| dc.description.abstract | Background: Cancer diagnosis is associated with increased chance of developing psychological, social
and psychiatric disorders, which impact on patient’s health state and medical treatment. Psychiatric
disorders are experienced by cancer patients at all stages of disease. The number of people diagnosed
with cancer is on the increase every year in the developing countries, Kenya being one of them and the
burden of cancer continues to grow. Psychological and social issues among adults cancer patients are
well documented in the rest of the world, Kenya has a little amount of data in place. A critical part of
cancer care is the recognition of the levels of psychological and social problems that present among
patients with cancer and determination of the appropriate level of intervention, ranging from brief
counselling or psychosocial interventions and social support to medication and specific coping styles.
Objectives: The main objective was to determine the psychological and social issues among adult
cancer patients seen at the oncology clinic of Moi Teaching and Referral Hospital (MTRH), Eldoret.
The Specific objectives were to determine the psychological, social issues that are associated with
cancer diagnosis and socio-demographic characteristics and clinical state of the patients diagnosed with
cancer.
Methodology: This was a cross-sectional and descriptive study. The study participants diagnosed with
cancer were enrolled and interviewed using researcher designed socio-demographic and clinical
questionnaire and the Mini International Neuropsychiatric Interview for adults (M.I.N.I Plus)
instrument. The participants were assessed after informed consent was obtained. Ethical approval was
obtained from Institutional Research and Ethics Committee (IREC) Moi Teaching and Referral Hospital
(MTRH) Moi University and Ethics and Research Committee Kenyatta National Hospital/ University of
Nairobi before conducting the study.
Data analysis: There was double entry of data followed by cleaning weekly. Data was entered into
Microsoft excel worksheet then exported to Statistical packages for social sciences (SPSS) version 16.0
for analysis to describe each DSM-IV diagnosis of each participant by summing up the ‘yes’ responses
that met each criterion for DSM-IV Axis I disorders. Results are presented in form of tables, charts and
graphs
Result: A total of 138 respondents participated in the study. Majority of the study participants were
females at 71.7% (99) whereas males were 28.3% (39). Breast cancer at 34.8% (48) and cervical cancer
at 12.3% (17) were the commonest. Most of the participants were in the advanced stages between stage
III at 33.3% and IV at 39.1%. Among the participants major depression episode (current, past, with
melancholic features) was noted in 42%, 15% and 21.7% respectively. 14.5% had dysthymia current.
Suicide risk high, moderate and low risks were 2%, 2.9% and 8% respectively. Panic disorder current
without agoraphobia was 2.2%, with agoraphobia 6.5% and agoraphobia without history of panic
disorder was 8.7%. Post traumatic stress disorder was 13% social phobia was 7.2%. Obsessive
compulsive disorder was 4.3%. Generalised anxiety disorder was 12.3%. Hypomanic episodes was at
5.1%; manic episodes at 7.2%. The less frequent disorders were alcohol and drug dependency/ abuse,
Psychotic disorders, Anorexia nervosa and Bulimia nervosa were each affecting less than 1% of the
patients. Antisocial personality disorders accounted for only 1.4% amongst the cancer patients. None of
the participants had the psychosocial issues documented in the clinical file notes. Only 7.9% (11)
reported to have discussed the psychological and social concern with the care givers that is a 92.1%
treatment gap.
Conclusion: Major Depressive Episode, anxiety disorder, Obsessive compulsive disorder,
Posttraumatic stress disorder were the main psychiatric disorders noted. Other disorders that were found
among cancer patients at MTRH include antisocial personality, social phobia, and alcohol and drug
dependency/abuse. Psychosocial oncology services for patients and families were found to be minimal. | en_US |
