Psychosocial distress in Ethiopian women with gynaecological cancer

Abstract

Gynaecological cancer significantly impacts the lives of patients and their families in terms of their psychosocial well-being. Patients in particular experience negative consequences in their physical, psychological, social, sexual, and financial well-being. Psychosocial distress, on the other hand, could lead to poor quality of life, ineffective treatment, and negatively affect survival. This situation becomes very complex and devastating in countries like Ethiopia, where women are subjected to various socioeconomic and cultural burdens. Above 7 thousand new cervical cancer cases are diagnosed, and about 5 thousand die each year, with over 115 million population, gynaecological cancer will continue to be important in Ethiopia. However, there are little to no studies on the prevalence of psychosocial distress in gynaecological cancer patients and the factors affecting it. Hence, it is critical that psychosocial distress of patients is well-studied and culturally appropriate interventions are proposed. Thus, this study aimed to investigate the psychosocial distress of gynaecological cancer patients in Ethiopia. The study objectives are to: examine the prevalence and the severity level of psychosocial distress that Ethiopian women diagnosed with gynaecological cancer face; examine the distress levels of spouses of women with gynaecological cancer; identify associated factors of psychosocial distress of women with gynaecological cancer; and examine the relationship between psychosocial distress, and social support, dyadic coping and quality of life of women with gynaecological cancer. A cross-sectional institution-based study was conducted in private and public hospitals, including the major cancer referral center in Ethiopia, for six months (July 2021 - December 2021). Two questionnaires were designed for patients and their spouses. The study used scales such as the Distress Thermometer, The Hospital Anxiety and Depression Scale, Brief Illness Perception Questionnaire, The Female Sexual Distress Scale-Revised, Social Provisions Scale, The Dyadic Coping Inventory, and the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire-Core 30-item for patients. Simple descriptive statistics and bivariate analysis were used to describe psychosocial distress and explore its associated factors. Statistically significant independent variables (p-value < 0.05) were entered into multiple logistic regression models and identified based on an adjusted odds ratio with 95% confidence intervals. A total of 406 gynaecological cancer patients and 157 spouses participated in the study. Overall, the study's findings show that all types of psychosocial distresses are highly prevalent in gynaecological cancer patients in Ethiopia, except spiritual concerns. Among the patients and spouses, 85.5% and 95% reported moderate-to-severe distress, respectively. About 60% and 53% of the patients also reported depression and anxiety. Patients’ illness perception and cancer stage were positively associated with distress level and anxiety. Perceived social support showed a negative association with depression. Quality of life was also negatively associated with patients’ distress, anxiety, and depression. Healthcare providers should consider providing psychosocial care to patients and their spouses. This includes addressing their social, psychological, and functional needs with an interdisciplinary approach. In addition, a further detail study could be helpful to understand better the complex behaviour of the disease and its psychosocial effect.