| dc.description.abstract | Introduction: About 15.8% of Uganda’s population is at risk of developing cancer before age of 75years. Approximately 34008/4574000 new cases and 22992/4574000 cancer deaths were experienced by 2020 according to Globocan statistics of 2020, compared to 32,617/44269587 new cases and 21,829/44269587 cancer deaths registered in 2018 according to the population-based Kampala cancer registry, established in 195 Very sick patients are diagnosed with late stage cancers, and therefore require hospitalization for intense treatments and monitoring. Prolonged length of stay of cancer patients in the hospitals increases hospital-acquired infections and deaths, due to certain institutional and individual factors. Little is known about hospital length of stay and its associated factors at UCI. Objective: The study aimed at determining length of stay, associated factors and challenges faced among patients admitted at inpatient Wards of UCI. Methods: The study used convergent parallel mixed methods design. Data were collected from cancer patients charts at, records unit at UCI, using a data abstraction tool by the Principal Investigator and well-trained research assistants. The dependent variable was length of stay (LOS) which was summarized using descriptive statistics, and independent variables included demographics (age, gender), socio characteristics like marital status, alcohol, smoking, and medical characteristics (including diagnosis, reasons for admission, treatment given while on ward and discharge status). The study used multivariable linear regression analysis to determine the factors associated with length of stay. Data entry was done in RedCap Data base and then exported to STATA 14.0 for analysis. After comparing the data, duplicates were deleted from the final data set. Also, an in-depth interview guide was used to collect information on the challenge’s patients face when admitted on wards of UCI from purposively selected participants with varying ages, different diagnoses at different wards cancer patients. Data was transcribed and translated, a narrative analysis was performed. Qualitative data were analyzed using thematic analysis. Results: Data was collected from 406 patient files. This study found that the average length of stay of patients admitted on the wards of UCI was 9.8days (+/-SD: +/-1.65) with a 95% CI (4.59 - 15.10). Factors like presence of next of kin (B=1.316;95% CI (0.726-1.906), p-value< 0.01), other comorbidities (sickle cell disease (B=--0.4023; 95% CI (-0.687—0.1175), p-value<0.02 ), wards that is STC(B=-0.486;95% CI (-0.785—0.785), p-value=0.01), , private (B=-0.448; 95% CI (-0.753—0.143)), p-value<0.02 ), on which patients are admitted, reasons for admission like DVT (B=-0.625; 95% CI (0.419-0.8312)_, p-value<0.001 ), thrombocytopenia (B=0.409; 95% CI(0.277-0.541), p-value=0.001 ), hypokalemia(B=-1.297; 95% CI (-1.493—1.101)), pvalue<0.001 ), pneumonia (B=0.710;; 95% CI (0.046-1.374), p-value=0.04 ), treatment types given to patients like support medication (B=0.512; 95% CI (0.222-0.803), p-value=0.01 ), other treatments (B=-0.408; 95% CI (-0.614—0.203), p-value=0.01 ), nutritional support (B=0.816; 95% CI (0.450-1.181), p-value=0.01 ), were statistically associated with length of stay of cancer patients admitted on wards of UCI. Various challenges were noted by the health care givers and the patients who were admitted on the different wards. These included patient-based, treatment based, ward based, health care givers based and psychosocial based challenges. Some of the challenges noted were inability to do anything on their own, no bed space, no privacy, financial difficulty (expensive drugs/drug stock outs from the government pharmacy, difficulty to get food for both caretaker and patient, expensive transport to the hospital), not easy to get blood products, language barrier, trauma and fear and others. Conclusions: The study indicated that the average LOS for this study was 9.8 days (+/- SD=+/1.65). This study found that 47.5% of the admitted patients had prolonged stay on the wards of UCI. It showed that about 53% of the patients admitted on the wards who had a short stay on the wards had better outcomes at discharge (improvement). This implies that those who stay long on the ward require more intensive treatments, care and monitoring in order to have efficiency on the ward, which requires recruitment or more health care giver and provision of sundries and drugs to the wards. This study found various factors like presence of next of kin, having sickle cell disease as other comorbidities, being admitted on, STC, and Private wards, reasons for admission like having DVT, thrombocytopenia, hypokalemia, pneumonia, being given treatments like support medication and other treatments (counselling, post-operative care, monitoring of pressure levels) while on ward were statistically significantly associated with LOS of cancer patients on wards of UCI. Therefore, there is need for administration of UCI and the Ministry of Health on oncology care, to put up admission and discharge plan policy in order to minimize on length of stay patients spend on the wards and the challenges they face. | en_US |
