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Searl J, Genoa K, Fritz A, Kearney A, Pandian V, Brenner MJ, Doyle P. Perceptions and practices of people with a total laryngectomy during COVID-19 pandemic: A mixed methods analysis. Am J Otolaryngol 2024; 45:104126. [PMID: 38039911 PMCID: PMC10939873 DOI: 10.1016/j.amjoto.2023.104126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/19/2023] [Indexed: 12/03/2023]
Abstract
PURPOSE People with a total laryngectomy (PTL) confront safety threats related to altered airway anatomy and risk of adverse events is amplified during healthcare crises, as exemplified by COVID-19 pandemic. Understanding these challenges, how they are navigated by PTL, and what resources can be deployed to alleviate risk can improve interprofessional care by speech-language pathologists (SLPs), otolaryngologists, and other professionals. MATERIALS AND METHODS An online survey was disseminated to PTL in the United States during the COVID-19 pandemic, querying participants about safety concerns and sources of information accessed to address care. Descriptive statistics and Chi-square were used to analyze information sources consumed by tracheoesophageal, esophageal, and electrolaryngeal speakers. Content analysis was completed to identify themes and quantify responses by subtheme. RESULTS Among 173 respondent PTL, tracheoesophageal speakers preferentially sought otolaryngologist input, whereas esophageal and electrolaryngeal speakers more often chose SLPs (p < .01). Overall, tracheoesophageal speakers had more SLP or otolaryngologist contact. Many PTL reported stringent handwashing, neck cleaning, and hygienic risk mitigation strategies. Six themes emerged in content analysis involving risk of infection/transmission, heightened vigilance, changes to alaryngeal communication, modified tracheostoma coverage, diagnostic testing, and risk from comorbid conditions. Limited provider contact suggested pandemic barriers to healthcare access. CONCLUSIONS PTL have a range of laryngectomy-specific needs and concerns, and type of alaryngeal communication was associated with source of information sought. Collaborations among healthcare professionals need to be optimized to improve patient navigation and overall access to specialized care.
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Affiliation(s)
- Jeff Searl
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA.
| | - Kathryn Genoa
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA.
| | - Alyssa Fritz
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA.
| | - Ann Kearney
- Division of Laryngology, Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.
| | - Vinciya Pandian
- Center for Immersive Learning and Digital Innovation, Johns Hopkins School of Nursing, Baltimore, MD, USA.; Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, USA; Global Tracheostomy Collaborative, Raleigh, NC, USA.
| | - Michael J Brenner
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA; Global Tracheostomy Collaborative, Raleigh, NC, USA.
| | - Philip Doyle
- Division of Laryngology, Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.
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Agostinelli V, Ballatore Z, Ricci G, Lucarelli A, Burattini M, Mariotti L, Catani C, Tarantino V, Berardi R. Impact of coronavirus disease 2019 pandemic on good clinical practice trials in oncology. EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2023; 4:1095-1103. [PMID: 38023994 PMCID: PMC10651351 DOI: 10.37349/etat.2023.00183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/10/2023] [Indexed: 12/01/2023] Open
Abstract
Aim Coronavirus disease 2019 (COVID-19) became pandemic on 11th March 2020 and it deeply stressed the healthcare system. Cancer patients represent a vulnerable population, so many recommendations have been approved to ensure optimal management. Clinical research was notably impacted by COVID too. This review aims to analyze the challenges occurred during a pandemic for the management of enrolled patients (enrollment, use of telemedicine visits, study procedures) and for the clinical trials system (from feasibility to selection visit, site initiation visit, monitorings, use of e-signature, deviations and discontinuations). Methods The studies included in the present review were selected from PubMed/Google Scholar/ScienceDirect databases. Results During the first phase of pandemic many clinical trials were suspended in accrual and, as the pandemic progressed, recommendations were established to guarantee the safety and the continuity of care of enrolled patients. In addition, lot of new strategies was found during the pandemic to reduce the negative consequences on clinical trial performance and to guarantee new opportunities of care in the respect of good clinical practice (GCP) in a bad scenario. Conclusions Among all modifiers, investigators would prefer to maintain the positive ones such as pragmatic and simplified trial designs and protocols, reducing in-person visits when not necessary and to minimizing sponsor and contract research organizations (CROs) visits.
