title: Palliative care-related self-report problems among cancer patients in East Africa: a two-country study.
abstract: OBJECTIVE
  Palliative care-related problems have not been measured in Africa in line with the WHO definition. This study aimed to measure the three-day period intensity of multidimensional problems (physical, psychological, social, and spiritual) among advanced cancer patients in Kenya and Uganda.
  
  
  METHODS
  Adults with advanced malignant disease gave self-report data to the African Palliative Outcome Scale (POS).
  
  
  RESULTS
  Among 210 respondents, more than half had an underlying HIV diagnosis (51.9 %). The worst ranked POS items were pain and information. In three multivariable ordinal logistic regression models with the 3 POS factors as dependent variables, for the first model (factor 1 physical and psychological well-being), as age increased, the well-being also improved (B = 0.022, p = 0.037), and as physical function score worsened, factor score also worsened (B = -0.685, p < 0.001). In the second model (factor 2 interpersonal well-being), a trend toward significance was found for gender, with being male predicting a higher (better) factor score (B = 0.502, p = 0.067). For the third model (factor 3 existential and spiritual), increasing age was predictive of higher (better) factor score (B = 0.023, p = 0.032), and worsening function was predictive of lower (worse) factor score (B = -0.543, p < 0.001).
  
  
  CONCLUSIONS
  This novel data revealed pain and information to plan for the future to affect patients most severely, underlining the importance of analgesia and social support. HIV infection did not affect the level of need. Our data suggest increasing need as function declines; therefore, home-based models with adequate family support are essential.
authors: 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: Richard
authors: R
authors: Harding
authors: Richard A
authors: RA
authors: Powell
authors: Eve
authors: E
authors: Namisango
authors: Anne
authors: A
authors: Merriman
authors: Nancy
authors: N
authors: Gikaara
authors: Zipporah
authors: Z
authors: Ali
authors: Irene J
authors: IJ
authors: Higginson
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology / Q000473:pathology / Q000523:psychology / Q000628:therapy; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000209:etiology / Q000523:psychology; D010166:Palliative Care / Q000379:methods / Q000523:psychology; D057566:Self Report; D018434:Sickness Impact Profile; D012944:Social Support; D029181:Spirituality; D014454:Uganda / Q000453:epidemiology