A nurse is caring for a client with end-stage breast cancer who is experiencing depression. Which of the following complementary therapies should the nurse incorporate into the care plan to assist with this manifestation?

Nursing care for a client with end-stage cancer and depression focuses on psychological support, emotional expression, and improving coping mechanisms alongside palliative symptom management. Breast cancer in its end-stage form is often associated with significant physical decline, emotional distress, and existential concerns. Depression in this context is commonly addressed using supportive, non-pharmacologic interventions that allow emotional processing and meaning-making. Complementary therapies that promote expression and coping are particularly beneficial in palliative care settings. Rationale: A. Shiatsu is a body-based complementary therapy that involves manual pressure techniques to promote relaxation and energy balance. While it may help reduce physical tension and anxiety, it does not specifically target emotional expression or depressive thought processing. In end-stage cancer care, interventions that directly support emotional processing are more appropriate for depression management. B. Journaling is appropriate because it provides a structured outlet for emotional expression, helping the client process feelings of sadness, fear, and grief. Writing thoughts and emotions can improve coping, reduce psychological distress, and enhance a sense of control during terminal illness. It is a simple, accessible intervention that supports mental health and is commonly used in palliative care. C. Acupuncture may be beneficial for symptom management such as pain, nausea, or fatigue in cancer patients, but it is not primarily used to address depression. While some patients may experience relaxation benefits, its main therapeutic role is physical symptom relief rather than emotional processing. Therefore, it is not the most direct intervention for depressive symptoms. D. Reiki is a form of energy therapy that may promote relaxation and comfort but lacks strong evidence for directly treating clinical depression. It may be used as an adjunct for stress reduction in palliative care, but it does not actively facilitate emotional expression or cognitive processing of depressive thoughts. More expressive therapies are preferred for managing depression in this context.