Psychosocial Distress among Patients with Cancer at Machakos Palliative Care Unit

Abstract

Cancer diagnosis and treatment are emotionally draining to patients and their caregivers. For a long time, treatment for cancer has been associated with pain, suffering and death. These negative consequences of cancer create psychosocial effects such as anxiety and fear. Therefore, there is need to recognize and accurately identify this psychosocial burden on patients by healthcare providers. These professionals can then figure out interventions for these psychosocial issues, possibly even leading to better compliance with overall prescribed treatment, and possibly yielding a better prognosis. The purpose of this study was to determine the prevalence and factors associated with the psychosocial distress among patients diagnosed with cancer at Machakos palliative care unit. Both qualitative and quantitative data were collected through descriptive cross-sectional design. A total of 97 patients were interviewed and filled the questionnaires and the NCCN distress thermometer and problem list. Two focus group discussions were conducted and one palliative care provider was interviewed as a key informant. Quantitative data was analysed using the Statistical Package for Social Sciences (SPSS) for windows version 24. Descriptive statistics such as the means, standard deviation and frequencies were computed. Pearson Chi square test of association and binary logistic regression were computed to determine associations between the independent and the dependent variables. The qualitative data findings were transcribed verbatim and data were analysed for themes about financial problems, pain, chemotherapy side effects, medical insurance, lack of hospital supplies and workload and staffing. Quantitative study findings revealed that majority (72.2%) of the respondents were distressed with 43.2% reporting severe levels of psychosocial distress. Majority of the respondents reported being in pain (83.3%), having problems with decision making about treatment (64.9%), experiencing fatigue (59.8%), having insurance/financial constrains (57.7%), worrying (50.5%) and having problems with eating (50.5%). The results also revealed that male patients diagnosed with cancer were 85% less likely to be distressed compared to female patients (0.R = 0.154, 95% CI 0.039- 0.605). In conclusion, there is a very high prevalence of psychosocial distress among patients with cancer with the leading psychosocial distress being consequence of pain. The study recommended that all patients with cancer be comprehensively screened for psychosocial distress at enrollment for the palliative care services and at prescribed intervals.