Prevalence of depression and association with quality-of-life among oncology patients at Princess Marina Hospital, Botswana: A cross-sectional study

Background: Depression significantly impacts cancer patients globally, complicating treatment outcomes by negatively affecting quality-of-life (QOL), self-care and treatment adherence. However, little is known about the prevalence of depression and its effects on QOL among cancer patients in Botswana. Aim: This study aimed to assess the prevalence of depression and its relationship with QOL among cancer patients at Princess Marina Hospital’s oncology unit. Setting: Patients seen at the oncology unit of Princess Marina Hospital, Botswana’s largest tertiary referral hospital. Methods: A cross-sectional study was conducted from February 2023 to August 2024. The sample size was 302. Socio-demographic data were collected using a researcher-designed questionnaire. Depression was assessed using the PHQ-9, with a score of 9 or higher indicating depression, and QOL was measured using the WHOQOL-BREF. Results: The prevalence of depression was 35.8% (95% confidence interval [CI]: 30.3%, 41.5%). Patients with depression had a higher mean pain score (6 vs. 4, p 0.001) and poorer QOL across all domains: physical health (40.9 vs. 59.7, p 0.001), psychological health (52.3 vs. 69.3, p 0.001), social relationships (49.0 vs. 68.3, p 0.001) and environmental health (48.1 vs. 58.8, p 0.001). A new diagnosis of cancer was associated with an increased risk of depression (p = 0.03). Conclusion: The prevalence of depression among cancer patients is high in Botswana, and it is associated with poorer QOL, highlighting a significant public health concern. Contribution: Treatment of depression in this group of patients, along with pain management, may be crucial in improving their QOL.