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Koech MJ, Mwangi J, Kithaka B, Kimaru S, Kusu N, Munyi L, Chahonyo S, Makokha F. Effects of stigma on quality of life of cancer survivors: Preliminary evidence from a survivorship programme in Kenya. Heliyon 2024; 10:e30165. [PMID: 38720711 PMCID: PMC11076907 DOI: 10.1016/j.heliyon.2024.e30165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/22/2024] [Accepted: 04/21/2024] [Indexed: 05/12/2024] Open
Abstract
Globally, cancer is a major public health problem. There is a paucity of information regarding stigma and how it affects the cancer survivors' quality of life (QoL) in Kenya. In a recent report by Globocan, 42,116 new cases and 27,072 fatalities related to cancer were documented in Kenya in 2020. Cancer survivors are more likely to suffer physical and psychological disorders as a result of their poor QoL. The purpose of this study was to evaluate the knowledge, attitudes, and beliefs regarding the stigma associated with the disease as well as how it affects their QoL among a cohort of cancer survivors supported by the KILELE Health Association. Methods This research used a cross-sectional design with both quantitative and qualitative methods. The study enrolled 45 cancer survivors from a cohort participating in the KILELE Health Association (KHA) survivors' program. The quantitative data were coded and analyzed using the 26th version of the Statistical Package for Social Sciences (SPSS). Utilizing content analysis, qualitative data was thematically evaluated. In accordance with the study's goals and key measures, the generated transcripts were organized into themes and sub-themes. Results Participants' mean age was 44.55 ± 9.89 years. Forty-two of the participants completed the survey and were thus included in the analysis. Cancer survivors reported experiencing low levels of stigma across the following dimensions: awkwardness (2.51 ± 0.75), severity (3.22 ± 1.29), financial discrimination (2.77 ± 1.17), personal responsibility (1.9 ± 1.38), avoidance (1.38 ± 0.68), and policy level stigmatization (5.09 ± 1.70). Awareness raising (97.62%), using communication channels (95.24%), advocacy, and lobbying (92.86%) were the most commonly stated strategies to change people's attitudes in terms of interventions to reduce stigma and improve QoL. Conclusion Respondents in this study showed low levels of stigma, which may be due to the support they receive from the KILELE Health Association. Strategic steps in advocacy, publicity, and education are required to end stigmatization to promote awareness and pique people's interest in cancer survivorship. Further research with a larger sample size of cancer survivors from various settings is warranted.
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Joshy G, Khalatbari-Soltani S, Soga K, Butow P, Laidsaar-Powell R, Koczwara B, Rankin NM, Brown S, Weber M, Mazariego C, Grogan P, Stubbs J, Thottunkal S, Canfell K, Blyth FM, Banks E. Pain and its interference with daily living in relation to cancer: a comparative population-based study of 16,053 cancer survivors and 106,345 people without cancer. BMC Cancer 2023; 23:774. [PMID: 37700229 PMCID: PMC10498633 DOI: 10.1186/s12885-023-11214-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/21/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Pain is a common, debilitating, and feared symptom, including among cancer survivors. However, large-scale population-based evidence on pain and its impact in cancer survivors is limited. We quantified the prevalence of pain in community-dwelling people with and without cancer, and its relation to physical functioning, psychological distress, and quality of life (QoL). METHODS Questionnaire data from participants in the 45 and Up Study (Wave 2, n = 122,398, 2012-2015, mean age = 60.8 years), an Australian population-based cohort study, were linked to cancer registration data to ascertain prior cancer diagnoses. Modified Poisson regression estimated age- and sex-adjusted prevalence ratios (PRs) for bodily pain and pain sufficient to interfere with daily activities (high-impact pain) in people with versus without cancer, for 13 cancer types, overall and according to clinical, personal, and health characteristics. The relation of high-impact pain to physical and mental health outcomes was quantified in people with and without cancer. RESULTS Overall, 34.9% (5,436/15,570) of cancer survivors and 31.3% (32,471/103,604) of participants without cancer reported bodily pain (PR = 1.07 [95% CI = 1.05-1.10]), and 15.9% (2,468/15,550) versus 13.1% (13,573/103,623), respectively, reported high-impact pain (PR = 1.13 [1.09-1.18]). Pain was greater with more recent cancer diagnosis, more advanced disease, and recent cancer treatment. High-impact pain varied by cancer type; compared to cancer-free participants, PRs were: 2.23 (1.71-2.90) for multiple myeloma; 1.87 (1.53-2.29) for lung cancer; 1.06 (0.98-1.16) for breast cancer; 1.05 (0.94-1.17) for colorectal cancer; 1.04 (0.96-1.13) for prostate cancer; and 1.02 (0.92-1.12) for melanoma. Regardless of cancer diagnosis, high-impact pain was strongly related to impaired physical functioning, psychological distress, and reduced QoL. CONCLUSIONS Pain is common, interfering with daily life in around one-in-eight older community-dwelling participants. Pain was elevated overall in cancer survivors, particularly for certain cancer types, around diagnosis and treatment, and with advanced disease. However, pain was comparable to population levels for many common cancers, including breast, prostate and colorectal cancer, and melanoma.
