Characterization of Distressing Symptoms and Coping Strategies Among Breast Cancer Patients Under Treatment at Kenyatta National Hospital

Abstract

Background: Cancer is ranked as the second cause of death globally, in 2020 it accounted for about10 million deaths mostly among women. Patients with breast cancer may experience various physical and emotional distressing symptoms during diagnosis, treatment and recovery mainly associated with cytotoxic agents and radiotherapy treatment. However, there are few or no studies focusing on these distressing symptoms in patients with breast cancer treatment in Kenya affecting planning and implementation of coping strategies. Objective: This study sought to determine the distressing symptoms and coping strategies associated with breast cancer treatment among patients attending CTC in KNH. Methodology: This was a descriptive cross-sectional study that involved both qualitative and quantitative methods. A questionnaire and focused group discussions were used for data collection at CTC in KNH and the target population was breast cancer patients on treatment and follow-up at the center. The sample size was made up of ninety-two participants with breast cancer who consented to the study. Simple random sampling was used to select the study participants and the study tools were pretested in female medical ward where breast cancer patients were admitted to check for reliability and validity. Ethical approval was sort from Kenyatta National Hospital-University of Nairobi Ethics and Research Committee board and permission to conduct the study from the Chief Executive Officer of Kenyatta National Hospital. Data analysis was done using SPSS and presented through pie charts and tables while thematic analysis was used for qualitative data. Results: The response rate in this study was 100%, majority (65.2%) of the respondents were married, Christians (91.2%), with an income of below 10000 Kenya shillings (55.4%) and the mean age was 48.49 years. The most, distressing symptoms was fatigue, pain, lack of appetite, drowsiness, nausea, anxiety, vomiting, depression, diarrhea, constipation and least symptom experienced was shortness of breath and the severity was anxiety, lack of appetite, loss of well-being, fatigue, nausea, pain and drowsiness. The coping strategies used were seeking spiritual help, maintaining hope and emotions, expressing emotions to friends, facing reality, reaching out for support to friends, distracting yourself by use of music, using positive affirmations, family support, group support, performing relaxation exercises, staying in the house and praying to God. There was satisfaction with management of distressing symptoms due to good treatment, affordable services, good treatment outcome, well-trained staff. The reasons for not being satisfied were long waiting time before start of treatment and lack of drugs. Conclusion: In Kenya patients diagnosed with breast cancer are more distressed by fatigue and pain but anxiety is more severe. There is a difference in the appearance of the distressing symptoms in different environments and patients use different coping strategies to cope with the distressing symptoms. There was lack of patient education at the Cancer Treatment Centre in Kenyatta National Hospital among breast cancer patients on coping strategies of the distressing symptoms arising from treatment of cancer. To better manage distressing symptoms among breast cancer patients, improve on timely services, drug supply and affordability of services. Irrespective of the management of the distressing symptoms patients are satisfied with the services offered at Cancer Treatment Centre in Kenyatta National Hospital. Recommendations: Characterizing of the distressing symptoms and coping strategies among breast cancer patients will help in incorporation of distress symptom assessment in the day-to-day care of cancer patients hence improving the compliance to treatment modalities leading to better outcomes and improved quality of life.