Quality of life and psychological distress in newly diagnosed treatment‑naïve cancer patients and their determinants at a Tertiary Hospital in Ethiopia

Abstract

Newly diagnosed cancer patients often experiencing significant psychological disruption and a decline in quality of life (QoL), which may lead to interruptions in treatment. Nevertheless, the psychosocial status of these patient remains inadequately understood in resource-limited settings. Therefore, the present study aimed to evaluate psychosocial vulnerability, specifically psychological distress and QoL among newly diagnosed, treatment naïve patients, as well as the factors associated with these outcomes. A cross-sectional study was conducted among 231 newly diagnosed cancer patients between June and December 2024 at the oncology Department of Jimma University Medical Center (JUMC). Psychological distress and QoL were assessed using the National Comprehensive Cancer Network (NCCN) distress thermometer (DT, version 1.2024) and the EORTC QLQ-C30, respectively. Data were analyzed using SPSS version 26. Multivariable logistic regression analysis was performed, and the strength of associations between dependent and independent variables was expressed as adjusted odds ratio (AORs) with 95% confidence intervals (CIs). Statistical significance was set at p-value < 0.05. More than half of the patients (51.95%: 95%CI 46%, 59%) experienced moderate-to-severe psychological distress. Higher odds of distress were observed among rural residents (AOR: 2.45), patients with co-morbidities (AOR: 3.59), those reporting low social support (AOR: 6.09), individuals with advanced-stage disease (AOR: 4.82), patients receiving palliative treatment intent (AOR: 2.32), those with ECOG performance status ≥ 2 (AOR: 4.15), and malnourished patients (AOR: 5.68). Notably, perceived low social support, advanced disease stage and malnutrition were common factors associated with both psychological distress and lower QoL scores. This study highlights the substantial burden of psychosocial vulnerability among newly diagnosed cancer patients, with more than half experiencing moderate-to-severe psychological distress. Significant differences in mean QoL scores were observed between early-and advanced-stage patients. Advanced stage disease, malnutrition, and low perceived social support were consistently associated with lower QoL scores. These findings underscore the urgent need to integrate psychosocial care with physical health care in oncology, particularly to address unrecognized psychosocial challenges in resource limited settings.