Psychosocial Experiences of Transition From Paediatric to Adult Wards of Adolescents Receiving Oncology Care at Kenyatta National Hospital

Abstract

Background: Adolescence is a time of considerable physical and emotional changes, and cancer diagnosis during this time can have a profound impact on a child's psychological and physical developmentand complicates the experiences typical to this life phase. Unfortunately, much of the focus in most of the oncological care settings is on disease management and hence adolescent cancer patients’ readiness and psychosocial and emotional experiences often remain largely overlooked. Objective:To assess the psychosocial experiences of adolescents receiving oncology care at Kenyatta National Hospital as they transition from pediatrics to adult wards. Methods:This was a sequential mixed-methods study conducted among 60 adolescents on cancer care in Kenyatta National Hospital (KNH) oncology unit. Bothquantitative and qualitative data were collected using a questionnaire administered by the interviewer and a focus group discussion (FGD) guiderespectively. The study tools were pre-testedat Kenyatta University Teaching and Referral Hospital. The study’s quantitative data were analyzed using descriptive measures that included percentages and frequencies using SPSS version 25.0. Association between variables of the study was evaluated using chi-square test at 95% CI. Results were shown in tables and figures. Qualitative data from the FGDs was thematically analyzed using content analysis and presented in narrative form. Results:Majority (88.3%, n = 53) of the respondents shared the view that their level of preparedness for transition from pediatrics to adult wards was inadequate. Being mentally depressed (66.7%), anxiety (100%), helplessness (63.3%), low self-esteem (81.7%) and guilt (76.7%) were the leading psychological experiences of adolescents receiving oncology care at Kenyatta National Hospital as they transitioned from pediatrics to adult wards. Sadness (93.3%), emotional pain (98.3%), anger (93.3%) and fear (96.7%) were the leading emotional experiences of adolescents receiving oncology care at Kenyatta National Hospital as they transitioned from pediatrics to adult wards. Social isolation (95%), self-pity (85%), loneliness (100%) and lack of or inadequate social supports (53.3%) were the leading social experiences of adolescents receiving oncology care at Kenyatta National Hospital as they transitioned from pediatrics to adult wards. Conclusions: Adolescents receiving oncology care at KNH underwent a wide range of psychological, emotional and social experiences as they transitioned from pediatrics to adult wards. They also perceived their preparedness for transition from pediatrics to adult wards as being inadequate. Recommendations:To address the challenge of adverse psychosocial and emotional experiences of transition from pediatrics to adult wards among adolescents on oncology care at KNH, age-appropriate patient tailored psychosocial support systems and services should be initiated prior to, during and in the post transition period for these patients.