Impact of Psychosocial Distress on the Quality of Life of Cancer Patients in Two Health Facilities in Cameroon

Abstract

Background: Psychosocial distress interferes with the ability to cope effectively with cancer, its physical symptoms and treatment. This in turn leads to poor outcomes in patients. Objective: The aim of this study was to investigate the impact of psychosocial distress on the quality of life of cancer patients in two health facilities in Cameroon. Methods: This study used a cross-sectional hospital-based design. The study was carried out over a period of three months from July-September 2020. The sample size was 120 cancer patients. A purposive sampling technique was used to recruit participants. Three validated questionnaires were used: DT, HADS and EORTC QLQ-C30 to assess, psychosocial distress, emotional distress and quality of life respectively. Results were presented using descriptive (frequency, percentage, mean) and inferential statistics (Pearson’s correlation, ANOVA). Data were analysed with SPSS version 21. All statistics were considered significant at an alpha value set at 0.05 level. Results: Majority of the patients 83 (69.2%) presented with clinically significant distress, with financial difficulties 87 (72.5%), fatigue 83 (69.2%), transportation 73 (60.8%) and difficulties with work/school 69(57.5%) being the most reported problems. Fifty nine (50.0%) and 56(47.5%) had moderate to severe anxiety and depression symptoms respectively. Overall on HADS, 67 patients (56.8%) presented with emotional distress. The quality of life was fair, with a mean of 52.4±21.3. There was a strong statistically significant relationship between psychosocial distress and the quality of life (P<0.0001), wherein psychosocial distress was found to have a negative impact on the quality of life of patients.Conclusion: Cancer patients do suffer from psychosocial distress which has a negative impact on their quality of life. This is thus a call for concern to health personnel in this setting. The psychosocial domain of cancer patients needs to be assessed for early identification of persons at risk, to better improve the quality of care which they receive and hence their quality of life.

Psychological distress in patients with cancer at the Kenyatta National Hospital in Nairobi, Kenya, during the COVID-19 pandemic

“…The median age of our study population was 54 years, which is similar to studies performed in Africa that have documented age between 46 and 54 years but lower than the west where the mean age reported is between 58 and 68 years. [10,[21][22][23]32,33] The female predominance observed in this study reflects similar findings from studies in Africa and the West. Breast cancer was the leading diagnosis at 26% followed by cervical cancer at 24% which mirrors the Kenyan national distribution of all cancers as reported in Globocan 2020.…”

“…[21,23] The mean distress score in our patients was similar to that in other studies with a range of 2.47-4.7 but much lower than that in studies conducted in palliative settings where more than 70% of patients had high levels of distress. [21][22][23]32,[35][36][37] In our study, ECOG performance status was the only factor associated with distress similar to what a Nigerian study showed. [22] Other studies have reported being female, type of malignancy, being on chemotherapy, or under palliative care as independent predictors of distress.…”

“…[5] This tool has been used in different settings, and its use is documented in a few African countries, including Kenya. [21][22][23] It is simple to use, easy to administer, and has good sensitivity and specificity. [24] Another commonly used tool in patients with cancer is the Edmonton Symptom Assessment Scale that is multidimensional and gives score on various symptoms of advanced cancer such as pain.…”

Psychosocial aspects of adult cancer patients: A scoping review of sub‐Saharan Africa

“…A total of 44 studies were identified in this category across SSA. The majority of studies reported that the burden of unmet psychosocial needs was between 20% and 90.4% among adult cancer patients 24–27 . Psychosocial issues commonly reported in most of the studies were related to physical strength, 28 emotional distress, 29–31 anxiety and depression, 29,32–38 sub‐optimal pain control, 39 body image/body issues (abnormal body sensations, feelings of unattractiveness, poor self‐esteem), 28,40–46 health information need, 47–49 support system lack, 45,50 relationship disruptions (e.g., rejection of sexual activities from their spouse, changes in the work role etc.…”

“…The majority of studies reported that the burden of unmet psychosocial needs was between 20% and 90.4% among adult cancer patients. [24][25][26][27] Psychosocial issues commonly reported in most of the studies were related to physical strength, 28 emotional distress, [29][30][31] anxiety and depression, 29,[32][33][34][35][36][37][38] sub-optimal pain control, 39 -91…”