimensional needs of caregivers for patients with cancer. Clinical Journal of Oncology Nursing, 17(5), 500506.
Strong, V., Waters, R., Hibberd, C., et al. (2008). Management of depression for people with cancer (SMaRT oncology 1): A randomised trial. The Lancet, 372(9632), 4048.
Teschendorf, B., Schwartz, C., Ferrans, et al. (2007). Caregiver role stress: When families become providers. Cancer Control, 14(2), 183189.
Thomas, C., Morris, S.M. & Harman, J.C. (2002). Companions through cancer: The care given by informal carers in cancer contexts. Social Science & Medicine, 54(4), 529544.
Tong, A., Sainsbury, P. & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349357.10.1093/intqhc/mzm042
Uitterhoeve, R.J., Vernooy, M., Litjens, M., et al. (2004). Psychosocial interventions for patients with advanced cancer: A systematic review of the literature. British Journal of Cancer, 91(6), 10501062.


Family caregivers' perceptions of depression in patients with advanced cancer: A qualitative study

  • Wadih Rhondali (a1) (a2) (a3), Anne Chirac (a1) (a4), Angélique Laurent (a4), Jean-Louis Terra (a4) (a5) and Marilène Filbet (a1)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed