Wellbeing among sub-Saharan African patients with advanced HIV and/or cancer: an international multicentred comparison study of two outcome measures

Health and Quality of Life Outcomes

Richard J Siegert⁴  Irene J Higginson¹  Nancy Gikaara⁶  Liz Gwyther³  Faith Mwangi-Powell⁶  Eve Namisango²  Richard A Powell⁶  Zippy Ali⁵  Lucy Selman¹  Richard Harding¹ 

[1] Department of Palliative Care, Policy & Rehabilitation, King’s College London, Cicely Saunders Institute, Bessemer Road, London SE5 9PJ, UK;African Palliative Care Association, Kampala, Uganda;Hospice Palliative Care Association of South Africa, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa;Person Centred Research Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand;Kenyan Hospice Palliative Care Association, Nairobi, Kenya;Formerly African Palliative Care Association, Kampala, Uganda

关键词: Self-report;    Outcome;    Palliative care;    Cancer;    HIV;    Sub-Saharan Africa;   

Others  :  814753
DOI  :  10.1186/1477-7525-12-80

 received in 2014-01-13, accepted in 2014-05-22,  发布年份 2014

【 摘 要 】

Background

Despite the high mortality rates of HIV and cancer in sub-Saharan Africa, there are few outcome tools and no comparative data across conditions. This study aimed to measure multidimensional wellbeing among advanced HIV and/or cancer patients in three African countries, and determine the relationship between two validated outcome measures.

Methods

Cross-sectional self-reported data from palliative care populations in Kenya, Uganda and South Africa using FACIT-G+Pal and POS measures.

Results

Among 461 participants across all countries, subscale “social and family wellbeing” had highest (best) score. Significant country effect showed lower (worse) scores for Uganda on 3 FACIT G subscales: Physical, Social + family, and functional. In multiple regression, country and functional status accounted for 21% variance in FACIT-Pal. Worsening functional status was associated with poorer POS score. Kenyans had worse POS score, followed by Uganda and South Africa. Matrix of correlational coefficients revealed moderate correlation between the POS and FACIT-Pal core scale (0.60), the FACIT-G and POS (0.64), and FACIT-G + Pal with POS (0.66).

Conclusions

The data reveal best status for family and social wellbeing, which may reflect the sample being from less individualistic societies. The tools appear to measure different constructs of wellbeing in palliative care, and reveal different levels of wellbeing between countries. Those with poorest physical function require greatest palliative and supportive care, and this does not appear to differ according to diagnosis.

【 授权许可】

   
2014 Harding et al.; licensee BioMed Central Ltd.

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