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Depression and social support among breast cancer patients in Addis Ababa, Ethiopia.

ABSTRACT: BACKGROUND:Depression is a common co-morbid, disabling disorder that affects 10-25% of cancer patients. It causes substantial functional impairment and lowers survival rate of breast cancer patients. Therefore, the aim of this study is to determine the magnitude of depression and its association with social support among breast cancer patients in Addis Ababa, Ethiopia. METHODS:A cross-sectional study which included 428 breast cancer patients was conducted in seven health facilities in Addis Ababa, Ethiopia. Depression and Social Support were assessed using standard tools Patient Health Questionnaire 9 (PHQ 9) and Multidimensional Scale of Perceived Social Support (MSPSS) respectively. Descriptive statistics were done based on the standard PHQ9 cut off points (0-4, 5-9, 10-14, 15-19 and???20). Mann-Whitney and Kruskal Wallis tests were employed to compare MSPSS score among depressed and non-depressed patients and across the different levels of depression. Bivariate and multivariate logistic regression was done to identify factors associated with depression. RESULT:The prevalence of depression among breast cancer patients was 25% (107/428), andaccording to the PHQ9 score categorization, 70/428 (16.4%), 30/428 (7.01%) and 7/428 (1.64%) of these patients were having moderate, moderately severe and severe depression respectively. Age, occupation, type of health facility treated, severity of pain, hormonal therapy and having problem with employer/ family were significantly associated with depression. The participants' MSPSS total score was overall found to be high (70.35?±?16.81). Those women who had moderate and severe depression had lower mean MSPSS scores compared to women with none/ minimal depression (P =?0.002). CONCLUSION:This study found that one in four breast cancer patients had depression. Depression is associated with poor social support given by family, friends and significant others. Therefore, screening for depression and psychosocial service should be integrated in the routine breast cancer care in Ethiopia.

SUBMITTER: Wondimagegnehu A

PROVIDER: S-EPMC6712811 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Depression and social support among breast cancer patients in Addis Ababa, Ethiopia.

Wondimagegnehu Abigiya A Abebe Workeabeba W Abraha Aynalem A Teferra Solomon S

BMC cancer 20190827 1

<h4>Background</h4>Depression is a common co-morbid, disabling disorder that affects 10-25% of cancer patients. It causes substantial functional impairment and lowers survival rate of breast cancer patients. Therefore, the aim of this study is to determine the magnitude of depression and its association with social support among breast cancer patients in Addis Ababa, Ethiopia.<h4>Methods</h4>A cross-sectional study which included 428 breast cancer patients was conducted in seven health facilitie ...[more]

PMID: 31455282

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Project description:IntroductionCancer is an emerging public health problem in Ethiopia, with breast and cervical cancers accounting for over half of all newly diagnosed cancers in women. The majority of women with breast and cervical cancer are diagnosed at late stage of the disease and most patients do not receive care consistent with global standards. However, little is known about the health-seeking behaviours, barriers to early detection and treatment, patient-reported outcomes, financial burden and survival of women with breast and cervical cancer in the country. Therefore, this study aims to document the experience of women with breast and cervical cancer from recognition of symptoms to diagnosis, treatment and survivorship/mortality in Addis Ababa city, Ethiopia.Methods and analysisA prospective follow-up study using mixed methods (both quantitative and qualitative) will be employed. All women newly diagnosed with breast and cervical cancer from 1 January, 2017 to 30 June 2018 in Addis Ababa will be included in the study. Interviewer-administered questionnaires will be used to collect information about medical consultations after recognition of symptoms, health-seeking behaviours, treatment received, barriers to early detection and treatment, and survivorship care. In-depth interview will be conducted on purposefully selected women with breast and cervical cancer. The primary outcomes of the study are time intervals (patient and diagnostic waiting times), stage at diagnosis and survival. Multivariable analysis will be employed to determine the contributions of independent variables on the outcomes of interest. HRs with 95% CIs will be calculated for time-to-event outcomes. Qualitative data will be analysed using thematic analysis.Ethics and disseminationThis protocol is ethically approved by Institutional Review Board of Addis Ababa University. Verbal informed consent will be obtained from study participants. Results will be disseminated in international peer-reviewed journals and presented in relevant conferences.

