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

Afr J Prim Health Care Fam Med. 2024 Apr 11;16(1):e1-e6. doi: 10.4102/phcfm.v16i1.4288.

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

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Kenya
  • Male
  • Middle Aged
  • Neoplasms* / psychology
  • Palliative Care / statistics & numerical data
  • Patient Preference*
  • Prognosis
  • Surveys and Questionnaires
  • Terminal Care

Grants and funding

Funding information Financial support for this study was provided by Duke Global Health Institute (DGHI) (Grant no. 4531740-APPROACH). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing and publishing the report.