��EXPLORING -ILLNESS Related Experiences of Adolescents admitted for Cancer treatment in Kenyatta National hospital- KENYA�

Study objectives

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• To explore the illnesses-related experiences of adolescents aged 11 – 18 years admitted for cancer treatment in Kenyatta National hospital-Kenya.
• Specific objectives
• To explore social and behavioral impairments in adolescents admitted for cancer treatment in KNH.
• To elucidate disruption from normal life caused by long breaks as the adolescents seek cancer treatment in KNH.
• To appraise the nature of emotional distress among adolescents admitted for cancer treatment in KNH.
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Background

• The cancer as a diagnosis has been on increase in all spheres; Children, adolescents, and adults.
• Health facilities offering cancer care in Kenya are few and lack sufficient supplies adolescents’ holistic care.
• The adolescents undergoing cancer treatment have social, academic, health, and physical problems that are unique to their age group and developmental needs that require a facility that can be in place to address all their needs.

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Study design

• A Phenomenological study qualitative research method.

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Themes identified

• 1. Uncertain future
• The participants’ lamented of uncertain future.
• Uncertainty in the treatment outcome … fear of loosing an organ or death
• “Yes, like where I visited being done the biopsy, that doctor mentioned that this cancer disease when it's found it requires that the leg be amputated;..didn't tell us other treatment option. Participant number 08

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Themes identified

• 2. Social development
• Narrated of how the disease impacted on their lives.
• Affected their education, motor skills, family economy
• “It has affected my schooling I have stopped attending School for I have to come for the treatment and also some other tasks at home.” Participant number 04

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Themes identified

• 2. Social development cont.
• Stigma
• “…… Ok, they will ask me why your nails have turned black and theirs are not like that. …. Yes because it’s better if the chemo doesn't have these side effects. For when people look at you then get surprised” Participant number 03

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Themes identified

• 3. Psychological
• The participants expressed some psychological issues like self-blame, hallucination, mood swing, fear/worry and stress.
• 4. Spirituality
• Cancer disease comes with it a lot of uncertainty which has resulted in human beings seeking help from a supreme being as well as blaming God.

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Themes identified

• 5. Physical effects
• The participants reported that due to the disease they lost their body weight, another said that she had lost her ability to see while others said they have experienced a lot of pain.

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Themes identified

• 6. Presenting complains
• Each of the study participants gave narration of how his or her problem/condition presented on the initial stages, what caused them to seek the medical attention which were Pains, Bleeding, Swelling/ lump and Accident

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Themes identified

• 7. Referral
• Narration on referral to KNH. Primary health care facility and social network were mentioned.
• “Then they told me to take those drugs for one week if it doesn't clear I get back.  When I got back they referred me here in Kenyatta”. Participant number 09

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Themes identified

• 8. Health education
• Accounts of how they were advised by medics on what to do and what not. Eating, Distance, treatment and procedures.
• “I don’t travel much and I'm not supposed to go where there many people. ….. Like now I'm not supposed to eat things that are sugary. Also, junk foods”. Participant number 04

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Themes identified

• 9. Treatment effects
• Participants reported both positive and negative effects.
• Some noted that cancer treatment helped them compared to how they were before.
• On side effects, loss of hair, darkening of nails, getting low blood levels,e.tc

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Discussion

• The initial symptoms of cancer disease may be mistaken leading to misdiagnosis conversely affecting treatment outcome. (Jemal, at el., 2011),
• Life uncertainty in adolescence diagnosed with cancer disease was evident in most of the study participants.
• Careers and important goals of life are formed in the adolescent stage. (Abram, Hozen and Penson (2007)

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Discussion

• Inability to participate in the usual chores which enabled ‘adol to build life skills for future survival. (Ness, at el., 2005), (performance limitation).
• Cognitive difficulties were also picked up in the research as (Berg, at el., 2009), noted that 92% of the childhood cancer survivors experienced memory and attention deficits with 40% reported cognitive difficulties in school and the job

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Conclusion

• The study highlighted that adolescents diagnosed with cancer have experiences to tell.
• Their way of life is totally affected: i.e..
• Schooling which is very key in self-development,
• Family life where social comfort is usually found
• Religious/ spiritual life .

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Recommendations

• A grave need for adolescent friendly cancer treatment center in Kenyatta National Hospital & Counties referral hospitals to address youths’ and their developmental issues as they receive treatment.
• Psychologists in cancer treatment areas
• Linkage and community integration for cancer survivors enhanced
• Sensitization and health talks on cancer to schools and the community

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