Project description:BACKGROUND:Despite the presence of high impact interventions to improve infant and young child feeding, only about 52% of mothers in Ethiopia exclusively breastfeed their child for the first six months after delivery. Although the decision to breastfeed a child is ultimately that of the mother, this decision could be influenced by a variety of factors including social-cognitive ones. OBJECTIVES:The objectives of the study were to describe the breastfeeding behaviour of primiparous mothers during their prenatal period in terms of intentions/goals, outcome expectancies, self-efficacy, and socio-structural factors and assess their exclusive breastfeeding (EBF) practices as well as identify the social-cognitive predictors of EBF practices among these mothers in Addis Ababa, Ethiopia. METHODS:A prospective follow up health facility-based study with quantitative methods was used with a sample of 233 primiparous women. Both structured and semi-structured questions were used for collection of data. The Statistical Package for Social Sciences (SPSS) version 21 was used for data analysis. Findings at the 95% confidence interval and P-value of 5% were reported as statistically significant. RESULTS:39.1% (n = 59) of the respondents were found to have high breastfeeding self-efficacy, 51.4% (n = 71) have good breastfeeding outcome expectancies, and 6.5% (n = 9) respondents had supportive breastfeeding socio-structural factors. Bivariate correlation analysis showed positive and statistically significant correlation between each of breastfeeding self-efficacy, outcome expectancy, and socio-structural factors, with EBF practice. However, only breastfeeding self-efficacy and outcome expectancies were statistically significant predictors of EBF among the primiparous women when controlling for confounding variables. CONCLUSIONS AND RECOMMENDATIONS:Health programmes aimed at improving EBF among primiparous mothers should look beyond providing health information alone. Rather improving primiparous women's breastfeeding self-efficacy and outcome expectancy is strongly recommended. Further community based large scale research is also recommended among similar groups of women.

Project description:BackgroundBreast cancer is the second most prevalent malignancy in Ethiopia and severely affects patients' health-related quality of life (HRQOL). We aimed to assess HRQoL, factors influencing HRQoL, and utilities among breast cancer patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.MethodsA hospital-based cross-sectional study was conducted in Tikur Anbessa Specialized Hospital from December 2017 to February, 2018. A total of 404 breast cancer patients were interviewed using the validated Amharic version of the European Organization for Research and Treatment of Cancer module (EORTC QLQ-C30), EORTC QLQ-BR23, and Euro Quality of Life Group's 5-Domain Questionnaires 5 Levels (EQ-5D-5?L) instruments. Mean scores and mean differences of EORTC- QLQ-C30 and EORTC- QLQ-BR23 were calculated. One-way ANOVA test was employed to determine the significance of mean differences among dependent and independent variables while stepwise multivariate logistic regression was used to identify factors associated with the global quality of life (GQOL). Coefficients and level specific utility values obtained from a hybrid regression model for the Ethiopian population were used to compute utility values of each health state. Data was analyzed using SPSS version 23.ResultsThe mean age of patients was 43.94?±?11.72?years. The mean score for GQoL and visual analog scale was 59.32?±?22.94 and 69.94?±?20.36, respectively while the mean utility score was 0.8 ±?0.25. Predictors of GQoL were stage of cancer (AOR?=?7.94; 95% CI: 1.83-34.54), cognitive functioning (AOR?=?2.38; 95% CI: 1.32-4.31), pain (AOR?=?7.99; 95% CI: 4.62-13.83), financial difficulties (AOR?=?2.60; 95% CI: 1.56-4.35), and future perspective (AOR?=?2.08; 95% CI: 1.24-3.49).ConclusionsThe overall GQoL of breast cancer patients was moderate. Targeted approaches to improve patients' HRQoL should consider stage of cancer, cognitive functioning, pain, financial status and worries about the patient's future health. This study also provides estimates of EQ-5D utility scores that can be used in economic evaluations.