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Affiliation(s)
- Grace Joshy
- National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Canberra, ACT, Australia.
| | | | - Kay Soga
- National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Canberra, ACT, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Rebekah Laidsaar-Powell
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Bogda Koczwara
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
- Department of Medical Oncology, Flinders Medical Centre, Adelaide, SA, Australia
| | - Nicole M Rankin
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Sinan Brown
- National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Canberra, ACT, Australia
| | - Marianne Weber
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Carolyn Mazariego
- School of Population Health, The University of New South Wales, Sydney, NSW, Australia
| | - Paul Grogan
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - John Stubbs
- Independent Cancer Consumer Advisor, Sydney, NSW, Australia
| | - Stefan Thottunkal
- National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Canberra, ACT, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Fiona M Blyth
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Canberra, ACT, Australia
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Mensah ABB, Mikare M, Mensah KB, Okyere J, Amaniampong EM, Poku AA, Apiribu F, Lamptey JNC. Impact of cancer diagnosis and treatment: a qualitative analysis of strains, resources and coping strategies among elderly patients in a rural setting in Ghana. BMC Geriatr 2023; 23:540. [PMID: 37670259 PMCID: PMC10481500 DOI: 10.1186/s12877-023-04248-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 08/21/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Rurality is fraught with numerous difficulties including a lack of advanced health facilities to provide health services, and an absence of specialist cancer services, and qualified personnel, among others. These factors exacerbate the challenges of elderly patients diagnosed with cancer and further pose limitations to activities/instrumental activities of daily living. Yet, there is limited scholarship on the strains that affect elderly patients diagnosed with cancer and the resources that helps them to overcome them. This study explores the strains, resources, and coping strategies of elderly patients diagnosed with cancer and undergoing treatment in rural Ghana. METHODS An exploratory, descriptive qualitative design was adopted. Purposive sampling was used to recruit 20 individuals to participate in in-depth interviews. The collected data was analysed inductively using Collaizi's framework. QSR NVivo-12 was used in managing the data. RESULTS The results were grouped into two main categories, namely: strains and resources. Within the category of strains, three main themes with their corresponding sub-themes emerged: cancer-related strains (systemic side effects from treatment, altered physical appearance and body image, and experience of pain), elderly strains (altered functional ability, limited social interactions and participation, psycho-emotional reactions, limited/restricted economic participation, and financial strains), and health system strains (negative attitude and insensitive communication, delay in diagnosis, lack of geriatric oncology care, lack of community-based specialist cancer centre and long travel distance to access care, and limited availability of essential cancer medicines and other radiations services). Four types of resources were available to cancer patients: personal resources, family resources, community resources, and healthcare systems resources. CONCLUSION In conclusion, elderly patients diagnosed with cancer experience physical, economic, psychological, and emotional strains that threaten their health and well-being. However, they are able to leverage family, community, and health system-related resources to navigate through the strains. There is, therefore, a need to expand advanced health facilities with geriatric oncology units and specialists to improve access to cancer care in rural areas. The government needs to assist elderly persons with costs associated with their diagnosis and treatment through the expansion of the National Health Insurance Scheme to include this as part of the benefits package.
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Affiliation(s)
- Adwoa Bemah Boamah Mensah
- School of Nursing & Midwifery, College of Health Sciences, Private Mail bag, Kwame Nkrumah University of Science and Technology, University Post Office, Kumasi, Ghana.