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Affiliation(s)
- Veronica Agostinelli
- Department of Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Zelmira Ballatore
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy
| | - Giulia Ricci
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy
| | - Alessandra Lucarelli
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy
| | - Michela Burattini
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy
| | - Lorenzo Mariotti
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy
| | - Claudia Catani
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy
| | - Valentina Tarantino
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy
| | - Rossana Berardi
- Department of Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy
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Embrett M, Packer TL, Fitzgerald E, Jaswal SK, Lehman MJ, Brown M, Burge F, Christian E, Isenor JE, Marshall EG, Martin-Misener R, Sampalli T, Zed J, Leigh JP. The impact of the COVID-19 pandemic on primary care physicians and nurses in Nova Scotia: a qualitative exploratory study. CMAJ Open 2023; 11:E274-E281. [PMID: 36944428 PMCID: PMC10035666 DOI: 10.9778/cmajo.20210315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has brought immense disruption worldwide, dramatically altering the ways we live, work and learn on a day-to-day basis; however, few studies have investigated this from the perspective of primary care providers. In this study, we sought to explore the experiences of primary care providers in the province of Nova Scotia, with the intention of understanding the impact of the COVID-19 pandemic on primary care providers' ability to provide care, their information pathways, and the personal and professional impact of the pandemic. METHODS We conducted an exploratory qualitative research study involving semistructured interviews conducted via Zoom videoconferencing or telephone with primary care providers (physicians, nurse practitioners and family practice nurses) who self-identified as working in primary health care in Nova Scotia from June 2020 to April 2021. We performed a thematic analysis involving coding and classifying data according to themes. Emergent themes were then interpreted by seeking commonalties, divergence, relationships and overarching patterns in the data. RESULTS Twenty-four primary care providers were interviewed. Subsequent analysis identified 4 interrelated themes within the data: disruption to work-life balance, disruptions to "non-COVID-19" patient care, impact of provincial and centralized policies, and filtering and processing an influx of information. INTERPRETATION Our findings showed that managing a crisis of this magnitude requires coordination and new ways of working, balancing professional and personal life, and adapting to already implemented changes (i.e., virtual care). A specific primary care pandemic response plan is essential to mitigate the impact of future health care crises.
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Affiliation(s)
- Mark Embrett
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
| | - Tanya L Packer
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
| | - Emily Fitzgerald
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
| | - Sabrena K Jaswal
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
| | - Michelle J Lehman
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
| | - Marion Brown
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
| | - Fred Burge
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
| | - Erin Christian
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
| | - Jennifer E Isenor
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
| | - Emily Gard Marshall
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
| | - Ruth Martin-Misener
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
| | - Tara Sampalli
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
| | - Joanna Zed
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
| | - Jeanna Parsons Leigh
- Research, Innovation & Discovery (Embrett), Nova Scotia Health Authority, Queensland, NS; Schools of Health Administration (Packer, Fitzgerald, Jaswal, Lehman), Occupational Therapy (Packer, Jaswal, Lehman) and Social Work (Brown), and Department of Family Medicine (Burge, Marshall), Dalhousie University; Nova Scotia Health Authority (Christian, Sampalli); College of Pharmacy (Isenor), Faculty of Health, and Department of Community Health and Epidemiology (Isenor), Faculty of Medicine, Dalhousie University; Canadian Center for Vaccinology (Isenor); Faculty of Health (Martin-Misener, Zed), Dalhousie University; Faculty of Health Administration (Parsons Leigh), School of Health Administration, Dalhousie University, Halifax, NS
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Perego G, Di Mattei VE, Mazzetti M, Milano F, Gatti C, Rancoita PMV, Taranto P, Rabaiotti E, Cioffi R, Candiani M. The Experience of COVID-19 in a Sample of Gynecological Cancer Patients Undergoing Chemotherapy: A Focus on the Psychological Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3851. [PMID: 36900862 PMCID: PMC10002022 DOI: 10.3390/ijerph20053851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Cancer patients are at an increased risk of developing severe consequences due to the COVID-19 infection. However, psychological outcomes in this population have been overlooked in the literature. The present study aims to identify significant psychological differences between gynecological cancer patients undergoing chemotherapy before and during the pandemic. Additionally, we explore the correlations between COVID-19-related concerns and anxiety, depression, distress, and quality of life levels. Forty-two patients completed the STAI-Y, the EORTC QLQ-C30, the BDI II, the DT, and an ad-hoc questionnaire that investigated COVID-19-related concerns. The analyses did not show significant differences in the psychometric scales between the two groups, highlighting a considerable resilience against mental health and quality of life deterioration during the COVID-19 pandemic in gynecologic cancer patients. However, COVID-19-related concerns were positively associated with anxiety and inversely related to emotional functioning levels. These results emphasize the importance of a comprehensive patient care and the need to implement a multidisciplinary approach that includes psychological support in the treatment plan. Moreover, it is essential to encourage clear communication to convey comprehensive information about the impact of the pandemic on physical and psychological levels, as well as to offer psychoeducational tools to face the pandemic.
