Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2018


Doctor of Nursing Practice (DNP)

Primary Advisor

Cathie E Guzzetta, PhD, RN, FAAN


Background: Awareness of a patient’s anxiety, depression, and quality of life (QOL) in those with metastatic uveal melanoma (MUM) can influence care that meets patients’ bio-psychosocial-spiritual needs.

Objectives: To measure the level of anxiety, depression, and QOL in patients with MUM and explore differences by gender, age range, time to metastatic disease, and duration of illness since metastasis.

Methods: We used a descriptive-comparative survey design. Over three months, a convenience sample of 70 patients with MUM aged ≥ 18 years, treated at a Mid-Atlantic hospital were invited to complete a combined survey of the Hospital Anxiety and Depression Scale and the World Health Organization Quality of Life-BREF.

Results: There were 65 respondents (93% response rate). 30.8% (n=20) had at least borderline anxiety, 13.8% (n=9) had at least borderline depression, and 32.3% (n=21) had a decrease in global QOL. Patients 18 to ≤ 60 years had higher anxiety scores (p=0.003) and lower QOL scores in environmental health (p=0.006). Those with a shorter duration of illness since metastasis had higher anxiety scores (p=0.01) and higher QOL scores in physical health (p=0.05). No differences were found by gender or time to metastatic disease.

Conclusions: Up to 30% of participants had at least borderline anxiety and a decreased global QOL while up to 10% had at least borderline depression. These findings support the integration of bio-psycho-social-spiritual practices in the care of patients with MUM.

Open Access


Available for download on Saturday, December 15, 2018