Chemotherapy remains a cornerstone of cancer management, but its therapeutic benefit depends on consistent patient adherence, particularly in resource-limited settings where the socio-demographic and psychological barriers to compliance remain under-researched. This study assessed the level of chemotherapy compliance and examined the psychological factors influencing adherence among oncology patients attending two public tertiary hospitals in Ekiti State, Nigeria. A descriptive cross-sectional design was employed, involving total enumeration of 51 oncology patients receiving chemotherapy at Ekiti State University Teaching Hospital (EKSUTH) and Federal Teaching Hospital, Ido-Ekiti (FETHI). Data were collected using a structured, interviewer-assisted questionnaire covering socio-demographic characteristics, treatment profile, compliance measurement, and socio-demographic and psychological influences on adherence. Data were analysed with descriptive statistics and the chi-square test of association, with statistical significance set at p < .05. Compliance was moderate to high: 40% of respondents always attended scheduled appointments, 54% always took supportive medication, and 80% intended to complete the full treatment course; however, 55% had missed at least one session and 52% had delayed treatment, mainly because of financial constraints (46%). Breast cancer was the most frequent diagnosis (37%), and most patients presented at stage II or III. Chi-square analysis showed significant associations between compliance and educational level, occupation, monthly income, health insurance status, distance to hospital, and travel time (p < .05), but not age, sex, or marital status. Psychological distress was widespread: 42% reported near-daily anxiety about side effects, 34% reported reduced motivation, and 96% doubted the curative potential of chemotherapy, despite 82% receiving family support. Chemotherapy compliance in this setting is undermined less by lack of intent than by financial, logistical, and psychological barriers. Nurse-led interventions that combine financial navigation, routine psychological screening, and family-centred education are recommended to strengthen adherence and improve treatment outcomes.
Keywords: Chemotherapy compliance, Psychological Distress, oncology patients