Influence of Psychosocial Distress Predictors on Quality of Life in Women With Breast Cancer in Nairobi County

Abstract

Breast cancer diagnosis and treatment affect a woman's physical, emotional, social, and sexual wellbeing, making quality of life a crucial treatment outcome. The aim of this study was to uncover some predictors of psychosocial distress and their influence on breast cancer patients’ quality of life. To achieve this purpose, the study focused on establishing the prevalence of psychological distress, the influence of socio-demographic variables, treatment-related side effects, body image, and the link between social support and quality of life in Kenyan women with breast cancer. The Stress Process Model (SPM), the Social Cognitive Theory of Health Promotion (SCTHP), and the Fundamental Cause Theory (FCT) served as the study's three guiding theories. The study design was sequential exploratory mixed-methods. Data were collected from two cancer hospitals in Nairobi County. With phenomenology explaining the breast cancer patients lived experiences, qualitative data was gathered through interview schedules with 20 patients, two 6-member focus group discussions, and 8 healthcare practitioners. A questionnaire was used to gather quantitative data from 256 patients from two hospitals, revealing a median age of 47 years. Thematic analysis found that breast cancer patients experienced both losses and unexpected gains. Financial hardship hit hardest. The effects of breast loss were enduring; the financial model had gaps; positive social support was plentiful, but there was also negative social support. Descriptive statistics found that psychosocial distress was prevalent and severe, with 63% of participants reporting severe distress and 23% reporting clinically significant distress. Additionally, 91% of participants reported financial distress, with 36% reporting clinical depression and 40% reporting anxiety. Of the individuals, 75% had comorbid clinical-severe depression and anxiety. In order to ascertain the factors that predicted psychosocial distress, a multinomial logistic regression analysis was conducted. Factors affecting outcomes included income (p<0.05, OR 5.50), early diagnosis (p<0.05, OR 0.31), severe treatment side effects (p<0.05, OR 2.89), poor body image (p<0.05, OR 1.83), and decreased sexual function (p<0.05, OR 3.83). Social support moderated psychosocial distress (p<0.05, OR 0.69). The results of the multivariate logistic regression analysis, which investigated the influence of psychosocial distress predictors on quality of life, indicated statistically significant relationships. The presence of some income (p<0.05, OR 1.08), early diagnosis (p<0.05, OR 2.03), mild treatment side effects (p<0.05, OR 1.88), negative body image (p<0.05, OR 0.915), diminished sexual function (p<0.05, OR 0.288), and adequate social support (p<0.05, OR 1.65). Social support moderated the influence of distress on quality of life (p<0.05, OR 1.57). All hypothesised psychosocial distress predicators correlated with quality of life. However, social support ameliorated the harmful effects of distress on participants' quality of life. The main unattended issues in treatment were body image and sexual function. Distress and emotional disorders such as anxiety and depression were either disregarded or not addressed effectively. Financial distress stood out; this calls for a reassessment of the SHIF cancer financing policy to close gaps. Furthermore, non-disease factors have an influence on the quality of life for women with breast cancer. As a result, it is critical to incorporate distress screening into cancer care and to adopt a multidisciplinary approach to managing both the disease and the psychosocial challenges that breast cancer patients face. The incorporation of psychotherapy and social interventions into breast cancer care is necessary to achieve the fundamental treatment goal of enhancing quality of life