Fear of Cancer Illness and its Influence on Self-Disclosure among Adult Patients at Kenyatta National Hospital Cancer Treatment Center in Nairobi City County, Kenya.
Waithaka, Hellen Njeri
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Despite the rapid increase in the number of cancer patients in Kenya, the immense physical and psychological challenges that this diagnosis brings both during and after treatment remain largely unaddressed. Literature shows that cancer illness is greatly feared. The fear may influence selfdisclosure by patients regarding the effects of cancer illness to people they interact with in their day-to-day living. Self-disclosure involves expressing personal experiences on emotions, thoughts, and wishes as a result of cancer diagnosis, verbally to significant others. Although such self-disclosure has been shown to reap psychological benefits, the action can be hampered by stigma and fear around cancer. Self-disclosure is also required in order to enlist and secure support during and after treatment of cancer. The main objective of this study was to determine the influence of fear of cancer illness on self-disclosure among adult patients at Kenyatta National Hospital Cancer Treatment Center (KNH-CTC) in Nairobi City County, Kenya. The study whose target population was 3500 adult cancer patients who annually got treatment and review at KNH-CTC, was informed by the Social Cognitive Processing Model of Emotional Adjustment to Cancer and employed a descriptive survey research design. A sample size (n=347) was determined using the Cochran formula. Non-probability sampling, using purposive sampling method was used to select the study participants. Questionnaire and Focus Group Discussion were used to collect data. Both validity and reliability of the research instrument were established before conducting the study. In addition, all research ethical and authorization protocols were observed. Descriptive and inferential statistics were used for quantitative analysis of data while thematic analysis was used to analyze qualitative data. The findings revealed that: generally participants had moderate to high levels of fear (n=199; M=57.4; SD=12.072); there was a statistically significant association between levels of fear and levels of self-disclosure, (χ2(4) = 11.722, p = .020) and that the highest levels of fear were experienced upon diagnosis but reduced in the course of treatment and over time. Participants acknowledged the benefits of selfdisclosure but were discouraged by fear of negative responses from the general population. Participants self-disclosed to family at the highest level (81.9%) and to health personnel at the lowest level (25.4%) for low to moderate levels of self-disclosure. It was therefore concluded that patients’ perception of cancer as a fearful illness affected their levels of self-disclosure especially to health personnel. More self-disclosure was done to family members who have limited capability of attending to all the needs of the patient. This may mean that some needs remain unattended to, impacting negatively on quality of life and effectiveness of treatment towards recovery. The study recommended the need to involve mental health professionals in the cancer management team. It also recommended further studies to be carried out among patients and general population on awareness of cancer management so as to provide scientific evidence to address the stigma and fear of cancer.