Pathways to health outcomes after cancer diagnosis: A systematic review of cancer survivorship in Nigeria.

OBJECTIVE: With advancements in medicine and technology, more people are surviving cancers. However, cancer mortality in Nigeria remains high. The yearly estimate is 72,000 cancer-related deaths, making cancer one of the leading causes of death in Nigeria. The current study aimed to identify and synthesize factors that facilitate or hinder cancer survivorship in Nigeria and add to our understanding of the patterns of cancer survivorship in LMICs, such as Nigeria. METHOD: Following preferred reporting items for systematic reviews and meta-analyses guidelines, a systematic review was conducted across PubMed, Cochrane, and Scopus databases. We identified 31 peer-reviewed studies that examined cancer treatment, management, care, and survivorship in Nigeria. RESULTS: Eight themes emerged from 31 peer-reviewed studies that examined the factors that facilitate or hinder cancer survivorship among Nigerians. They include themes such as self-care and management, treatment options, availability of pseudo-doctors/pharmacists, and the desire to live. The themes were further grouped into three overarching themes: psychosocial, economic, and health care. CONCLUSION: Cancer survivors in Nigeria face many unique experiences that impact their health outcomes and chances of survivorship. Therefore, understanding cancer survivorship in Nigeria must involve studies on diagnosis, treatment, remission, surveillance, after-cancer care, and end-of-life. With enhanced support, cancer survivors will have improved health, thereby reducing the cancer mortality rate in Nigeria.

The Need to Appear Healthy: Concealment of Chronic Illness, Privacy, and Self-Sufficiency Among Chronically Ill Older Nigerians.

Background and Objectives: Prior research has highlighted the beneficial impact of social networks and social support on older adults' physical and psychosocial well-being. However, the impact of the relationship between chronic illness and social networks on the psychosocial well-being of older Nigerians remains understudied. This study explored how older Nigerians with chronic illnesses navigate the physical, mental, and emotional changes due to their chronic disease diagnosis within their social contexts. Research Design and Methods: The current qualitative study used semistructured in-depth interviews with 19 purposively sampled older adults, aged 50 years and over, chronically ill, and receiving clinical care to examine the role of social networks in how chronically ill older Nigerians cope with their diagnosis. Results: Three main themes reflecting participants' experiences emerged from the findings: (1) closely knit circles, (2) privacy and self-sufficiency, and (3) body image. Results show that chronically ill older Nigerians prefer to keep the knowledge of their conditions strictly within their close family circles. It was considered horrific to inform friends, community members, and religious groups about one's chronic illness. Findings further reveal that the need to appear healthy to one's social network stems from the fear of being discriminated against and attempts to maintain some level of normalcy when interacting with others. Additionally, feelings of inferiority and shame limited their participation in social activities and social network maintenance. Discussion and Implications: We discuss the implications of the results for the mental well-being and quality of life of chronically ill older Nigerians and make recommendations for policies and resources that can improve the well-being of chronically ill Nigerians.

COVID-19: Experiences of Social Workers Supporting Older Adults With Dementia in Nigeria.

Amidst the COVID-19 pandemic, numerous public health protocols were instituted by government agencies to safeguard individuals with dementia, their family caregivers, and formal care providers. While these preventive measures were implemented with good intentions, they inadvertently imposed significant challenges on medical social workers in Nigeria. This paper explored the experiences of medical social workers caring for people with dementia during the COVID-19 pandemic in Nigeria. Twenty-six medical social workers from 6 government hospitals in Southwestern Nigeria participated in an in-depth interview. The research reveals 3 pivotal aspects: Firstly, the escalating demands within the work environment, where medical social workers grapple with the intricate task of conveying sensitive information about dementia diagnosis and COVID-19 prevention protocol, managing expectations regarding dementia diagnoses, and navigating resource constraints for individuals with dementia during the pandemic. Secondly, discernible impacts on the work climate and interprofessional relationships shed light on the challenges these professionals face in collaborating with other healthcare providers. Lastly, the reverberations on social workers' personal lives underscore the pandemic's toll on their well-being. Thus, the findings underscore the need for proactive measures to equip medical social workers to face the distinctive challenges in dementia care during future pandemics. Recognizing the potential resurgence of global health crises, the research highlights the need for strategic preparedness to mitigate the impact of future pandemics on the well-being of individuals with dementia and the professionals dedicated to their care.

"He [the doctor] said I should go and wait for my death:" Dualities in care and support access among female cancer survivors.

INTRODUCTION: While some countries have positive outlooks and technology at their disposals to detect and treat cancer in its earliest stages, other countries frequently demonstrate trends of late-stage presentation and treatment hesitancy. Nigeria is a nation that has a high cancer burden, with poorer outcomes than higher income countries (HICs). To add to the body of cancer knowledge in global health, and inform relevant policies to improve cancer survivorship, our study offers insight on cancer survivors' experiences in accessing care and support in Nigeria. METHODS: The study employed a qualitative descriptive method. Semi-structured interviews were conducted with a purposive sample of 30 female breast cancer survivors in Nigeria (Mage = 42 years). Their responses were transcribed, coded, and analyzed for themes. RESULTS: The four major themes identified were: 1) views about chemotherapy and treatments; 2) support from families and others; 3) support from health care providers; and 4) religion and coping. Each of these themes include sub-themes that offer insights on the dualities of cancer survivorship. DISCUSSION: The high cancer death rate in Nigeria may be masking the growing number of cancer survivors, especially women diagnosed with breast cancer. It is important to design interventions that not only target cancer prevention but improving the health and quality of life of those affected by cancer in Nigeria until end of life. The findings highlight a critical need for more attention on cancer survivorship in Nigeria.

Perceived risk of COVID-19 diagnosis and stigma among Nigerians.

The World Health Organization (WHO) classified Nigeria as one of the 13 African countries with a higher risk of spreading COVID-19. Although the Nigerian government and its health agencies set directives in place to help curb the spread of COVID-19, there are instances of unconcerned attitudes and adherence to false and superstitious beliefs surrounding COVID-19 among Nigerians. The current study examined the general perception of COVID-19 risk among Nigerians. Additionally, it examined the fear of possible stigmatization if an individual is diagnosed with COVID-19. A cross-section of 332 Nigerian men and women responded to measures on perceived vulnerability to diseases, perception of risk of being infected with COVID-19, COVID-19 stigma, and social and demographic characteristics. The findings show that respondents with a higher perception of vulnerability to diseases reported higher COVID-19 risk and perception of COVID-19-related stigma. Further, we found that gender, age, and education impacted COVID-19 risk and perception of COVID-19-related stigma. Our findings suggest that risk perceptions and attitudes towards COVID-19 can impact the level of preparedness against a pandemic. Also, the findings could inform strategies for the proper implementation of health protective measures at national, state, and local government levels during a viral outbreak.