title: Wellbeing among sub-Saharan African patients with advanced HIV and/or cancer: an international multicentred comparison study of two outcome measures.
abstract: 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.
authors.affiliation: Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, Bessemer Road, London SE5 9PJ, UK. richard.harding@kcl.ac.uk.
authors.forename: Richard
authors.initials: R
authors.lastname: Harding
authors.forename: Lucy
authors.initials: L
authors.lastname: Selman
authors.forename: Zippy
authors.initials: Z
authors.lastname: Ali
authors.forename: Richard A
authors.initials: RA
authors.lastname: Powell
authors.forename: Eve
authors.initials: E
authors.lastname: Namisango
authors.forename: Faith
authors.initials: F
authors.lastname: Mwangi-Powell
authors.forename: Liz
authors.initials: L
authors.lastname: Gwyther
authors.forename: Nancy
authors.initials: N
authors.lastname: Gikaara
authors.forename: Irene J
authors.initials: IJ
authors.lastname: Higginson
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Siegert
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D010166:Palliative Care; D012737:Sex Factors; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult