Assessing quality of life among gynaecological cancer patients receiving care in the palliative care unit at Kenyatta national hospital

Abstract

Quality of life (QOL) assessment among cancer patients is considered to be an important aspect in palliative care. QOL assessment helps in the identification of the physical, psychological, social and spiritual needs of the patient. Gynaecological cancers are among the most common types of cancers afflicting women. Although patient assessment and palliative care among cancer patients is undertaken at the palliative care unit of Kenyatta National Hospital (KNH), how the disease and its treatment affect the QOL of these patients is unknown. This study sought to determine the QOL and its associated factors among Kenyan women with gynaecological cancers receiving palliative care. Predictors of QOL were also evaluated. A cross sectional descriptive study was conducted that included 108 respondents diagnosed with endometrial, ovarian, cervical or vulva cancers being followed up and treated in the palliative care unit at Kenyatta National Hospital. The data was collected between the months of April and June 2014. QOL was measured using the Missoula Vitas QOL Index. The association between socio-demographic and clinical factors with QOL was analyzed using one way ANOVA and linear regression analysis to identify the predictors of QOL. The mean total QOL score was reported to be 17.2 (expected range 0-30); mean global QOL score of 3.5 (range 0-5). The symptom subscale had the highest score (mean 8.2); followed by transcendent subscale (mean 6.2); then function subscale (mean 5.6); then interpersonal subscale (mean 5.3) and wellbeing subscale had the least score (mean -2.9). Women aged 65 years and above, with secondary or tertiary levels of education had high mean total QOL scores. Patients who were formally employed and earned more than 10,000 Kenyan shillings were reported to have high mean total QOL scores. Patients with ovarian and endometrial cancers were reported to have higher mean total QOL scores than those with cervical and vulva cancers. Age, level of education, occupation, average monthly income, type of cancer treatment, duration of illness and type of cancer were reported to be the independent predictors of QOL. The quality of life among gynaecological cancer patients receiving palliative care at KNH was moderate but tended towards high QOL. The psychological and social needs of these patients are not adequately identified and addressed. Age, education, occupation, income, type of cancer, type of cancer treatment and duration of illness were the factors influencing QOL. There is need to adopt a QOL assessment instrument in the palliative care unit to assist the palliative care team members in identifying and addressing specific needs that affect the QOL of patients with advanced cancer.