Contextual quality of life of HIV-positive patients with cervical carcinoma at Tygerberg Hospital

Abstract

Objective: In South Africa, the majority of cervical carcinoma cases present when they are in the advanced stage. Concomitant HIV/AIDS further compromise patient health. Data on the impact of HIV/AIDS on the quality of life of cases with advanced cervical carcinoma are lacking. Contextual factors, e.g. patient’s educational level and income, influence their experience of quality of life. Design: A cross-sectional study was carried out on the quality of life of newly diagnosed cases of cervical carcinoma. Self-administered questionnaires were completed by patients and other contextual factors (e.g. age, educational level, socio-economic status and clinical information), were obtained from patient folders. Setting and subjects: Newly diagnosed cases of invasive cervical carcinoma who presented at the Gynaecological Oncology Unit, Tygerberg Hospital, were included in the study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (QLQ)-C30 version 3 and QLQ-CX24 were used. Results: The total study cohort of 73 patients (HIV-negative and HIV-positive) had a median age of 49 (28.3- 85.2 years). Of the patients, 7.1% had no formal education. The cohort had an unemployment rate of 41.5%, and 14.2% were pensioners. The marital state was predominantly single persons (31.4%), with a mean monthly income of R 1 373 (R0-14 000). Advanced stage of the disease was present in more than 50% of cases, and 32.2% were stage IIIb. Sixteen patients were HIV positive with an HIV-positive incidence of 22%.The comparative quality-of-life domains of HIV-negative and HIV-positive cases were statistically equal. Advanced stage, as a contextual factor, impacted significantly on a number of quality-of-life domains. These domains are amenable to medication. Conclusion: HIV/AIDS did not adversely influence the quality of life of the newly diagnosed cervical carcinoma cases. In this regard, stage of disease had a significant impact on the domains of pain, insomnia, nausea and vomiting, appetite loss and constipation. These aspects are amenable to treatment. Cognitive function was adversely influenced by increasing age, poor education and a low monthly income. When giving support to patients with regard to enhancing their quality of life, this should be recognised and communicated to them.