title: Assessment of knowledge, accessibility and utilization of palliative care services among adult cancer patients at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia, 2014: a cross-sectional institution based study.
abstract: BACKGROUND
  Cancer has been the leading cause of death worldwide for more than two decades. More than 150,000 cancer cases were estimated to exist in Ethiopia each year. The goal of cancer palliative care (PC) services are to prevent and relieve suffering and to support the best possible quality of life (QOL) for patients and their families, regardless of the stage of disease or the need for other therapies. This study attempted to assess the knowledge, accessibility and Utilization of PC Services for adult cancer patients by their perspective at Tikur Anbesa Specialized Hospital (TASH), Addis Ababa, Ethiopia.
  
  
  METHODS
  A cross-sectional Institution based study was conducted among respondents who had Cancer at TASH. TASH was the only referral center of PC and cancer treatment in Ethiopia. The Hospital was selected for this study purposively. Data was collected by interviewing the client's using a pretested Amharic version questionnaire. During the survey, 384 respondents with cancer were interviewed. Data entry was done using Epi Info version 3.5.2 and exported to SPSS version 20 for analysis. Logistic regression model was applied to control confounders.
  
  
  RESULTS
  Of the total clients interviewed, more than 62.2 % respondents had previous knowledge for cancer PC services. About 86 % of client's were in the age 35 years and older. About 9 out of 10 (89.8 %) respondents reported problems on accessibility of PC services. Respondents previous knowledge of PC services (AOR = 26.9, 95 % CI 12.3, 59), presence of little (more than 75 % of physical problems/symptoms responded) physical well being of the respondents (AOR = 3.1, 95 % CI 1.96, 4.9), full (all social relationship problems responded as good/positive by respondents) social well being of the respondents (AOR = 1.7, 95 % CI 1.01, 2.8); monthly income $US 25-50 of the respondents (AOR = 0.25, 95 % CI 0.09, 0.7) and marital status single (never married) (AOR = 55.4, 95 % CI 1.2, 2660.4) were significantly associated with respondents utilization of PC services.
  
  
  CONCLUSIONS
  High number of respondents reported problems on accessibility of PC services for cancer in TASH and more than just an average of respondents REPORTED presence of previous knowledge. Respondent's previous knowledge about services, physical well being, social well being, income and marital status were a concern for utilization of cancer PC services at TASH. Health care providers at TASH will be recommended to have a sustainable health education session program on cancer PC services to adult clients after diagnosis of cancer.
authors.affiliation: Department of Nursing and Midwifery, Arba Minch College of Health Sciences, Arba Minch, South West Ethiopia. lserawit@yahoo.com.
authors.forename: Serawit
authors.initials: S
authors.lastname: Lakew
authors.affiliation: Department of Oncology, Tikur Anbesa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia. hasnamusema@yahoo.com.
authors.forename: Hasna
authors.initials: H
authors.lastname: Musema
authors.affiliation: Department of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia. tsehay.shimelis@aau.edu.et.
authors.forename: Tsehay
authors.initials: T
authors.lastname: Shimeles
authors.affiliation: School of Nursing, University of California, San Francisco, USA. jmchallinor@gmail.com.
authors.forename: Julia
authors.initials: J
authors.lastname: Challinor
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006782:Hospitals, Special; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care / Q000706:statistics & numerical data*; D011788:Quality of Life; D011795:Surveys and Questionnaires