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Affiliation(s)
- Gaia Perego
- School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Valentina Elisabetta Di Mattei
- School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Martina Mazzetti
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Francesca Milano
- Department of Psychology, University of Milano-Bicocca, 20132 Milan, Italy
| | - Carola Gatti
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Paola Maria Vittoria Rancoita
- University Centre for Statistics in Biomedical Sciences (CUSSB), Vita-Salute San Raffaele University, 20132 Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Paola Taranto
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Emanuela Rabaiotti
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Raffaella Cioffi
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Massimo Candiani
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
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Mavragani A, Duffin S, Gough RE, Bath PA. Use of Online Health Forums by People Living With Breast Cancer During the COVID-19 Pandemic: Thematic Analysis. JMIR Cancer 2023; 9:e42783. [PMID: 36473015 PMCID: PMC9907982 DOI: 10.2196/42783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/24/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND At the time of the UK COVID-19 lockdowns, online health forums (OHFs) were one of the relatively few remaining accessible sources of peer support for people living with breast cancer. Cancer services were heavily affected by the pandemic in many ways, including the closure of many of the customary support services. Previous studies indicate that loneliness, anxiety, distress, and depression caused by COVID-19 were common among people living with breast cancer, and this suggests that the role of OHFs in providing users with support, information, and empathy could have been of increased importance at that time. OBJECTIVE This study aimed to examine how people living with breast cancer shared information, experiences, and emotions in an OHF during the COVID-19 pandemic. METHODS This qualitative study thematically analyzed posts from the discussion forums of an OHF provided by the UK charity, Breast Cancer Now. We selected 1053 posts from the time of 2 UK lockdowns: March 16, 2020, to June 15, 2020 (lockdown 1), and January 6, 2021, to March 8, 2021 (lockdown 3), for analysis, from 2 of the forum's boards (for recently diagnosed people and for those undergoing chemotherapy). We analyzed the data using the original 6 steps for thematic analysis by Braun and Clarke but by following a codebook approach. Descriptive statistics for posts were also derived. RESULTS We found that COVID-19 amplified the forum's value to its users. As patients with cancer, participants were in a situation that was "bad enough already," and the COVID-19 pandemic heightened this difficult situation. The forum's value, which was already high for the information and peer support it provided, increased because COVID-19 caused some special information needs that forum users were uniquely well placed to fulfill as people experiencing the combined effects of having breast cancer during the pandemic. The forum also met the emotional needs generated by the COVID-19 pandemic and was valued as a place where loneliness during the pandemic may be relieved and users' spirits lifted in a variety of ways specific to this period. We found some differences in use between the 2 periods and the 2 boards-most noticeable was the great fear and anxiety expressed at the beginning of lockdown 1. Both the beginning and end of lockdown periods were particularly difficult for participants, with the ends seen as potentially increasing isolation. CONCLUSIONS The forums were an important source of support and information to their users, with their value increasing during the lockdowns for a variety of reasons. Our findings will be helpful to organizations offering OHFs and to health care workers advising people living with breast cancer about sources of support.
