Toward integration of palliative care into cancer care: A study on profile of psychosocial and clinical complications among attendees of a Nigerian oncological center.
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e20675 Background: The integration of palliative care into cancer management is abysmal in this context and paucity of empirical evidence constitutes constraint for policy formulation and their translation into cancer care. This study assessed psychosocial and clinical complications among Nigerian cancer subjects. We postulated the interplay of psychosocial and clinical factors would constitute evidence for palliative care. Methods: This is an observational study among 200 adult participants with histological diagnosis of cancer recruited using systematic random sampling. Eligible participants were interviewed by the researchers using socio-demographic/clinical profile questionnaire, Centre for Epidemiological Studies Depression Scale Revised (CES-DR) and Schedule for Clinical Assessment in Neuropsychiatry (SCAN). Data analyses were done using SPSS-15. Results: The commonest type of malignancy was breast cancer (51.0%); cervical cancer 29.5%, colorectal and prostatic cancers were 10.5% and 9.0% respectively. Slightly less than half (49.0%) of subjects had advanced cancer. Most subjects (36.5%) had symptoms for over a year at presentation. Two-thirds (66.0%) had pain, 52% had weight loss and 20.0% had external ulcer. Ninety-eight (49.0%) subjects had depressive symptomatology (CES-DR score ≥16), while prevalence of depression based on SCAN was 27.5%. Depression was significantly associated with higher educational status (p=0.003), unemployment (p=Ÿ0.004), unmarried status (p=0.004), advanced cancer stage (p=0.006), longer duration of cancer (p=0.048), pain (p<0.001), physical complications (p<0.001). However, unmarried status, unemployment, pain and duration of cancer still correlated with depression following logistic regression. Conclusions: In this study, preponderance of physical, psychosocial complications, advanced stage illness and high symptoms burden suggest that integration of palliative care into cancer management should be the rule rather than exception. Lastly, further research on palliative care with translation of resulting research based evidence into cancer care is implied.
