Palliative care-related self-report problems among cancer patients in East Africa: a two-country study (original) (raw)

2014, Supportive Care in Cancer

Purpose Palliative care-related problems have not been measured in Africa in line with the WHO definition. This study aimed to measure the three-day period intensity of multidimensional problems (physical, psychological, social, and spiritual) among advanced cancer patients in Kenya and Uganda. Methods Adults with advanced malignant disease gave selfreport data to the African Palliative Outcome Scale (POS). Results Among 210 respondents, more than half had an underlying HIV diagnosis (51.9 %). The worst ranked POS items were pain and information. In three multivariable ordinal logistic regression models with the 3 POS factors as dependent variables, for the first model (factor 1 physical and psychological well-being), as age increased, the wellbeing also improved (B=0.022, p=0.037), and as physical function score worsened, factor score also worsened (B= −0.685, p<0.001). In the second model (factor 2 interpersonal well-being), a trend toward significance was found for gender, with being male predicting a higher (better) factor score (B= 0.502, p=0.067). For the third model (factor 3 existential and spiritual), increasing age was predictive of higher (better) factor score (B=0.023, p=0.032), and worsening function was predictive of lower (worse) factor score (B=−0.543, p<0.001). Conclusions This novel data revealed pain and information to plan for the future to affect patients most severely, underlining the importance of analgesia and social support. HIV infection did not affect the level of need. Our data suggest increasing need as function declines; therefore, home-based models with adequate family support are essential.