Depression Level among Lung Cancer Patients and Breast Cancer Patients: Chapter 1-3
Comparison of Depression Level
between Lung Cancer Patients
and Breast Cancer Patients
that were hospitalized in
Ospital ng Maynila Medical Center
Kimberly O. Bacorro
Dean Nenita F. Buan
Research I Adviser
TABLE OF CONTENTS
CHAPTER 1: THE PROBLEM AND ITS BACKGROUND
Background of the Study
Statement of the Problem
Scope and Limitation of the Study
Significance of the Study
Definition of Terms
CHAPTER 2: REVIEWS OF RELATED LITERATURE AND STUDIES
Synthesis of Reviewed Literature and Studies
CHAPTER 3: RESEARCH METHODOLOGY
Methods of Research
Description of Respondents
Data Gathering Procedure
Analysis of Data
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
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.
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.
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.
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
1. What is the profile of the respondents with respect to the
following personal dimensions:
1.4 Specify if lung cancer patient or breast cancer patient
1.5 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?
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
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
•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
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.
REVIEW 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.
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)
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)
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
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)
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,
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.
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 RESPONDENTS
The 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 age
2.) able to understand, speak, and read English
3.) no history of other cancers
4.) able to provide informed consent
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
DATA GATHERING PROCEDURE
The 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.