Psychological distress, social function and financial burden of cancer patients receiving treatment in an African setting.

Abstract

e19048 Background: The improvement in the quality of cancer treatment is key to increasing survival. However, the functional well-being of these patients is equally important. This study aimed to assess the degree of psychological distress, social function and financial burden in patients undergoing cancer treatment in our center. Methods: A cross-sectional study was designed to prospectively recruit patients in our teaching hospital between December 2019 to February 2020. Those with cancer, aged 18 years and above, who had surgery, chemotherapy and (or) radiotherapy for treatment were included while those who had not commenced cancer treatment were excluded. Information on their clinicopathologic characteristics was obtained. The degree of psychological distress was assessed using a distress thermometer (DT) based on an 11-point scale. Social function was assessed using validated SCARF social functioning index (SSFI) (Cronbach's alpha = 0.818) which has 4-domains, each with scores ranging from 0 (very poor) to 4 (very good). Financial burden (FB) was assessed on a 5-point Likert scale. SPSS was used for data analysis with p < 0.05 considered significant. Results: Seventy-two patients were analyzed with a mean age of 50.3 ± 13.7 years and male to female ratio of 0.8:1.0. The median time from diagnosis was 6.0 (2.5 – 16.0) months and 51 (70.8%) were on palliative treatment. The median psychological distress score was 6.0 (4.0 – 8.0) while the mean SSFI score was 12.0 ± 3.3. Relationship with immediate family (3.4 ± 0.7) had a significantly higher sub-score than two other domains (occupational role: 2.3 ± 1.4, p < 0.001; self-concern/care: 3.0 ± 1.0, p < 0.001). Fifty patients (69.4%) had heavy or extreme financial burden with 34 (47.2%) admitting to income reduction since onset of therapy. Female sex (p < 0.001, 95% CI: 1.246 – 3.597), higher ECOG score (p = 0.033, 95% CI: 0.061 – 1.383) and palliative treatment (p = 0.038, 95% CI: 0.084 – 2.768) were independent predictors of psychological distress. Conclusions: Despite the marked psychological distress and huge financial burden in patients receiving cancer treatment in this setting, they still maintained a relatively normal status in most of the social function domains.

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

“…[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. [15,32,35,37] The problem list identified transportation as a major problem under the practical problem domain.…”

“…[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.…”

“…Few studies in Africa have reported high levels of distress mostly among patients with cancer with advanced disease or in palliative settings. [21][22][23] With the growing burden of cancer in sub-Saharan Africa, there is a need to understand these factors and develop strategies to address distress in tandem with ongoing advances in cancer care. This study aimed to determine the levels of psychological distress in patients with cancer in Kenyatta National Hospital using the NCCN distress thermometer and problem checklist.…”

Influence of Social Workers' Empathy Ability on Suicidal Ideation of Cancer Patients

“…In some developed countries in Europe and the United States, medical social workers have become a mature and specialized profession to intervene in the medical process of patients in the whole process, and their education and training system is sound ( 1 ). Patients with cancer face the threat of long course of the disease, treatment cycle, and even death, which destroys their mental health and social function ( 2 , 3 ). Therefore, they need social work services as part of holistic care and health management.…”