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Affiliation(s)
| | - Suzanne Duffin
- Information School, Faculty of Social Sciences, University of Sheffield, Sheffield, United Kingdom
| | - Rosemarie E Gough
- School of Health and Related Research, Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, United Kingdom
| | - Peter A Bath
- Information School, Faculty of Social Sciences, University of Sheffield, Sheffield, United Kingdom
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Linjawi M, Shakoor H, Hilary S, Ali HI, Al-Dhaheri AS, Ismail LC, Apostolopoulos V, Stojanovska L. Cancer Patients during COVID-19 Pandemic: A Mini-Review. Healthcare (Basel) 2023; 11:healthcare11020248. [PMID: 36673615 PMCID: PMC9859465 DOI: 10.3390/healthcare11020248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
Since its emergence, coronavirus disease 2019 (COVID-19) has affected the entire world and all commerce and industries, including healthcare systems. COVID-19 adversely affects cancer patients because they are immunocompromised. Increased COVID-19 infection and shortage of medical supplies, beds and healthcare workers in hospitals affect cancer care. This paper includes a description of the existing research that shows the impact of COVID-19 on the management of cancer patients. Aged people with various chronic conditions such as cancer and comorbidities face more challenges as they have a greater risk of disease severity. COVID-19 has affected care delivery, including patient management, and has been responsible for increased mortality among cancer patients. Cancer patients with severe symptoms require regular therapies and treatment; therefore, they have a higher risk of exposure. Due to the risk of transmission, various steps were taken to combat this disease; however, they have affected the existing operational efficiency. Herein, we present the changing priorities during COVID-19, which also affected cancer care, including delayed diagnosis, treatment, and surgeries.
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Affiliation(s)
- Maryam Linjawi
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Hira Shakoor
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Serene Hilary
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Correspondence: (S.H.); (L.S.)
| | - Habiba I. Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Ayesha S. Al-Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, OX3 9DU, UK
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3030, Australia
| | - Lily Stojanovska
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3030, Australia
- Correspondence: (S.H.); (L.S.)
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Kenis I, Theys S, Daem M, Decoene E, Demolder V, Duprez V, Pape E, Quaghebeur M, Verhaeghe S, Foulon V, Van Hecke A. Experiences of patients with cancer and their relatives confronted with COVID-19 related delay or change in care: A qualitative study. J Adv Nurs 2022; 78:4150-4164. [PMID: 36052660 PMCID: PMC9538827 DOI: 10.1111/jan.15431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/08/2022] [Accepted: 08/20/2022] [Indexed: 12/12/2022]
Abstract
AIMS To provide in-depth insight into how patients and their relatives experienced change or delay in cancer treatment and care due to COVID-19. DESIGN A qualitative study including semi-structured interviews with patients with cancer and their relatives. METHODS Between July and October 2020, 42 patients who were confronted with a change or delay in cancer treatment or care, and 11 relatives were interviewed. Data collection and analysis were performed according to the most important methods of grounded theory, including iterative data collection and analysis, theoretical sampling, constant comparative analysis and theoretical sensitivity. RESULTS This study shows that patients with cancer and relatives experienced paradoxical feelings when confronted with change or delay in treatment or care due to COVID-19. Patients and relatives felt relieved (e.g. less risk of infection), but were also concerned and anxious (e.g. fear for progression, fear for more side effects). Due to these ambivalent feelings, it was difficult for patients and relatives to cope with the change or delay in treatment or care, both when this was decided by the physician and by themselves. In combination with the general impact of COVID-19 on their daily lives, the change or delay led to additional distress. The interviews showed that exploring the meaning of change or delay of care for patients and their relatives and discussing what would help them might prevent or relieve distress. CONCLUSION The findings of our study show that COVID-19 and the associated delay or changes in cancer treatment and care had a major impact on the well-being of patients and their relatives. Person-oriented care is even more important during (emergency) situations in which care might be changed or delayed.
