Nutritional knowledge in association with dietary practices of Cancer patients: A case study of Kenyatta National Hospital Cancer treatment center, Nairobi

Abstract

Cancer is on the increase in Kenya and has become one of the leading public health problems. This increase is possibly attributed to change in behavior and adoption of predisposing lifestyles such as smoking, alcohol intake, low consumption of fruits and vegetables, high intake of highly processed foods and lack of physical activity. Cancer patients undergoing treatment such chemotherapy and radiotherapy experience side effects such as lack of appetite, nausea, vomiting and diarrhea. This often leads to malnutrition and low immune function, making them even more predisposed to infections. In this light therefore, cancer patients need nutritional counseling and education to assist them make prudent dietary choices. This study was therefore designed to assess the nutritional knowledge and association with dietary practices of cancer patients. The study cross sectional and involved a sample of 132 patients attending the cancer treatment centre clinic at Kenyatta National Hospital. The study was carried out in the months of October to November 2012. The patients were either undergoing chemotherapy or radiotherapy. Information from the patients was collected using a previously pretested structured questionnaire. Information was collected on socio demographic, social economic status, nutritional knowledge and dietary practice. The nutrition knowledge section was divided into Recommended Dietary Intake, food groups and food choice and diet-disease relationship. Food consumption frequencies were assessed and data on dietary intake obtained. Results were subjected to analysis as frequencies, percentages, chi- square tests and linear and logistic regression. Results showed that of the patients 75% were female and 25% were males. Various patients (44%) were unemployed others (27%) were farmers. The most prevalent cancer among the female patients 55% was breast cancer followed by cervical cancer 17% nasal esophagus cancer at 5% respectively. In males the most prevalent one was prostate (21%), followed by nasal esophagus 18%, stomach cancer and palate cancer 9% respectively. The age-group that had most patients at 58% was the middle age (36-59yrs). The education level of patients who were secondary graduates was 40%, college graduates were at 34%, primary school graduates was at 9% and those who had not gone to school were at 17%. The patients who were unemployed were 44%, those employed were 30% while those who were self-employed were 37%. The average income for patients attending the clinic was Kshs 9,111. The total nutrition knowledge average score was 46%.The most frequently consumed foods included green leafy vegetables, beans, fruits and beef. The average Individual Dietary Diversity Score (IDDS) was 4 with the most consumed food group being starchy staples (92%). There was a significant positive correlation between the nutrition knowledge and IDDS of patients, but nutritional knowledge only influenced the IDDS only up to 3%. Patients with average to above average Nutrition knowledge were 9 times more likely to consume fruits compared to those with below average nutrition knowledge. Patients with average and above average nutritional knowledge were 4 times likely to consume vegetables than those below average nutritional knowledge. Results indicate that there was significant positive association between nutritional knowledge of the patients and their dietary practices especially for foods like fruits and vegetables and protein foods that are considered crucial in the management of cancers. However, considered on their own consumption of beans and peas as source of protein showed a negative correlation.