Nutritional status and quality of life of paediatric cancer patients undergoing chemotherapy at Moi Teaching and referral hospital Eldoret, Kenya
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Date
2017-02
Authors
Okemwa, Julian Nyaboke
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Abstract
Malnutrition is a common problem among patients with cancer and ranges from 30%
- 80% globally. In Kenya cancer ranks third as a cause of death after infectious
diseases and cardiovascular diseases. The aim of this research was to assess the
nutritional status, the prevalence of nutrition- impact symptoms (NIS) at each disease
stage and determine the relationship between nutritional status and quality of life
(QoL) of the 52 children suffering from cancer on chemotherapy at Moi Teaching and
Referral Hospital (MTRH) Eldoret, Kenya. The research adopted across-sectional
analytical design with which the interviewer administered the questionnaires to collect
data on socio demographic, food consumption, nutrition management practices and
the nutritional status from the respondents. Observational check list was also used to
gather information on patient’s general appearance or any physical sign of
malnutrition. Quality of life was assessed using Lansky scores while Nutritional Risk
Screening (NRS-2002) was used to screen for any nutritional risk in the study
population. Data was entered and analyzed using statistical package for social
sciences (SPSS) version 21 and summarized using descriptive statistics such as
frequencies, means and percentages. Anthropometric data was analyzed using WHO
Anthro software (version 3.2.2) for children <5 years while WHO Anthro plus
software (version 1.0.4) was used to analyze data for children above 5 years. Pearson
correlation was done to test for the relationship between nutritional status and quality
of life. A P value of < 0.05 was considered statistically significant. The study findings
showed that 55.8% of the respondents were wasted, 34.6% stunted, while 29.4% were
underweight. It was noted that 28.9% of the sample population were nutritionally at
risk. Nutrition impact symptoms were more pronounced in the second and third stages
of cancer where most of the respondents experienced vomiting (94.3%), decreased
appetite (80.8%) and diarrhoea (69.2%). The study found a significant negative
correlations between Quality of life and nutrition risk scores of the respondents (r = -
0.33, p = 0.02) at a significant level of (p < 0.05). QoL correlated positively with
nutritional status based on Body Mass Index-for-age Z-scores (r = 0.41, p= 0.01) with
a significant level of (p < 0.05). QoL was also found to positively correlate with
Height-for-Age Z-scores, (r = 0.06, p = 0.72) though the correlations were not
statistically significant (P > 0.05). It can therefore be concluded that chemotherapy
was associated with poor nutritional status and reduction in the quality of life ratings.
The use of the Nutrition Impact Symptom (NIS) checklist in the paediatric oncology
clinic/ward triggers more therapeutic interventions. The awareness for NIS will likely
evoke more research in assessment, impact, and treatment.
Description
Department of foods, nutrition and dietetics a research thesis submitted in partial fulfillment of the
requirements for the award of the degree of master of science (foods, nutrition and dietetics) in the school of applied human sciences of Kenyatta University, February, 2017