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Affiliation(s)
- Ilyse Kenis
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological SciencesKU LeuvenLeuvenBelgium
- Department of Public Health and Primary Care, Faculty of Medicine and Health SciencesUniversity Centre for Nursing and Midwifery, Ghent UniversityGhentBelgium
| | - Sofie Theys
- Department of Public Health and Primary Care, Faculty of Medicine and Health SciencesUniversity Centre for Nursing and Midwifery, Ghent UniversityGhentBelgium
| | - Michiel Daem
- Cancer Center, Ghent University HospitalGhentBelgium
| | - Elsie Decoene
- Cancer Center, Ghent University HospitalGhentBelgium
| | | | - Veerle Duprez
- Department of Public Health and Primary Care, Faculty of Medicine and Health SciencesUniversity Centre for Nursing and Midwifery, Ghent UniversityGhentBelgium
| | - Eva Pape
- Department of Public Health and Primary Care, Faculty of Medicine and Health SciencesUniversity Centre for Nursing and Midwifery, Ghent UniversityGhentBelgium
- Cancer Center, Ghent University HospitalGhentBelgium
| | | | - Sofie Verhaeghe
- Department of Public Health and Primary Care, Faculty of Medicine and Health SciencesUniversity Centre for Nursing and Midwifery, Ghent UniversityGhentBelgium
- Department of Health CareVIVES University CollegeRoeselareBelgium
| | - Veerle Foulon
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological SciencesKU LeuvenLeuvenBelgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, Faculty of Medicine and Health SciencesUniversity Centre for Nursing and Midwifery, Ghent UniversityGhentBelgium
- Nursing DepartmentGhent University HospitalGhentBelgium
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8
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Rising incidence of late stage breast cancer after COVID-19 outbreak. Real-world data from the Italian COVID-DELAY study. Breast 2022; 65:164-171. [PMID: 35998429 PMCID: PMC9388078 DOI: 10.1016/j.breast.2022.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/13/2022] [Accepted: 08/16/2022] [Indexed: 11/03/2022] Open
Abstract
Purpose Methods Results Conclusions COVID-19 impacted on breast cancer (BC) diagnoses with a reduction of 25% in 2020. Fewer early-stage BC and more symptomatic patients were diagnosed during 2020. Timing of access to BC diagnosis, staging and treatment has not been affected by COVID-19. Less BC cases were reviewed in multidisciplinary tumor meetings during 2020.
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9
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Haier J, Beller J, Adorjan K, Bleich S, De Greck M, Griesinger F, Hein A, Hurlemann R, Mees ST, Philipsen A, Rohde G, Schilling G, Trautmann K, Combs SE, Geyer S, Schäfers J. Decision Conflicts in Clinical Care during COVID-19: A Patient Perspective. Healthcare (Basel) 2022; 10:healthcare10061019. [PMID: 35742070 PMCID: PMC9222354 DOI: 10.3390/healthcare10061019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 12/16/2022] Open
Abstract
(1) Background: Uncertainty is typical for a pandemic or similar healthcare crisis. This affects patients with resulting decisional conflicts and disturbed shared decision making during their treatment occurring to a very different extent. Sociodemographic factors and the individual perception of pandemic-related problems likely determine this decisional dilemma for patients and can characterize vulnerable groups with special susceptibility for decisional problems and related consequences. (2) Methods: Cross-sectional data from the OnCoVID questionnaire study were used involving 540 patients from 11 participating institutions covering all major regions in Germany. Participants were actively involved in clinical treatment in oncology or psychiatry during the COVID-19 pandemic. Questionnaires covered five decision dimensions (conflicts and uncertainty, resources, risk perception, perception of consequences for clinical processes, perception of consequences for patients) and very basic demographic data (age, gender, stage of treatment and educational background). Decision uncertainties and distress were operationalized using equidistant five-point scales. Data analysis was performed using descriptive and various multivariate approaches. (3) Results: A total of 11.5% of all patients described intensive uncertainty in their clinical decisions that was significantly correlated with anxiety, depression, loneliness and stress. Younger and female patients and those of higher educational status and treatment stage had the highest values for these stressors (p < 0.001). Only 15.3% of the patients (14.9% oncology, 16.2% psychiatry; p = 0.021) considered the additional risk of COVID-19 infections as very important for their disease-related decisions. Regression analysis identified determinants for patients at risk of a decisional dilemma, including information availability, educational level, age group and requirement of treatment decision making. (4) Conclusions: In patients, the COVID-19 pandemic induced specific decisional uncertainty and distress accompanied by intensified stress and psychological disturbances. Determinants of specific vulnerability were related to female sex, younger age, education level, disease stages and perception of pandemic-related treatment modifications, whereas availability of sufficient pandemic-related information prevented these problems. The most important decisional criteria for patients under these conditions were expected side effects/complications and treatment responses.
