Triggers of distress during chemotherapy among cancer survivors from two tertiary hospitals in Kenya

Background: Chemotherapy for many types of cancers improves outcomes. On the other hand, chemotherapy is associated with various side effects that can trigger distress affecting the quality-of-life of patients. Better understanding of causes of patients’ distress and experience during chemotherapy is a precursor for comprehensive cancer care. Study objective: To explore the triggers of distress during chemotherapy among cancer survivors from two tertiary hospitals in Kenya Design: This was a qualitative design study applying an interview guide. Methodology :An in-depth interview was conducted on those who had received and completed chemotherapy not more than 12 months previously at the time of assessment. A total of 30 people consisting of 15 participants from each hospital were recruited during follow-up clinics. Transcription was done using pen and paper and coding and qualitative thematic analysis was done using NVivo software. Results: The age range was 18 to 68 years with majority aged between 31 and 43 years. The most prevalent cancer types were breast at 50% and cervical at 23%. Out of the 30 studied; majority had received chemotherapy as neo-adjuvant therapy. 50% had received 8 cycles of chemotherapy, 37% received 6 cycles and 13% received 4 cycles or less. Five themes identified as triggers of distress were; financial, emotional, social, physical problems and health- services related triggers which included poor patient- provider communication and shortage of drugs. Conclusion: Patients on chemotherapy do encounter multiple problems during chemotherapy and there is need for psychosocial interventions commenced at the initial phase of treatment