Health-related Quality of Life Among Adult Patients With Cancer in Uganda

Abstract

AimTo investigate prevalence of clinical cases with regard to health-related quality of life (HRQoL) and its association with socio-demographic and clinical factors among adult patients attending specialized cancer care in Uganda.MethodsA cross-sectional study was performed with 385 patients cared for at Uganda Cancer Institute (response rate 95%). HRQoL was measured using EORTC QLQ-C30 including its subscales measuring functioning and symptoms as well as overall health status and quality of life (QoL). Predetermined thresholds indicating clinical importance were applied to identify patients exhibiting functional impairments and symptoms at a level meriting concern (clinical cases). Socio-demographic and clinical characteristics were collected through study-specific items and medical records, respectively. Multivariable logistic regression models identified factors associated with being a clinical case in seven selected subscales of the EORTC QLQ-C30 (Physical, Role, Social and Emotional Function, Global health status/QoL, Pain and Fatigue). ResultsThe mean age of the study participants, in - and outpatients with various cancers, was 48 years. The majority reported their functioning at levels indicating clinical caseness (68%−87%), as well as significant pain (80%), and fatigue (63%). Higher age and lack of education were associated with clinical caseness. Clinical characteristics related to caseness included having an advanced disease stage, being hospitalized, receiving palliation, not on active cancer treatment as well as diagnosed with head/neck cancers.Conclusion The study demonstrated that more than two thirds of adult patients cared for at a specialized cancer facility in Uganda rate HRQoL at levels meriting concern. The large proportion of patients with pain calls for implementation of guidelines such as the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology for Adult Cancer Pain, to improve pain management in Uganda. A majority of the patients reported fatigue at a clinical level which can be addressed by educational interventions to teach patients self-care strategies to conserve energy.

Health-related quality of life among adult patients with cancer in Uganda – a cross-sectional study

“…Furthermore, because we lacked information regarding the dates of patients’ diagnoses, it was not possible to adjust for changes over time. The generalisability of the results to patients who speak languages other than Luganda and English can be questioned [ 54 , 55 ].…”