Quality of life in male cancer patients at Kenyatta National Hospital, Nairobi

Abstract

Background: The quality of life of cancer patients is likely to be influenced by psychological reactions of the cancer patients yet there are no documented issues related to quality of life in cancer patients in Kenyan hospitals. Objective: To investigate issues which affect the quality of life in male cancer patients. Design: Prospective cross sectional study. Setting: Kenyatta National Hospital, Nairobi, Kenya. Methods and subjects: Cancer patients above 12 years of age were interviewed during the course of their stay in the hospital, specifically to gather information on; semi structured questions and a modified Beck's 24 item depression inventory with a view to solicit for their reaction on issues which pertains to quality of life. Main outcome measures: Age group, level of education, tribe, geographical place (province) of birth, chief complains, main concerns, views on doctors, contact with psychiatrist and psychologist, the anatomic site of cancer, treatment given and responses on modified Beck's depression inventory. Results: Forty two patients were studied, their age range 13-72 years, mean 43.2 and peak 13-26 years. Forty seven per cent of cases had no formal education. The cancers were gastrointestinal tract 33%, blood and lymphoid tissue (26%), bone and muscle (11.9%), skin (9.4%) and genitourinary tract (4.8%). Treatment given was chemotherapy, radiotherapy and surgery. Ninety three per cent were unable to cope. Chief complaints were pain, inability to work, feeling miserable and concerns were families, health and work retardation. Modified Beck's depression score was 20%, with major issues being; work retardation, insomnia, weight loss, and anorexia. Most affected were, age group 27-35 years (and least 13-26 years), uneducated, living in Nairobi (city), having carcinomas, treatment with combined surgery and radiotherapy. Low education level and residence in Nairobi coped poorly. Radiation therapy group appeared to cope better than other modalities. Conclusion: The issues affecting the quality of life of male cancer patients stated were pain, inability to work, poor coping with cancer and psychological reactions of work retardation, insomnia, weight loss, fatigability and depression. Gambling, suicidal ideas and social withdrawal were minimal. Other concerns were families, health and work.

Experiences of patients undergoing chemotherapy - a qualitative study of adults attending Uganda Cancer Institute

“…The described experiences are partly in line with the findings from the two existing studies of cancer patients undergoing chemotherapy treatment in East Africa [5][6] . The study from Tanzania revealed that being diagnosed with and undergoing treatment for cancer often had a strong impact on health-related quality of life, causing multiple concerns regarding the need for care and support.…”

“…Only two studies from East Africa have been found that describe patients' experiences of undergoing chemotherapy [5][6] . One of these publications studied Kenyan males by means of self-reported questionnaires and found that 93% of the participating men reported complaints regarding pain, inability to work and feeling miserable and that they expressed concerns regarding their families, health and work retardation 5 . The other publication had a mixed-methods design and investigated health-related quality of life among adult Tanzanians with cancer.…”

Using a supportive care framework to understand and improve palliative care among cancer patients in Africa

“…Our review of the literature demonstrated that the experience of living with cancer in Africa creates significant psychological problems for the affected patients and caregivers (Harding et al, 2011; Hameed, 2011). Common psychological problems include depression, difficulties in coping, poor self-image and self-esteem, loss, and sexual challenges (Harding et al, 2011; Kamau et al, 2007; Lavy, 2007; Mwanda et al, 2004).…”

“…Physical comfort, pain relief, proper nutrition, and an ability to carry out usual daily functions encompass the physical domain (Fitch, 2009). In the reviewed studies, such physical problems as pain, weight loss, fatigue, and shortness of breath were frequently experienced by palliative care patients with cancer (Mwanda et al, 2004). Among the reported physical symptoms, pain was most frequently experienced (Harding et al, 2011; Tapsfield & Jane Bates, 2011).…”

“…Because of the distance and travel costs, some relatives could not afford to visit. This combination led to social isolation and withdrawal (Mwanda et al, 2004; Selman et al, 2009). Though some patients accepted the social limitations, their desire for social support remained evident.…”