title: Health-related quality of life and needs of care and support of adult Tanzanians with cancer: a mixed-methods study.
abstract: BACKGROUND
  Cancer is among the three leading causes of death in low income countries and the highest increase with regard to incidence figures for cancer diseases are found in these countries. This is the first report of the health-related quality of life (HRQOL) and needs of care and support of adult Tanzanians with cancer.
  
  
  METHODS
  A mixed-methods design was used. The study was conducted at Ocean Road Cancer Institute (ORCI) in Dar es Salaam, Tanzania. One hundred and one patients with a variety of cancer diagnoses treated and cared for at ORCI answered the Kiswahili version of the EORTC QLQ-C30 investigating HRQOL. Thirty-two of the patients participated in focus group interviews discussing needs of care and support. Data from focus group interviews were analyzed with content analysis.
  
  
  RESULTS
  The findings show that the patients, both women and men, report a low quality of life, especially with regard to physical, role, and social function and a high level of symptoms and problems especially with financial difficulties and pain. Financial difficulties are reported to a remarkably high extent by both women and men. The patients, both women and men report least problems with emotional function. A content analysis of the interview data revealed needs of food and water, hygienic needs, emotional needs, spiritual needs, financial needs, and needs of closeness to cancer care and treatment services.
  
  
  CONCLUSIONS
  The high score for pain points out that ORCI is facing severe challenges regarding care and treatment. However, when considering this finding it should be noted that the pain subscale of the Kiswahili version of the EORTC QLQ-C30 did not reach acceptable internal consistency and showed less than satisfactory convergent validity. This also applies to the subscales cognitive function and global health/quality of life. Attention should be drawn to meet the identified needs of Tanzanian cancer patients while hospitalized but also when at home. Increased accessibility of mosquito nets, pads, and pain-killers would help to fulfil some needs.
authors.affiliation: Department of Public Health and Caring Sciences, Psychosocial Oncology and Supportive Care, Uppsala University, Box 564, Uppsala 751 22, Sweden. louise-von.essen@pubcare.uu.se
authors.forename: Golden M
authors.initials: GM
authors.lastname: Masika
authors.forename: Lena
authors.initials: L
authors.lastname: Wettergren
authors.forename: Thecla W
authors.initials: TW
authors.lastname: Kohi
authors.forename: Louise
authors.initials: L
authors.lastname: von Essen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D017144:Focus Groups; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires; D013636:Tanzania; D055815:Young Adult