Impact of childhood cancer on immediate families of children with cancer at the University Teaching Hospital, Lusaka, Zambia

Abstract

The study was carried out to assess the impact of childhood cancer on immediate families of children with cancer at the University Teaching Hospital, Lusaka with the aim of making recommendations to assist these families.Objectives: The objectives of the study were to determine the financial and psychosocial impact of childhood cancer on the families, assess their financial and psychosocial support systems and compare with that of families who have children with other medical illnesses.Study Design: A case control hospital based study was carried out between June and November 2005. Cases were families of children with cancer admitted to the Pediatric Hematology-oncology ward at UTH while controls were families of children admitted to ward AOS for medical illnesses. Setting: The study setting was the University Teaching Hospital, Pediatric Hematology-oncology ward and AOS (Pediatric Medical Ward), Lusaka, Zambia.Subjects: A total of 120 subjects were recruited in the study, out of which 60 were cases and 60 were controls. An interview schedule was used to collect data.Main outcome measures: The main outcome measures were psychosocial impact, financial impact and support systems. Results: The findings revealed that majority of the cases (53.3%) had a high psychosocial impact OR-4.6 (CI 95%; 2.03, 10.28; p<0.01, df=l) while 80% of the controls had a low psychosocial impact.The study showed that families with a child with cancer were more likely to have financial pressures than their counterparts with a child with other medical illnesses (p<0.01). The study further showed that there was a statistical significant difference (p<0.01) between the cases (88.3%) and controls (3.3%) in terms of expenditure of more than KlOO, 000 on medication. Majority of controls (41.7%) spent less than K50, 000 on medication. On diagnostic investigation expenses, 61.7% of cases spent more than KlOO, 000 while 46.7% of controls did not spend any money on investigations. On support systems, most of the cases (66.7%) had inadequate support systems as compared to controls [(50%) (p=0.064)].Conclusion: In order to help these families, some of the recommendations that were made to the concerned parties are: 1. There is need to strengthen counseling sessions to help clients who have children with cancer. More counselors among nurses need to be trained because nurses spend more time with the clients.2. There is need to raise awareness among community members on support of families who have children with cancer.3. Support groups should be formed in the community in collaboration with religious and nongovernmental organizations to assist families of children who have cancer.4. The government should strengthen the social welfare department in assistance of these clients as most of the families come from far places and they have no relatives in Lusaka.5. There is need for replication of the study using larger samples.