QoL among palliative care patients poor in South Africa, Uganda
MedWire News: HIV and cancer patients in South Africa and Uganda report relatively poor quality of life (QoL), research shows.
Patients also reported that close relationships, feeling at peace, and having a sense of meaning were more important to QoL than physical comfort, report Lucy Selman (King's College, London, UK) and colleagues in the journal Health and Quality of Life Outcomes.
"These findings show that it is vital to identify and meet the psychological and spiritual care needs of patients, as well as to rigorously assess and treat pain and other symptoms," say the researchers.
Overall, palliative care in sub-Saharan Africa is considered "patchy, and coverage is poor," even though South Africa and Uganda have made strides in its provision.
In 2001, Uganda became the first country in Africa to make palliative care a priority in its national health plan.
In this analysis, the researchers sought to describe the QoL among patients with an incurable, progressive disease receiving palliative care in South Africa and Uganda.
In total, 285 patients, mean age 40 years old, participated in the cross-sectional survey. More than 80% of patients were diagnosed with HIV, while 18% were diagnosed with cancer.
Using the Missoula Vitas Quality of Life Index (MVQOLI), the mean global QoL score was 2.81, where 0 is the worst score and 5 the best score.
Patients were also assessed using the five subscales assessing physical, social, psychological and spiritual domains.
The mean total score for the subscales was 17.32 from a possible score of 30. Patients scored most poorly on the function subscale, followed by the subscales for well being, symptoms, transcendence, and interpersonal relationships.
Despite this, the most important QoL factors to patients were inner peace and finding meaning in their lives. Following these measures in importance were QoL factors such as being active and physical comfort.
Compared with cancer patients, those with HIV scored significantly worse on measures of well being, transcendence, and total QoL.
Overall, patients in South Africa and Uganda scored significantly worse on QoL measures than similar US populations.
In sub-Saharan Africa, more than 20 million people are living with HIV infection, with 1.7 million adults and children infected with the disease in 2007.
Cancer, as well as other non-communicable diseases, is also becoming an urgent public health issue. One in five deaths in sub-Saharan Africa is due to cancer.
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