Quality of life and associated factors among cancer patients receiving palliative care in Western Uganda: a cross-sectional study

Abstract

Background Quality of life (QoL) is a vital outcome of palliative care for cancer patients, yet in a number of Sub Saharan settings, including Western Uganda, there is a dearth of evidence on the level of quality of life and its correlates. Our goal therefore, was to assess the level of quality of life and associated factors among cancer patients receiving palliative care in Western Uganda. Methods A cross-sectional study was conducted using a pretested questionnaire that included socio-demographics, clinical information and the MissoulaVitas Quality of Life Index (MVQOLI-15R), a tool that measures quality of life of patients with advanced, incurable and progressive disease such as cancer. It is a 16-item instrument comprising of f ive subscales of: function, symptom, interpersonal, well-being and transcendence that encompass physical, social, psychological and spiritual dimensions. This tool was previously validated for a similar segment of patients. The above data collection instrument was translated into Runyoro and Runyankore and administered to consecutively enrolled cancer patients at Mobile Hospice Mbarara and Little Hospice Hoima, both of which are found in Western Uganda. Results Two hundred four patients were recruited. They had a mean age of58.8 ± 15.2 years and 154 (75.5%) of them were female. The commonest diagnosis was cancer of the cervix, 101(49.5%). The mean global QoL score was 3.47 ± 0.88 (possible range 0[worst] to 5[best]). The mean total QoL score was 13.44 ± 1.62 (possible range 0[worst] to 30[best]). Patients scored most poorly on symptoms (-6.78±), followed by Interpersonal (-4.01), transcendence (-3.53), function (-2.50) and well-being (1.31). The possible ranges for the subscales is (-30[worst] to 30[best]). With regard to factors associated with QoL, stage of disease, treatment with radiotherapy and pain intensity were found to have statistically significant associations with QoL of cancer patients receiving palliative care in this context. Conclusion QoL of cancer patients under palliative care in Western Uganda was found to be low. Treatment with radiotherapy, pain intensity and stage of disease were established to key predictors of QoL of these patients. Therefore, it is vital for cancer patients to be diagnosed with early stage, have their pin well controlled and get treated with radiotherapy where appropriate in order to harness better outcomes such as QoL for them