Coronavirus 2019 Preventive Protocols and Cancer-care- Experiences and Perspectives of Adult Cancer Patients at Kenyatta National Hospital Cancer Treatment Centre

Abstract

Background: This study was conducted in the month of September, 2021 to explore adult cancer patients' experiences and perspectives on cancer care during implementation of COVID-19 prevention protocols. The rationale was to fill the gap in knowledge on adult patient experiences and perspectives on cancer care, develop further understanding of the clinical situation, inform more integrated approaches to treatment of cancer patients during the COVID-19 pandemics and future pandemics. Methods: The study was a cross sectional survey that employed a face- to- face in-depth interview method approach. The study targeted adult patients with cancer on follow-up or on active treatment attending clinics or had been/were admitted at CTC in KNH between March 2020 and May 2021 and understood English and/or Kiswahili language. The sample size (12) for the study was based on the data saturation; the point in data collection when new data no longer brings additional insights to the research questions. Purposive sampling was employed. Pretesting of the In-depth interview guide was carried out in two of the cancer units at KNH that did not take part in the main study (adult haemato-oncology clinic 23 and adult ward 8C). Approval to conduct this study was granted by Kenyatta National Hospital (KNH)- University of Nairobi Ethics and Research Committee reference number KNH-ERC/A/305 dated 06 September, 2021 (P353/05/2021). Approach to data analysis was by content analysis technique for qualitative data. Audio Recorded data was transcribed and entered into a computer through a word processing program. QSR International’s NVivo 11 Software was employed while demographic data was checked for completeness and keyed into a computer program, statistical package for social scientist version 28.0 for analysis. Data was presented in frequency tables and emerging themes. Study Findings: The respondents were of varied socio-demographic and clinical characteristics. Various themes emerged from the respondents’ reports. Cancer services were accessed by adult patients at the study area though some respondents had difficulties in attending services. COVID-19 preventive protocols implementation effects on patients included financial hardship, psychological effects like fear of infection, social isolation and physical health deterioration. Generally, the respondents who received services were satisfied with cancer care services afforded to them. The study respondents employed various coping mechanisms like seeking divine intervention, seeking financial assistance, reduction in expenditures and adherence to preventive protocols. Conclusion: The respondents continued receiving cancer care at study site of which most of the respondents were able to access. The study respondents experienced adverse economic effects, physical health deterioration, social and psychological effects during COVID-19 implementation period. The respondents were satisfied with the services provided and employed various coping mechanisms to contain the effects of the pandemic preventive protocols’ implementation on their care. Recommendation: The study recommends increase in clinic days to include weekends to cater for a large number of patients. An upgrade of the National Hospital Insurance Fund (NHIF) scheme to cover most if not all the cancer care services in line with universal health coverage goals is a necessity. The study also recommends that cancer centres should be decentralized to counties to make patients access cancer services with ease especially during pandemics.