Impact of Social Support on Psychological Wellbeing and Quality of Life of Cancer Patients at Kenyatta National Hospital

Abstract

Background: The ever-increasing incidence of cancer means that cancer-associated emotional and mental distress is set to increase. Despite this, research in cancer care has mainly focused on the management of physical symptoms, with lack of studies assessing the impact of cancer on patient’s mental health and quality of life throughout the course of illness and the possible remedies. Purpose: This study aimed to determine the impact of social support on psychological wellbeing and quality of life of cancer patients at Kenyatta National Hospital. Materials and Methods: This was an analytic cross-sectional study. One hundred and eighty nine cancer outpatients were invited to participate in the study upon giving written informed consent. A semi-structured questionnaire was used to collect participants’ sociodemographic characteristics as well as to determine stage and type of cancer. The World Health Organization’s Quality of Life tool was used to measure the participants’ quality of life while their psychological wellbeing was measured by the Hospital Anxiety and Depression Survey. Multidimensional Scale of Perceived Social Support measured the patient’s level of perceived social support. Data was double-entered into MS-Access software and checked for errors prior to commencement of data analysis using STATA software. For discrete variables, frequency tables and proportions were used to describe the distribution of data while for continuous variables, measures of central tendency were computed. At bi-variate and multivariate levels, correlation and regression analysis were done to investigate the relationships between study variables and provide regression coefficients. The level of significance was set at p<0.05. Results: A total of 189 participants consented to participate in the study and their mean age was 57.1±13.1 years. Majority were females (65.1%), Christians (94.7%), married (68.3%), employed (58.2%) and with post primary education (55.0%). Over two thirds (69.8%) earned Kshs.10000 and below. The three types of cancer sampled were in almost equal proportions (Breast: 35.4%, Cervical: 31.7% and Prostate cancer: 32.8%). More than half of the respondents had depression (57.3%) and anxiety (62.3%). Quality of life scores was as follows: Psychosocial 42.8 (SD 12.7), Environmental 41.7 (SD 10.9). Social 41.0 (SD 14.6) and Physical 39.5 (SD13.5) domains. The highest source of social support came from family 5.6 (SD 1.3), followed by significant others 4.4 (SD 1.9) and finally friends 3.8 (SD 1.5). Low level of education, lack of formal employment, being widowed, earning low income and being in the advanced stage were significantly associated with higher depression scores (p<0.05). Similarly, low levels of social support was significantly associated with higher depression and anxiety and lower quality of life scores. Conclusions: There is a positive association between social support and psychological wellbeing and quality of life of cancer patients. Integrating social support in the management of cancer patients has the potential to improve patient’s psychological wellbeing and quality of life. Longitudinal studies correlating social support and treatment outcomes among cancer patients are recommended.