Quality of Life of Cancer Patients in Palliative Care in Northern Malawi: A descriptive cross-sectional study

Abstract

Background Cancer continues to cause major morbidity and mortality in low- and middle-income countries thereby contributing to unmet palliative care services. Palliative care among cancer patients aims to improve Quality of Life (QoL). This study was conducted to assess the quality of life of cancer patients in palliative care. Methods Through a descriptive cross-sectional design, 158 cancer patients in palliative care services were assessed using the WHOQOL-BREF tool which is a validated and reliable tool to assess quality of life. The study was conducted in the northern region of Malawi. The participants were assessed in four domains of quality of life namely physical, psychological, environment health and social relationships. We also assessed individual’s overall perception to quality of life and satisfaction with their health. Results A total of 158 patients were interviewed with mean age of 53 years and majority were females 102 (64.6%). The most frequent cancer sites among the study subjects were Cervical 60 (38%) followed by skin (Kaposi’s sarcoma) 32 (20.3%). Only 54 (34.2%) patients had laboratory confirmed cancer. Majority 98 (62.0%) of the patients had received palliative chemotherapy and 103 (65.2%) were on opioids for pain control. The results show a significant positive correlation between the overall quality of life and overall satisfaction and the scores of the physical and psychological domains, with r > 0.4 (p < .001). Higher education (p < 0.05), being on palliative chemotherapy (p < 0.05) and longer duration of cancer (p < 0.05) were associated with better quality of life. Morphine was found to be a significant negative predictor affecting both the Physical domain (β = −9.24; p = 0.045) and Q1 (β = −0.53; (p < 0.05), but not psychological domain and overall satisfaction of health. Age, gender, occupation and religious affiliation were not related to overall QOL and satisfaction. Conclusion There are various factors that affect QOL among patients in palliative care. Physical and environmental domains are major determinants of overall QOL and satisfaction. The effectiveness of palliative care services in maintaining the overall quality of life requires comprehensive supportive care.