Browsing by Author "Kohi, Thecla W."

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    Cancer-related concerns and needs among young adults and children on cancer treatment in Tanzania: A qualitative study
    (MBC Cancer, 2019) Kohi, Thecla W.; Essen, Louise von; Masika, Golden M.; Gottvall, Maria; Dol, Justine
    Background: Cancer is one of the leading causes of morbidity and mortality worldwide. Seventy percent of deaths of cancer occur in low or middle-income countries, where the resources to provide cancer treatment and care are minimal. Tanzania currently has very inadequate facilities for cancer treatment as there are only five sites, some with limited services; two are in Dar es Salaam and one each in Mwanza, Kilimanjaro and Mbeya that offer cancer treatment. Despite cancer being a prevalent problem in Tanzania, there is a significant shortage of information on the experiences of young people who receive cancer treatment and care. The aim of this study was to explore cancer-related concerns and needs of care and support among young adults and children who are receiving cancer treatment in Dar es Salaam, Tanzania. Methods: Using an explorative, qualitative design, two focus group discussions (FGDs) with young adults (18 to 25 years) and four FGDs with children (9 to 17 years) were held. Data were transcribed into English and analyzed using content analysis. Results: Identified concerns included physical effects, emotional effects, financial impacts, poor early care, and poor treatment. Identified needs included the need for improved care in hospital by the staff, need for community support, financial needs, needs for improved cancer care and treatment in the hospitals, and the need for increased education about cancer. Resilience was identified, particularly around hope or faith, having hope to be healed, and receiving good care from staff. Conclusion: Young adults and children receiving cancer treatment in Tanzania have many needs and concerns. Improvements with regard to the care provided in hospital by the staff, the cancer care and treatment in the hospital, and population-wide education about cancer are necessary to address the identified needs and concerns. Further studies on specific approaches to address the concerns and needs are also warranted.
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    Concerns and needs of support among guardians of children on cancer treatment In Dar es salaam: A qualitative study.
    (Wolters Kluwer Health, 2019) Masika, Golden M.; Gottvall, Maria; Kohi, Thecla W.; Essen, Louise von; Dol, Justine S.
    Background: Cancer in children in Tanzania is a concerning health issue, yet there is a shortage of information about the experiences of the guardians of children who receive cancer treatment. Objective: To explore concerns and needs of support among guardians of children on cancer treatment in Dar es Salaam, Tanzania. Method: Using a qualitative design, 3 focus group discussions were held with 22 guardians of children aged 9 to 17 years. Guardians were recruited from Muhimbili National Hospital, Dar es Salaam, where their children were receiving cancer treatment. Data were analyzed using thematic content analysis. Results: Guardians experienced several issues during the initial stages of their child’s cancer treatment, including the process of seeking a diagnosis, and experiences with care at the peripheral (regional) hospitals and national hospital. They also shared what they felt would lessen their difficult experiences. Seven themes emerged in this study: financial concerns, emotional concerns, barriers to cancer care, need for improved cancer care, need for information, need for tangible support, and gratitude and hope. Conclusion: Guardians of children with cancer experience challenges during initial stages when seeking a diagnosis and have concerns and needs related to cancer care and treatment. Implications for practice: Improvements are needed regarding care at regional hospitals, the cancer diagnosis, and the recognition of early signs of cancer and quick referral to diagnostic centers, compassionate caring behaviors by healthcare workers, budgetary support from the government to meet the medication supply demands, and meeting stakeholders’ support needs.
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    Health-related quality of life and needs of careand support of adult Tanzanians with cancer:a mixed-methods study
    (BioMed Central, 2012) Masika, Golden M.; Wettergren, Lena; Kohi, Thecla W.; Essen, Louise von
    Background: Cancer is among the three leading causes of death in low income countries and the highest increasewith regard to incidence figures for cancer diseases are found in these countries. This is the first report of thehealth-related quality of life (HRQOL) and needs of care and support of adult Tanzanians with cancer. Methods: A mixed-methods design was used. The study was conducted at Ocean Road Cancer Institute (ORCI) inDar es Salaam, Tanzania. One hundred and one patients with a variety of cancer diagnoses treated and cared forat ORCI answered the Kiswahili version of the EORTC QLQ-C30 investigating HRQOL. Thirty-two of the patientsparticipated in focus group interviews discussing needs of care and support. Data from focus group interviewswere analyzed with content analysis. Results: The findings show that the patients, both women and men, report a low quality of life, especially withregard to physical, role, and social function and a high level of symptoms and problems especially with financialdifficulties and pain. Financial difficulties are reported to a remarkably high extent by both women and men.The patients, both women and men report least problems with emotional function. A content analysis of the interview data revealed needs of food and water, hygienic needs, emotional needs, spiritual needs, financial needs,and needs of closeness to cancer care and treatment services. Conclusion: The high score for pain points out that ORCI is facing severe challenges regarding care and treatment.However, when considering this finding it should be noted that the pain subscale of the Kiswahili version of theEORTC QLQ-C30 did not reach acceptable internal consistency and showed less than satisfactory convergentvalidity. This also applies to the subscales cognitive function and global health/quality of life. Attention should bedrawn to meet the identified needs of Tanzanian cancer patients while hospitalized but also when at home.Increased accessibility of mosquito nets, pads, and pain-killers would help to fulfil some needs.
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    Sexual and reproductive health communication intervention for caretakers of adolescents: a quasi-experimental study in Unguja-Zanzibar
    (BMC, 2019) Seif, Saada A.; Kohi, Thecla W.; Moshiro, Candida S.
    Background: Caretakers/parents or parents figure need to be trained to promote effective communication about sexual and reproductive health to their adolescents. This study assessed the effect of an intervention aiming to improve caretaker-adolescent communication on sexual and reproductive health matters through improving information, motivation, and behavioral skills related to sexual health communication. The study also evaluated the relationship of information, motivation, and behavioral skills model-constructs with communication practice. Information-Motivation-Behavioural skills model was used as a framework to guide the intervention implementation and evaluation process. Method: This is a quasi-experimental non-randomized controlled pre- and post-test study which involved one thousand caretakers of adolescents in all the six districts of Unguja-Zanzibar. All participants completed interviewer-administered structured pre-test questionnaire. The experimental group then received sexual health communication intervention addressing the information, motivation, and behavioral skills related to sexual health communication, while the control group received the sexual health information only. All participants were then reassessed for their information, motivation, behavioral skills and their sexual health communication after 1 month, 6 months and at 1 year following the intervention. To evaluate the effect of intervention at the post-test measures, Univariate Analyses of Covariance was performed whereby the pre-test score and variables on which the groups differed were considered as covariates. Standardized mean difference statistics of Cohen’s d was used to calculate the effect size, and the cut-off point for the level of significance was set at two-sided, p-value < 0.05. Results: Results shows that the immediate post-test sexual health communication, motivation and behavioral skills scores were statistically significantly higher in the experimental group compared to control group (p < 0.05). Moreover, sexual health communication score after 6 months and at 1 year were statistically significantly higher in the experimental group compared to control group (p < 0.05). Information construct however did not differ between groups in post-test measures. Furthermore, results revealed that communication practice is statistically significantly associated with information, motivation and behavioural skills in post-test measures. Conclusion: The findings provided preliminary evidence for the effectiveness of SRH communication intervention and supported the significance of IMB model-constructs to inform the SRH-communication intervention and to guide the intervention evaluation.