A Qualitative Study on Psychosocial Challenges of Patients With Cancer in Ethiopia Using the Social-Ecological Model

Author:

Wondimagegnehu Abigiya12ORCID,Assefa Mathewos3,Teferra Solomon4,Kantelhardt Eva J.25,Zebrack Bradley6,Addissie Adamu12

Affiliation:

1. Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

2. Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany

3. Department of Oncology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

4. Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

5. Department of Gynecology, Martin-Luther-University, Halle, Germany

6. School of Social Work, University of Michigan, Ann Arbor, MI, USA

Abstract

Cancer diagnosis and treatment can be physically arduous, disrupting patients’ social and work lives. Understanding the extent of these problems is key to addressing patients’ needs, but specific psychosocial challenges have not yet been well studied in resource-limited settings. A qualitative study was conducted in the capital and two regions of Ethiopia with the aim of exploring psychosocial challenges among cancer patients. A total of 14 in-depth interviews (IDIs) and 16 focus group discussions (FGDs) were done with cancer patients, health professionals, community representatives, and religious leaders. Four separate interview guides were used to facilitate the interviews and discussions. All transcribed documents, field notes, and reflexive memos were entered into NVivo 12 software, and deductive thematic analysis using the social-ecological model was applied to summarize the main findings. At an individual level, emotional distress, suicidal risk, denial, and refusal of treatment were identified immediately after diagnosis while hopelessness, feeling depressed, and fear of death were commonly reported psychosocial challenges during the course of treatment. Involvement of family members in major treatment decisions was recognized at an interpersonal level. Our result also revealed that cancer patients had strong social support from family members and close friends. In the community, traditional medicine and religious rituals were considered an alternative treatment for cancer. The findings indicate that counselling and psychoeducation are crucial for cancer patients, family members, and close friends. Awareness creation programmes should be delivered through collaboration with religious leaders and traditional healers.

Funder

Else-Kroener-Fresenius Foundation through Martin Luther University, Halle-Wittenberg, Germany

German Academic Exchange Service to Martin Luther University, Halle-Wittenberg, Germany

Hospital Partnerships programme through the Deutsche Gesellschaft für Internationale Zusammenarbeit

Ministry for Economic Cooperation and Development

Publisher

SAGE Publications

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