BackgroundCancer patients frequently experience psychological problems related to reactions of cancer diagnosis, cancer type, treatment effects, recurrence, fear of end-of-life, survivorship, and financial burden. Psychological assessment has been integrated into cancer care in some countries, but there is limited knowledge about the practice in Rwanda. ObjectiveTo assess the prevalence and associated factors of anxiety and depression among patients with cancer attending a private referral hospital in Rwanda. MethodsA descriptive cross-sectional study design was used with the Hospital Anxiety and Depression Scale (HADS) instrument to assess cancer patients. A probability systematic random sampling technique was used to recruit 96 patients. Data were analysed using descriptive statistics to determine the association of variables with anxiety and depression. ResultsThe majority of cancer patients had depression (67.7%) and anxiety (52.1%). Anxiety was associated with employment status (p=0.02), cancer stage (p=0.02), weight loss (p=0.00) and depression (p=0.00). Depression was associated with cancer stage (p=0.02), pain (p=0.03), weight loss (p= 0.03), cancer treatment (p=0.02) and anxiety (p=0.001). Conclusion: Anxiety and depression were reported in over half of the study population indicating a need to create and integrate psycho-oncology into standard oncology care.Rwanda J Med Health Sci 2019;2(2):118-125.

Background: Cervical cancer is the third most common cancer attacking women globally, and the second in Eastern Africa where Rwanda is located. Regular screening is an effective prevention approach for cervical cancer. Despite that, the screening rate for cervical cancer in Africa is estimated between 10% and 70%, with a number of barriers. This is especially the case in sub-Saharan Africa. In Rwanda, there is limited literature on the rate of use of screening services or the barriers to cervical screening. Objective: To assess knowledge, utilization, and barriers of cervical cancer screening among women attending selected district hospitals in Kigali, Rwanda. Methods: A descriptive cross-sectional study with a structured questionnaire was used to collect data. Nominal ‘yes’ or ‘no’ questions were used to gather data on knowledge and utilisation of cervical cancer and its screening. Likert-type scale questions were used to identify different barriers to screening services. Data were analysed using descriptive and inferential statistics. Respondents were selected by systematic random sampling from the database of women attending gynaecology services at three district hospitals in Kigali, Rwanda. Results: Three hundred and twenty-nine women responded to the survey. Half of the respondents (n = 165) had high knowledge level scores on cervical cancer screening. The cervical cancer screening rate was 28.3%. Utilization of screening was associated with knowledge (P = 0.000, r = -0.392) and selected demographic factors (P = 0.000). Individual barriers included poor knowledge on availability of screening services, community barriers included living in a rural area, and health provider and systems barriers included lack of awareness campaigns, negative attitudes of healthcare providers toward clients, and long waiting times; all barriers limit the access to screening services. Conclusion: A low rate of cervical cancer screening was identified for women attending selected district hospitals in Kigali-Rwanda due to various barriers. On-going education on cervical cancer and its screening is highly recommended. It is important that trained health providers encourage their clients to have cervical cancer screening and work to reduce related barriers.

Introduction: Breast cancer in Rwanda is a major concern for women’s health, as most breast cancer diagnoses are made at an advanced stage. Yet, diagnosis can be done early with breast cancer screening practices. Aim: To assess factors influencing breast cancer screening practices among women of reproductive age in South Kayonza District of Rwanda. Methodology: A quantitative survey was conducted with 246 women between 16 and 49 years of age from four health centres in South Kayonza District. A structured, pretested, and self-administered questionnaire was used to assess the influence of knowledge, health facilities, and socioeconomic and cultural factors on breast screening practices among women in South Kayonza. Result: Among all respondents, 55.5% had moderate knowledge about breast cancer risk factors and 60.2% also had moderate knowledge on the influence of breast cancer screening. While 28% were knowledgeable about Breast Self-Examination (BSE), 16.4% were knowledgeable about Clinical Breast Examination (CBE) and breast ultrasound. Responses about the practice of breast screening in the last two years showed 72% of respondents had never practiced BSE and 81.3% had not used CBE or breast ultrasound scan. The main source of information about breast cancer screening was the radio, used by 30.4% of respondents. Significant relationships were found between age and marital status with breast cancer screening practices. Conclusion: This study revealed low levels of knowledge about breast cancer, breast cancer screening, and practice regarding breast cancer screening. There is a need to promote awareness of breast cancer and create a program, which can influence breast cancer screening knowledge and practice to ultimately improve health among women in south Kayonza.

Psychosocial care is considered an important component of quality cancer care. Individuals treated for cancer can experience biologic or physical, emotional, spiritual, and practical consequences (eg, financial), which have an impact on their quality of living. With the establishment of cancer centers in Africa, there is growing advocacy regarding the need for psychosocial care, given the level of unmet supportive care needs and high emotional distress reported for patients. Nurses are in an ideal position to provide psychosocial care to patients with cancer and their families but must possess relevant knowledge and skills to do so. Across Africa, nurses are challenged in gaining the necessary education for psychosocial cancer care as programs vary in the amount of psychosocial content offered. This perspective article presents competencies regarding psychosocial care for nurses caring for patients with cancer in Africa. The competencies were adapted by expert consensus from existing evidenced-based competencies for oncology nurses. They are offered as a potential basis for educational program planning and curriculum development for cancer nursing in Africa. Recommendations are offered regarding use of these competencies by nursing and cancer program leaders to enhance the quality of care for African patients with cancer and their family members. The strategies emphasize building capacity of nurses to engage in effective delivery of psychosocial care for individuals with cancer and their family members.

Introduction : Au Rwanda, le cancer du sein est une grande préoccupation pour la santé des femmes puisque la plupart des diagnostics sont faits à un stade avancé de la maladie. On sait pourtant que les pratiques de dépistage du cancer du sein permettent d’accélérer le diagnostic. Objectif : Évaluer les facteurs qui influencent les pratiques de dépistage du cancer du sein chez les femmes en âge de procréer habitant le district de Kayonza, au Rwanda. Méthodologie : Une étude quantitative a été menée dans quatre centres de santé au sud du district de Kayonza auprès de 246 femmes de 16 à 49 ans. Un questionnaire structuré, prétesté et autoadministré a été utilisé pour évaluer l’influence des connaissances, des centres de santé et des facteurs socioéconomiques et culturels sur les pratiques de dépistage du cancer du sein chez les femmes dans le sud de Kayonza. Résultats : Parmi les répondantes, 55,5 % avaient une connaissance moyenne des facteurs de risque du cancer du sein, et 60,2 % sur l’incidence du dépistage du cancer du sein. On a constaté que 28 % étaient familiarisées avec l’auto-examen des seins (AES) et 16,4 % avec l’examen clinique des seins (ECS) et l’échographie mammaire. Au cours des deux années précédentes, les réponses entourant les pratiques de dépistage du sein ont révélé que 72 % des répondantes n’avaient jamais réalisé d’AES et que 81,3 % n’avaient jamais passé d’ECS ou d’échographie mammaire. Pour 30,4 % des répondantes, l’information sur le dépistage du cancer du sein provenait principalement de la radio. Des relations significatives avec les pratiques de dépistage du cancer du sein sont ressorties pour l’âge et l’état matrimonial. Conclusion : L’étude témoigne du peu de connaissances sur le cancer du sein, le dépistage et les pratiques relatives au dépistage de cette maladie. Il est donc nécessaire de promouvoir la sensibilisation au cancer du sein et de créer un programme qui puisse améliorer les connaissances et les pratiques en matière de dépistage afin d’améliorer la santé des femmes du sud de Kayonza.