Perception of cervical cancer patients on their health related quality of life and palliative care needs in western Kenya

Abstract

Cervical cancer is the third most common female cancer worldwide and causes approximately 275,000 deaths annually worldwide, of which 88% occur in low income countries. In Kenya cervical cancer is the leading female cancer in both incidence and mortality rates at 40.1 and 21.8 respectively. Eighty percent of reported cases of cancer in Kenya are diagnosed at advanced stages, leading to many patients who need palliative care services to improve their quality of life. For a long time the focus has been on clinical management of cancers but now Health Related Quality of Life (HRQoL)) is emerging as an important health outcome which requires to be incorporated in the holistic management of patients. There are few studies in Africa that have investigated HRQoL issues. This study set out to determine quality of life and palliative care needs of cervical cancer patients in western Kenya. The study was conducted at Jaramogi Oginga Odinga teaching and referral hospital in western Kenya. Study population was estimated to be 2454 and sample size was 365. A HRQoL assessment tool FACT-Cx Version 4, a structured questionnaire, and in-depth interview guide were used to collect data. Reliability was tested using test-retest and internal consistency was computed using Cronbach's α coefficient while validity was achieved through expert review. Data was analyzed using SPSS version 20. Descriptive statistics, Pearson correlations, chi-square and regression analysis were conducted to examine the relationship between the independent variables and dependent variable. Statistical significance was tested at p ≤ 0.05. The results showed that the mean HRQoL was 35.35 (SD=13.21).More than half of the respondents experienced poor functional and physical wellbeing 221(66.2%) and 201 (60.2%) respectively and no patient experienced good functional and physical wellbeing. While 189(56.6%) experienced fair overall quality of life. There was a statistically significant relationship between cervical cancer stage and physical wellbeing of cervical cancer patients. Regression analysis between age, marital status, level of education and religion was used to determine their influence on overall quality of life. All the independent variables showed positive influence on overall quality of life. Age, level of education and religion had statistically significant relationship with overall quality of life. Only marital status did not have statistically significant relationship with overall quality of life. The study concluded that, cervical cancer patients experience poor functional and physical wellbeing though they do fairly better with emotional and social wellbeing. Therefore, more needs to be done in improving functional and physical wellbeing of these patients.