| | - Maurice Mikare
- School of Nursing & Midwifery, College of Health Sciences, Private Mail bag, Kwame Nkrumah University of Science and Technology, University Post Office, Kumasi, Ghana
- Nursing and Midwifery Training College - Zuarungu, P. O. Box 660, Bolgatanga, Ghana
| | - Kofi Boamah Mensah
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, University Post Office, Private Mail bag, Kumasi, Ghana
| | - Joshua Okyere
- School of Nursing & Midwifery, College of Health Sciences, Private Mail bag, Kwame Nkrumah University of Science and Technology, University Post Office, Kumasi, Ghana
- Department of Population and Health, University of Cape Coast, University Post Office, Cape Coast, Ghana
| | - Er-Menan Amaniampong
- School of Nursing & Midwifery, College of Health Sciences, Private Mail bag, Kwame Nkrumah University of Science and Technology, University Post Office, Kumasi, Ghana
- Department of Sociology and Social Work, Faculty of Social Sciences, College of Humanities and Social Sciences, Kwame Nkrumah University of Science and Technology, University Post Office, Private Mail bag, Kumasi, Ghana
| | - Abena Agyekum Poku
- School of Nursing & Midwifery, College of Health Sciences, Private Mail bag, Kwame Nkrumah University of Science and Technology, University Post Office, Kumasi, Ghana
- Department of Komfo Anokye Teaching Hospital, P. O. Box, 1934, Kumasi, Ghana
| | - Felix Apiribu
- School of Nursing & Midwifery, College of Health Sciences, Private Mail bag, Kwame Nkrumah University of Science and Technology, University Post Office, Kumasi, Ghana
| | - Joe-Nat Clegg Lamptey
- Department of Surgery, University of Ghana Medical School, University of Ghana, Accra, Ghana
- Korle-Bu Teaching Hospital, Accra, Ghana
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Oh YS, Lim J. Patient-Provider Communication and Online Health Information Seeking among a Sample of US Older Adults. JOURNAL OF HEALTH COMMUNICATION 2021; 26:708-716. [PMID: 34743676 DOI: 10.1080/10810730.2021.1998846] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Negative communications with health professionals are a stressor to older adults in healthcare settings. In this situation, older adults seek health information on the Internet as alternative information sources and may consider this as having the equivalent value of communicating with a health professional. This study examines the relationship between communications with health professionals and online health information seeking in older adults. This study used the Health Information National Trends Survey, Cycle 3, and included participants (N = 743) aged 65 or older who used the Internet. A multiple logistic regression was employed to examine the association of health professional communication with online health information seeking. Multinomial logistic regression analysis was applied to examine the association between health communications and three types of online health information seeking in older adults. Online health information seeking was significantly associated with negative communications with health professionals. Health communications only predicted online health information seeking by oneself, and females were more likely to search for health information on the Internet than males. The results of this study show that older adults' online health information seeking is an active coping strategy to reduce health risks and improve health promotion in healthcare.
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Affiliation(s)
- Young Sam Oh
- Department of Public Administration and Social Work, Pukyong National University, Busan, South Korea
| | - Jinseop Lim
- Department of Gerontal Health & Welfare, Pai Chai University, Daejeon, South Korea
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Experiences of older patients with cancer from the radiotherapy pathway - A qualitative study. Eur J Oncol Nurs 2021; 53:101999. [PMID: 34294576 DOI: 10.1016/j.ejon.2021.101999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/21/2021] [Accepted: 07/07/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE To explore and describe experiences of older patients with cancer throughout their radiotherapy treatment, from diagnosis until follow-up after treatment. METHODS Individual interviews were conducted to explore different phases of radiotherapy. Interviews were recorded and transcribed verbatim. Inductive content analysis was applied. Each interview was coded separately. Then to the codes were analyzed further, and an overall theme was developed. RESULTS Twelve older patients with cancer, (7 male, 5 female) aged ≥ 65 related their experiences from radiotherapy treatment. A main theme describes the essence of their experiences; Understanding "just enough". The theme comprises five main categories: Understandable, adapted information is crucial for trusting health services; Previous experiences influence patients' perception and understanding; Involvement of next of kin is crucial to patients' comprehension; Professional treatment decisions and well-organized treatment determines satisfaction and Experiences of cooperation and coordination of services affects dependability. CONCLUSIONS Findings from this study describe how understanding "just enough" - not too much nor too little - may assist older patients with cancer in participating in treatment decisions, preventing false beliefs, feeling reassured during treatment and in navigating the complex health care system. Next of kin are important assets for older patients with cancer in understanding "just enough". Cancer nurses may map comprehension of information, as well as reveal patients' previous experiences.
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Abstract
BACKGROUND Breast cancer is more prevalent among women 60 years or older than among women younger than 60 years. However, we know much more about the breast cancer experiences of younger women than of older women. Such knowledge is important, for example, to guide treatment decisions or to provide psychosocial care. OBJECTIVE The aim of this study was to gain insight into the experiences of women with breast cancer 70 years or older. METHODS Semistructured interviews were conducted with 21 older patients with breast cancer in the Netherlands. We used open coding and affinity diagramming to evoke the themes reflecting the experiences of these women. RESULTS Four themes emerged from the data: living through and coping with breast cancer, information exchange and informed choice, support experiences, and impact on daily life. Getting breast cancer took some women by surprise. However, older women with breast cancer coped fairly well and were satisfied with the support they received, especially from oncology nurses. Disturbing treatment adverse effects and changes in appearance, comorbid diseases, lack of clear information, and/or an unsupportive environment complicated their living with breast cancer. CONCLUSIONS Even though many older women with breast cancer handle their disease rather well, some women do encounter difficulties. Lack of support, comorbid diseases, and treatment adverse effects warrant extra attention. IMPLICATIONS FOR PRACTICE Nurses' close attention to women at risk and early intervention could help relieve individual suffering, while taking these womens' strengths into account can enhance self-management.
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A qualitative study on coping strategies of young women living with breast cancer in Ghana. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2019. [DOI: 10.1016/j.ijans.2019.100173] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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