Patients’ Perception of Quality of Care for Neurotoxic Anticancer Therapy at a National Hospital, Kenya

Abstract

Background: Systemic Anticancer Therapy (SACT), commonly referred to as chemotherapy, is essential in cancer treatment but can lead to severe neurotoxicity, particularly Chemotherapy-Induced Peripheral Neuropathy (CIPN). Effective CIPN management requires patient-centred approaches and high quality of care (QOC). This study evaluated patients’ perceptions of CIPN QOC as provided by nurses to those on neurotoxic SACT at Kenyatta National Hospital (KNH). Methods: Cross-sectional quantitative survey at KNH involved 121 patients diagnosed with cancer. Data was collected via REDCap on demographics, treatment, and QOC based on modified British Columbia Cancer CIPN guidelines. Analysis: This was done using Stata. Performance on single elements (information provision, knowledge possessed, or documentation) were examined using binomial tests against the expected 50%; a p-value of less than 0.05 indicated that at least half of the cases met the expectation. Single performance elements were aggregated to compute ordinal variables and were tested against the expected medians, using the Wilcoxon-Mann-Whitney test. A p-value of <0.05 indicated that the observed median was significantly higher than the expected median. Results: The response rate was 100%. While 75.2% (p<0.001) of patients recalled receiving CIPN health education, more than half, 61.2% (p<0.009), attributed it to nurses. Awareness of CIPN was 97.8%, with 91.2% informed about warning signs. There was a significant correlation between CIPN patient education and self-care strategy recall (p < 0.01). However, documentation conducted by nurses on CIPN assessment was (32.2%) and on education was (34.2%), these were significantly lower than the expected 50%, p>0.005. Conclusion: While nurses contributed to patient awareness and self-management for CIPN, significant deficiencies in documentation and continuity of care persist. Addressing these systemic gaps requires continuous, comprehensive training for nurses on CIPN and the broader care during SACT in order for the nurses to empower the patients for better CIPN selfcare thus improving patients’ quality of life. Additionally, there is a need of investing on improving quality documentation through the use of efficient tools and workforce support.