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.

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INTRODUCTIONBurnout is characterized by loss of emotional strength, not valuing human beings living together with or offering service and decreased in job performance and success due to lack of interest related to occupational stressors.1Burnout was recognized as work related danger among human oriented professionals including health care professionals since they are required to work many hours to help humans and face a challenge of high demand and low resources.1 Burnout is due to prolonged work related stress that is not managed. In a work environment this leads to high worker turnover, absenteeism, compromise of interpersonal relationships, reduced productivity and low personal achievement. 2High level of burnout was identified among nurses working in ICU (Intensive Care Unit) and Emergency Department. A systematic review on burnout among ICU health professionals found the prevalence to range from 6% to 47%. 3 Moreover, this systematic review found the following risk factors: age, gender, work experience, ABSTRACT Background: Intensive Care Unit (ICU) and Emergency Department are more stressful areas therefore nurses in those areas are prone to high level of burnout than others. In Rwanda, studies on burnout among nurses are limited and there is no research targeting specifically nurses working in ICU and Emergency Department. Therefore, this study aimed to determine the level of burnout among nurses working in ICU and Emergency Department in a selected referral hospital of Kigali. Methods: A quantitative approach was adopted. The descriptive cross-sectional design was used. Sixty nurses were involved in the study and they were selected using a total population sampling strategy. A self-administered questionnaire and Maslach Burnout Inventory Human Service Survey were used to collect data. Data were analysed using SPSS version 21.0. Results: The study found high level of burnout among 61.7% of the participants under study. High workload and intention to leave were associated with burnout (P<0.05). Burnout was measured by high Emotional Exhaustion (EE) 29 (48.3%), high Depersonalization (DP) 15 (25%) and low Personal Accomplishment (PA) 30 (50%). Conclusions: The high level of burnout identified among ICU and emergency department nurses is mainly associated with high workload and intention to leave the work within the next 12 months.