Project description:BackgroundBreast cancer is the most common cancer affecting women in Ethiopia with increasing burden, and chemotherapy treatment produces a detrimental effect on individual wellbeing. Since last few years quality of life has been the primary goal of cancer treatment, yet little research has been conducted on quality of life of breast cancer patients under chemotherapy.ObjectiveTo determine the quality of life and associated factors among patients with breast cancer under chemotherapy at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia.MethodsInstitution based cross-sectional study was conducted on 404 patients with breast cancer, who took at least one cycle of chemotherapy treatment using face to face interview at oncology unit of Tikur Anbessa specialized hospital day care center from February to April 2018. The validated Amharic version of European organization for research and treatment of cancer core 30 (EORTC QLQ-C30) and quality of life questionnaire specific to breast (QLQ-BR23) was used to measure health related quality of life. Both descriptive and inferential statistics were used. For the purpose of interpretation quality of life score was dichotomized in to two using the calculated mean score, which is 53 as a cutoff point, then, bi-variable and multivariable logistic regression was used to describe association between dependent and independent variables. Hence, patients who score above 53 for quality of life were considered to have good quality of life.ResultOf the total sample, overall response rate was 99.77%. The average quality of life score of patients with breast cancer under chemotherapy treatment was 52.98 (SD = 25.61). Majority of patients had scored poor in emotional functioning, sexual functioning, and financial difficulties. Educational status of college and above, being divorced, higher household income, higher scores of physical and social functioning were associated with significantly improved (better) quality of life. Lower scores of fatigue, insomnia, financial difficulties and systemic therapy side effects all were associated with better scores of quality of life of breast cancer patients. Whereas, patients receiving < = 2 cycles of chemotherapy had significantly lower scores of quality of life.Conclusion and recommendationQuality of life of breast cancer patients under chemotherapy treatment is poor in comparison with the reference data and international findings. Therefore, quality of life assessment should be incorporated in patient's treatment protocol. And financial aids may significantly improve the quality of life of breast cancer patients under chemotherapy treatment.

Project description:IntroductionRoutine cervical screening has been shown to greatly reduce both the number of new cervical cancers diagnosed each year and the number of deaths resulting from the disease. Nevertheless, cervical screening knowledge and screening uptake is very low in developing countries. In Ethiopia, the coverage of cervical cancer screening is only 1%. In this study, we aimed to assess cervical cancer screening knowledge and barriers for screening uptake among women in Addis Ababa Ethiopia.MethodsA facility-based cross-sectional study was conducted from February to March 2015 in Addis Ababa, Ethiopia. A total of 520 women were selected by a multi-stage sampling procedure. Interview based questioner was used to collect the data. Descriptive statistics was used to describe the socio-demographic and clinical profiles of the women. Multivariate logistic regression using adjusted odds ratio (AOR) and 95% confidence interval (CI) was used to identify independent predictors for cervical screening knowledge. A p-value of <0.05 was set to determine level of statistical significance.ResultsAmong all women, 42.7% had heard of cervical cancer screening and 144 (27.7%) women had adequate knowledge of cervical cancer screening. The mean (±SD) age of women was 27.7 (±5.49) years. In total, a quarter (25%) of eligible women had experience of cervical cancer screening. Not being married (adjusted odds ratio (AOR) = 1.8, 1.1-3.3), having an awareness of cervical cancer (AOR = 5.0, 2.7-9.1) and receiving information from health professionals (AOR = 1.9, 1.1-3.2) were the predictors for good cervical cancer screening knowledge. An absence of symptoms (57%), a lack of knowledge about screening (56.3%) and the lack of a screening service in their living area (42.2%) were the perceived barriers for screening uptake.ConclusionsCervical screening knowledge was low among women and less than half had heard of screening. Women also had low experience of screening. The lack of a screening service, the absence of symptoms and not knowing about screening were the perceived reasons for the low uptake. Hence, awareness campaigns and education should be undertaken by health professionals. Access and availability of screening service is also essential to improve screening uptake.

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Depression and social support among breast cancer patients in Addis Ababa, Ethiopia.

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Depression and social support among breast cancer patients in Addis Ababa, Ethiopia.

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