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Affiliation(s)
- Jörg Haier
- Comprehensive Cancer Center Hannover, Hannover Medical School, 30625 Hannover, Germany; (J.B.); (J.S.)
- Correspondence:
| | - Johannes Beller
- Comprehensive Cancer Center Hannover, Hannover Medical School, 30625 Hannover, Germany; (J.B.); (J.S.)
- Medical Sociology Unit, Hannover Medical School, 30625 Hannover, Germany;
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, 81377 Munich, Germany;
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany;
| | - Moritz De Greck
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, 60528 Frankfurt, Germany;
| | - Frank Griesinger
- Department of Hematology and Oncology, Pius-Hospital Oldenburg, Carl von Ossietzky University, 26129 Oldenburg, Germany;
| | - Alexander Hein
- Department of Gynecology and Obstetrics, Erlangen University Hospital, 91054 Erlangen, Germany;
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany
| | - René Hurlemann
- Department of Psychiatry, Carl von Ossietzky University, 26129 Oldenburg, Germany;
| | - Sören Torge Mees
- Department of General, Visceral and Thoracic Surgery, Friedrichstadt General Hospital, 01067 Dresden, Germany;
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, 53105 Bonn, Germany;
| | - Gernot Rohde
- Department of Respiratory Medicine and Allergology, University Hospital, Goethe University, 60590 Frankfurt am Main, Germany;
| | - Georgia Schilling
- Department of Hematology, Oncology, Palliative Care and Rheumatology, Asklepios Hospital Altona, Asklepios Tumorzentrum, 22763 Hamburg, Germany;
| | - Karolin Trautmann
- Department of Hematology and Oncology, University Hospital Carl Gustav Carus, 01307 Dresden, Germany;
| | - Stephanie E. Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany;
| | - Siegfried Geyer
- Medical Sociology Unit, Hannover Medical School, 30625 Hannover, Germany;
| | - Jürgen Schäfers
- Comprehensive Cancer Center Hannover, Hannover Medical School, 30625 Hannover, Germany; (J.B.); (J.S.)
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10
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Barcellini A, Massaro M, Dal Mas F, Langendijk JA, Høyer M, Calugaru V, Haustermans K, Timmermann B, Thariat J, Scartoni D, Vennarini S, Georg P, Orlandi E. A year of pandemic for European particle radiotherapy: A survey on behalf of EPTN working group. Clin Transl Radiat Oncol 2022; 34:1-6. [PMID: 35243028 PMCID: PMC8885798 DOI: 10.1016/j.ctro.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/11/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Amelia Barcellini
- Radiation Oncology, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
- Corresponding author at: Radiation Oncology, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy.
| | | | - Francesca Dal Mas
- Department of Management, Lincoln International Business School, University of Lincoln, Lincoln, UK and Interdepartmental Research Center “Organization and Governance of the Public Administration”, University of Pavia, Pavia, Italy
| | - Johannes A. Langendijk
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Morten Høyer
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | | | - Karin Haustermans
- Department of Radiation Oncology, University Hospital Leuven, Leuven, Belgium
| | - Beate Timmermann
- Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen (WTZ), German Cancer Consortium (DKTK), Germany
| | - Juliette Thariat
- Radiation Oncology Department, François Baclesse Center/ARCHADE, Normandy University, Caen, France
| | - Daniele Scartoni
- Proton Therapy Unit, Hospital of Trento, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Sabina Vennarini
- Proton Therapy Unit, Hospital of Trento, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
- Pediatric Radiotherapy Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Petra Georg
- MedAustron Ion Therapy Center, Wiener Neustadt, Austria
| | - Ester Orlandi
- Radiation Oncology, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
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Bogaert B, Buisson V, Kozlakidis Z, Saintigny P. Organisation of cancer care in troubling times: A scoping review of expert guidelines and their implementation during the COVID-19 pandemic. Crit Rev Oncol Hematol 2022; 173:103656. [PMID: 35337970 PMCID: PMC8942466 DOI: 10.1016/j.critrevonc.2022.103656] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 12/12/2022] Open
Abstract
This scoping review mapped the main themes in existing expert guidelines for cancer care issued during the COVID-19 crisis from the period of March 2020-August 2021. The guidelines published during the research period principally relate to the first two waves in Europe and until the beginning of the vaccination campaign. They elaborated recommendations for cancer care reorganisation, in particular triage and quality of care issues. The article highlights the ethical, epistemological, as well as practical reasons that guidelines were not always followed to provide some lessons learned for future crises to enable better guideline development processes. We also elaborate early evidence on the impact of triage decisions and different perspectives on cancer care reorganisation from ethics and social science literature.
