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Title: | Cancer pain assessment, management and effect on the quality of life of patients at a tertiary hospital in Ghana |
Authors: | Asiedu-Ofei, Akua Afriyie Woode, Eric |
Keywords: | Cancer pain assessment Tertiary Hospital |
Issue Date: | 16-Jul-2021 |
Abstract: | Background: Despite extensive technological advancements in medicine in recent
years, cancer still remains poorly managed resulting in pain and affecting adversely the
quality of life (QoL) of patients. Additionally, evidence suggests that effective cancer
pain management is largely inadequate in low and middle income countries such as
Ghana.
Aim: This study seeks to assess the severity and management of cancer pain at the
Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana.
Methods: Using a structured questionnaire, the socio-demographic data, clinical
characteristics, and drug history of 204 consenting ambulatory oncology patients, aged
18 years or older, attending clinic at the Oncology Directorate, KATH were obtained
from medical folders and the Hospital Administration Management System (HAMS)
from January – December, 2015. Structured interviews were also conducted for the
patients using the Brief Pain Inventory Long Form (BPI-LF) and the World Health
Organization Quality of Life-Brief version (WHOQoL- Bref) to evaluate patients‘ level
of self-reported pain and how pain affects their quality of life. Data obtained was
analysed using reliability and validity tests, parametric and non-parametric tests.
Results: Majority of patients were females (82.8%), married (56.6%), Christians
(89.3%), and employed (86.8%), with mean age and parity of 53.54 years (SD =
15.457) and 4.39 children (SD = 3.118) respectively. Most patients (81.4%) subscribed
to the National Health Insurance Authority (NHIA) registration to cover medical
expenses. Diagnosis for breast cancer (37.7%), stage III/ IV disease (63.3%) and
metastases (32.5%) were predominantly identified. Only 9.1% of patients had positive
family history of cancer while 8 in 10 (79.6%) patients had Eastern Cooperative
Oncology Group performance status of 1. Hypertension was the predominant comorbid
condition identified in 19.6% of the patients. Dual chemotherapeutic agents
combination therapy (46.5%) and mono analgesic therapy (51.1%) were most used.
Internal consistency reliability of the BPI-LF and WHOQoL-Bref were 0.876 and 0.910
respectively. More than half of the patients (63.7%) reported moderate pain while
28.4% reported severe pain. Cancer pain interfered highly with sleep (46.2%) and
general activity (42.5%) of patients. Common sites of cancer pain reported by patients
were abdomen (20.3%) and left breast (12.4%). A set of patients‘ factors did not predict
their overall quality of life and the regression model did not adequately fit the data (R2=
0.44).
Conclusion: Patients predominantly reported moderate cancer pain. Pain management
was mostly inadequate in the patients and pain significantly affected the quality of life
of the patients. |
Description: | A thesis submitted in fulfillment of the requirements for the Degree of Doctor of Philosophy in Pharmacology in the Department of Pharmacology Faculty of Pharmacy and Pharmaceutical Sciences College of Health Sciences Kwame Nkrumah University of Science & Technology, Kumasi. June 2019 |
URI: | http://hdl.handle.net/123456789/14415 |
Appears in Collections: | College of Health Sciences
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