Original Research - Special Collection: Pain Management and Palliative Care

Prognostic awareness and prognostic information preferences among advanced cancer patients in Kenya

Hussein Elias, Semra Ozdemir, Joann Bairavi, Emmah Achieng, Eric A. Finkelstein
African Journal of Primary Health Care & Family Medicine | Vol 16, No 1 | a4288 | DOI: https://doi.org/10.4102/phcfm.v16i1.4288 | © 2024 Hussein Elias, Semra Ozdemir, Joann Bairavi, Emmah Achieng, Eric A. Finkelstein | This work is licensed under CC Attribution 4.0
Submitted: 04 September 2023 | Published: 11 April 2024

About the author(s)

Hussein Elias, Department of Family Medicine, Moi University School of Medicine, Eldoret, Kenya; and Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
Semra Ozdemir, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Republic of Singapore; and, Department of Population Health Sciences, Duke Clinical Research Institute, Duke University, Durham, United States of America
Joann Bairavi, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Republic of Singapore
Emmah Achieng, Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya; and, Moi Teaching and Referral Hospital, Eldoret, Kenya
Eric A. Finkelstein, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Republic of Singapore; and, Duke Global Health Institute, Duke University, Durham, United States of America

Abstract

Background: Cancer is the third leading cause of death in Kenya. Yet, little is known about prognostic awareness and preferences for prognostic information.

Aim: To assess the prevalence of prognostic awareness and preference for prognostic information among advanced cancer patients in Kenya.

Setting: Outpatient medical oncology and palliative care clinics and inpatient medical and surgical wards of Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya.

Methods: The authors surveyed 207 adults with advanced solid cancers. The survey comprised validated measures developed for a multi-site study of end-of-life care in advanced cancer patients. Outcome variables included prognostic awareness and preference for prognostic information.

Results: More than one-third of participants (36%) were unaware of their prognosis and most (67%) preferred not to receive prognostic information. Increased age (OR = 1.04, 95% CI: 1.02, 1.07) and education level (OR: 1.18, CI: 1.08, 1.30) were associated with a higher likelihood of preference to receive prognostic information, while increased symptom burden (OR= 0.94, CI: 0.90, 0.99) and higher perceived household income levels (lower-middle vs low: OR= 0.19; CI: 0.09, 0.44; and upper middle- or high vs low: OR= 0.22, CI: 0.09, 0.56) were associated with lower odds of preferring prognostic information.

Conclusion: Results reveal low levels of prognostic awareness and little interest in receiving prognostic information among advanced cancer patients in Kenya.

Contribution: Given the important role of prognostic awareness in providing patient-centred care, efforts to educate patients in Kenya on the value of this information should be a priority, especially among younger patients.


Keywords

prognosis; prognostic awareness; prognostic information preferences; advanced cancer; Kenya

Sustainable Development Goal

Goal 3: Good health and well-being

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