PSYCHOSOCIAL FACTORS DETERMINING QUALITY OF LIFE AMONG CANCER PATIENTS IN NEPAL
Cancer is on the rise in Nepal but existing research lacks the exact data to estimate its burden on society and the psychosocial suffering of the patients. Cancer patients are being treated using varieties of medical treatment in Nepal but growing literatures indicate that a single medical treatment approach is not adequate. The importance of assessing the psychosocial factors both positive and negative in assuring the quality of life of cancer patients may generate awareness of the inner world and understanding of the patient, the nature and level of social support, the enhancement of coping strategies and facilitating readjustment. We studied the association of selected psychosocial variables with their quality of life among the cancer patients in Nepal. A methodological triangulation approach was used to assess the demographics,
disease characteristics and psychosocial factors; and their relation with quality of life (QoL). The present study was conducted among 300 Nepalese adult cancer patients from hospitals as well as from their own residence. The study revealed that majority of research participants had less than one fourth of psychosocial adjustment factors such as perceived high level of social support, self-esteem and coping. The majority of the respondents were suffering from anxiety (67.1%) and depression (70.9%). There was significant statistical association between social support, but it was negatively correlated with QoL that means that even with high level of social support, the quality of life of the cancer patients was low or vice versa. However, 18 (90%) of the 20 research participants of the qualitative study expressed that strong social support has a vital role in maintaining quality of life but the attitude of the care providers needed to be helpful. The greater the WHOQOL-BREF score of the quality of life, the lower the cancer patient’s self-esteem was, and vice versa. Qualitative study revealed that out of 20 research participants, 16 (80%) were not satisfied with their life. Whereas, 4 (20%) of them stated ‘will power’ to be an important key in the maintenance of quality of life. Anxiety and depression was inversely correlated with environment domain of QoL among cancer patients. This study concluded that psycho-social factors determine the QoL of the cancer patients. Social support and coping were proved as strong predictors for QoL.