Depression and spiritual distress in adult palliative patients in primary care

Background: Palliative care patients have high probability ofhaving depression and spiritual distress but few studies aboutthe prevalence of spiritual distress in palliative patients,particularly in primary care, have been conducted. Also, thedifferential diagnostic between depression and spiritualdistress often lack clarity. Aims: To identify the prevalence and the clinical indicators ofdepression and spiritual distress in palliative patients inprimary care.Methods: Observational and cross-sectional study conductedin 2016 in a Portuguese primary care unit.Patients with chronic disease and Prognostic IndicatorGuidance (PIG) criteria were recruited from the GeneralPractitioners patients’ file. Patients were interviewed forcollection of demographics, clinical data, presence orabsence of spiritual distress and depression.Depression diagnosis comprised DSM-5 criteria and wassupported by HADS scale. Spiritual distress diagnosiscomprised a three component criteria: the researcher’sclassification, the patient’s confirmation, and a FACIT-Spscore below 36. Data treatment comprised Independent t-test, Shapiro-Wilktest, Pearson’s χ2, using SPSS 22. The study was approved bythe ethical Commission of the Universidade CatólicaPortuguesa.Results: A total of 1.457 adults were identified, of which 200met chronic disease criteria, and 39 met PIG criteria. A totalof 30 patients completed the study. Palliative patients had amean age of 72.7 (SD ± 13.4).The majority of palliative patients were married orliving together (67%). Most of the palliative patients had alow-medium socio-economic status (87%). The prevalence ofdepression was 23% (N=7) in this sample. The prevalence ofspiritual distress was 23% (N=7) in this sample. Discussion and conclusion: Palliative care patients’depression and spiritual distress need to be accuratelyidentified towards the most correct decision-making, and themost effective treatment and holistic caring, including family.