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Affiliation(s)
- Brenda Bogaert
- Department of Social Sciences and Humanities, Centre Léon Bérard, Lyon, France.
| | - Victoria Buisson
- Department of Social Sciences and Humanities, Centre Léon Bérard, Lyon, France.
| | - Zizis Kozlakidis
- International Agency for Research on Cancer, World Health Organization, Lyon, France.
| | - Pierre Saintigny
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France; Univ Lyon, Claude Bernard Lyon 1 University, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France.
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12
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Ballatore Z, Merloni F, Ranallo N, Bastianelli L, Vitarelli F, Cantini L, Ricci G, Ferretti B, Alessandroni P, Del Prete M, Chiorrini S, Safi M, Ficarelli R, Benedetti G, Faloppi L, Marcellini M, Stoico R, Berardi R. Cancer patient perspective in the arena of COVID-19 pandemic. Psychooncology 2021; 31:39-45. [PMID: 34315188 PMCID: PMC8420223 DOI: 10.1002/pon.5774] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 07/17/2021] [Accepted: 07/19/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) outbreak has been declared a global pandemic of unprecedented proportions. Italy is a country which has been heavily affected. Cancer patients are at a higher risk owing to their intrinsic fragility related to their underlying disease and oncologic treatment. Against this backdrop, we conducted a survey to investigate how patients perceived their condition, clinical management and availability of information during the pandemic. METHODS Between 15 April and 1 May 2020 a survey was submitted to cancer patients at oncology departments in the Marche region. Questions regarding the perception of personal safety, continuity of cancer care, information quality and psychological distress. RESULTS Seven hundred patients participated in the survey; 59% were female and 40% were aged between 46 and 65. The majority of the participants perceived compliance with appropriate safety standards by cancer care providers and 80% were reassured about their concerns during the medical interview. 40% were worried of being at a higher risk of infection and 71% felt they were at a greater risk because of chemotherapy. 55% felt that postponing cancer treatment could reduce its efficacy, however 76% declared they did not feel abandoned at the time of treatment postponement. Patients between 46 and 65 years declared a significant reduction in sleep (p < 0.01) and in concentration (p = 0.03). CONCLUSIONS The emergency care offered to cancer patients has been deemed satisfactory in terms of both safety standards and care management. However, the majority of participants perceived the mutual negative influence between their oncologic disease and the risk of infection highlighting the need for special measures to ensure safe continuity of care.
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Affiliation(s)
- Zelmira Ballatore
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Filippo Merloni
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Nicoletta Ranallo
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Lucia Bastianelli
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Francesca Vitarelli
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Luca Cantini
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Giulia Ricci
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | | | - Paolo Alessandroni
- U.O. OncologiaAzienda Ospedaliera Ospedali Riuniti Marche NordPesaroItaly
| | | | | | - Mobin Safi
- U.O. OncologiaOspedale C. UrbaniJesiItaly
| | - Rita Ficarelli
- U.O. OncologiaPresidio Ospedaliero Unico “Santa Maria della Misericordia”UrbinoItaly
| | | | | | | | - Rosa Stoico
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
| | - Rossana Berardi
- Clinical OncologyUniversità Politecnica delle MarcheAOU Ospedali Riuniti di AnconaAnconaItaly
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