The Availability and Utilization of Psychosocial Services for Breast Cancer Patients in Addis Ababa, Ethiopia: A Mixed Method Study

Background: Provision of psychosocial services has substantial impact in cancer care by reducing emotional distress and improving both the quality of life and survival of patients, but the availability and utilization of the services have been not well-studied in developing countries, particularly in Ethiopia. The aim of this study was to explore the types of psychosocial services available for breast cancer patients and utilization in selected health facilities in Addis Ababa, Ethiopia. Methods: A mixed method study was conducted using a cross-sectional survey involving a sample of 428 patients with breast cancer, followed by a qualitative study in seven health facilities in Addis Ababa, Ethiopia. A total of nine in-depth interviews (IDIs) were conducted with purposefully selected four breast cancer patients and five key informants using two separate interview guides. Descriptive statistics were calculated using SPSS software, and both bivariate and multivariate logistic regressions were done to identify factors associated with provision of psychosocial services. Thematic analysis was used for the qualitative data using NVivo 12 plus software. Result: Only 47 (11.1%) patients received psychosocial services, either in the form of counseling, emotional support or provision of information. Addis Ababa residency, severity of pain and longer duration since diagnosis were factors associated with provision of psychosocial services. Health professionals reportedly provided such services along with their routine activities, and patients predominantly received social/emotional support from family members, friends and colleagues. There was no well-structured counseling service, emotional support or group discussion sessions for breast cancer patients in these health facilities. The main reasons reported by health professionals for not providing these services were high patient flow/workload, inadequate space, lack of training and not having qualified professionals to organize and deliver psychosocial services in those hospitals in Addis Ababa, Ethiopia. Conclusion: This study revealed that very few breast cancer patients received psychosocial services from health professionals, and the services were not integrated and delivered in a structured way. Therefore, integrating and implementing psychosocial services in cancer care is recommended both in private and government health facilities in Ethiopia.