Determinants of Patient Experience and Its Association With Symptom Burden and Quality of Life Among Cancer Patients in Nigeria: A Tertiary-Centre Cross-Sectional Study

PURPOSE Patient experience is increasingly recognised as a quality indicator in oncology, but its relationship with clinically meaningful outcomes such as quality of life (QoL) remains unclear, particularly in resource-limited settings with advanced disease and high unmet supportive care needs. We evaluated patient experience and its association with symptom burden and QoL among cancer patients in a tertiary centre in Nigeria. METHODS We conducted a cross-sectional study of 320 cancer patients. Patient experience, symptom burden, and QoL were assessed using validated patient-reported measures, including the European Organisation for Research and Treatment of Cancer PATSAT-C33 and QLQ-C30 instruments. Associations were examined using Spearman correlation and multivariable linear regression, adjusting for socio-clinical factors. RESULTS The mean age was 46.6 ± 14.7 years; 60.6% were female and 79.4% presented with stage III-IV disease. Patient experience scores were uniformly high (range 4.57-4.85) with minimal variability. In contrast, substantial symptom burden was observed: severe pain in 63 (19.8%), sleep disturbance in 233 (72.8%), depressive symptoms in 218 (68.1%), including 122 (38.1%) moderate-to-severe, and financial difficulties in 232 (72.5%), with 128 (40.0%) moderate-to-severe burden. Patient experience was not associated with QoL (ρ = –0.012; P = .830; adjusted β = –0.090; 95% CI –0.340 to 0.161; P = .481). By contrast, symptom burden showed strong independent associations with reduced QoL, including pain (β ≈ –0.80; P = .0001), depression (β ≈ –0.90; P = .0001), sleep disturbance (β ≈ –0.70; P = .0002), and financial difficulties (β ≈ –0.80; P = .0001). CONCLUSION In this LMIC setting, QoL is driven predominantly by symptom burden rather than perceived care experience. Despite high patient experience scores, substantial unmet needs persist, particularly in psychological and financial domains. These findings highlight a disconnect between reported experience and actual well-being, and support prioritising integrated psycho-oncology services, symptom-directed supportive care, and financial toxicity interventions to improve patient-centred outcomes.