The Symptom Burden and Quality of Life in Cancer Patients in the Gaza Strip, Palestine: A Cross-Sectional Study

• Published in: PloS one Vol. 17; no. 1; p. e0262512
• Main Authors: ElMokhallalati, Yousuf, Alaloul, Enas, Shatat, Mohammed, Shneewra, Tasneem, El Massri, Saad, Shaer, Omar, Relton, Samuel, Abu-Odah, Hammoda, Allsop, Matthew J
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13.01.2022; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Arabs; Breast cancer; Cancer; Cancer patients; Cancer therapies; Care and treatment; Cost of Illness; Cross-Sectional Studies; Demographics; Disease; Evaluation; Female; Health aspects; Health sciences; Hospitals; Humans; Male; Medicine; Medicine and Health Sciences; Middle Aged; Middle East - epidemiology; Mortality; Narcotics; Neoplasms - physiopathology; Neoplasms - psychology; Oncology; Opioids; Outpatient care facilities; Outpatients; Patients; People and Places; Psychometrics; Quality of life; Quality of Life - psychology; Questionnaires; Signs and symptoms; Social aspects; Sociodemographic Factors; Sociodemographics; Surveys and Questionnaires; Middle East; Palestinian Territories; Hong Kong China; Gaza Strip; United Kingdom > UK; China; Palestinian territory
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0262512

Cancer is the second leading cause of death in the Gaza Strip, Palestine, but there is an absence of evidence systematically assessing symptom burden and quality of life (QoL) using validated tools. Our objective was to assess associations between socio-demographic and disease-related characteristics, symptom burden and QoL in a sample of cancer patients accessing outpatient services in the Gaza Strip. A cross-sectional, descriptive survey using interviews and medical record review involving patients with cancer accessing oncology outpatient services at Al Rantisi Hospital and European Gaza Hospital (EGH) in the Gaza Strip was employed. Socio-demographic and disease-related data, the Lebanese version of the Memorial Symptom Assessment Scale (MSAS-Leb), and the Arabic version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) were collected. Multiple linear regression was used to judge the relative influence of determinants of QoL. Of 414 cancer patients approached, 385 patients consented to participation. The majority were women (64.7%) with a mean age of 52 years (SD = 16.7). Common cancer diagnoses were breast (32.2%), haematological (17.9%) and colorectal (9.1%). The median number of symptoms was 10 (IQR 1.5-18.5). Mean overall QoL was 70.5 (SD 19.9) with common physical and psychological symptoms identified. A higher burden of symptoms was associated with marital status, education and income. Limited access to both opioids and psychological support were reported. A high symptom burden was identified in outpatients with cancer. Increasing provision and access to supportive care for physical and psychological symptoms should be prioritised alongside exploring routine assessment of symptom burden and QoL.