Coping during COVID-19: a mixed methods study of older cancer survivors

Pandemic coping and COVID-19 preventive behaviors among cancer survivors

BACKGROUND

Cancer survivors are at greater risk for COVID-19 complications, emphasizing the importance of adherence to COVID-19 prevention. Active coping mechanisms can help manage pandemic stress but disengaged coping practices can have adverse effects.

OBJECTIVES

1) Identify differences in COVID-19 coping styles and COVID-19 preventive behaviors among cancer survivors in active treatment, survivors not in treatment, and a comparison group without a cancer history. 2) Exploring variables that may predict adherence to COVID-19 preventative behaviors.

PATIENT INVOLVEMENT & METHODS

This study used an online survey among two categories of cancer survivors - one group in active treatment and one group no longer in treatment - and one group without a cancer history (N = 897 total).

RESULTS AND DISCUSSION

Cancer survivors in treatment were more likely to utilize both active and disengaged coping (p < .001). This could indicate that the additional COVID-19 strain is making survivors more likely to engage in coping in any way possible. Cancer survivors not in treatment were less likely to report intent to carry out COVID- 19 preventative behaviors compared to the comparison group (p = .009). Providers should understand how survivors may use both coping mechanism types because these coping strategies predict both depression and adherence to COVID-19 preventive behaviors.

The Role of Mass Media in Influencing the Lifestyle of the Elderly during the COVID-19 Pandemic

The elderly represent one of the categories that was most affected by the pandemic period. The purpose of this research was to analyze the ways in which mass media and very often contradictory information flows influenced the lives and personal communications of the Romanian elderly population during the COVID-19 pandemic. In order to conduct the research, we used a mixed-methods approach. For the quantitative research, we gave a questionnaire to the elderly population of Romania, and for the qualitative research, we conducted interviews. Our quantitative sample included 881 retired persons with an age between 55 and 94 years old; the mean age was 71.48 years old with 6.6 years standard deviation. The elderly described the pandemic period using negative words: fear, loneliness, anxiety, disaster; the channel they mostly watched and trusted was the TV; they were aware of the measures they had to take to protect themselves; they missed most of the meetings with the family and the main problems they had were represented by loneliness, the inability to be with their families or the lack of access to medical services. The elderly's mass media consumption during the pandemic was mostly represented by TV consumption; the information spread by mass media was sometimes contradictory; it influenced their behavior and may have generated feelings of anxiety among them.

Experiences of Patients in Turkey with Breast Cancer throughout the COVID-19 Pandemic and their Coping Mechanisms: A Qualitative Study

This research was conducted in Turkey to determine the experiences and coping mechanisms of breast cancer patients during the COVID-19 pandemic. The research was conducted using qualitative descriptive phenomenology. Data were collected from ten patients via in-depth interviews through semi-structured questionnaires. Content analysis, incorporating a combination of deductive and inductive approaches, was conducted to determine the themes and subthemes. Interviews were transcribed verbatim, simultaneously with the analysis and collected data. The study data were categorized into 3 contexts, 7 themes and 39 subthemes. The first context titled "Problems accompanying the disease" includes the effects of the pandemic, the fear of being infected with COVID-19 and hospital-related themes. The second context titled "Coping strategies" comprises the themes of coping behaviors and healthy lifestyle behaviors. The last context is titled "Anxiety about being infected, and suggestions for the future". In the study, problems experienced by patients with breast cancer throughout the COVID-19 pandemic were investigated from a broad perspective. Patients treated in chemotherapy units constitute the vulnerable group affected by the pandemic most. Therefore, it is important to investigate the experiences of oncology patients, particularly of patients with breast cancer and their coping strategies, and to take necessary precautions accordingly.

Fear of Missing Out, Emotional Intelligence and Attachment in Older Adults in Argentina

In recent years, the rise of social networks has changed relationships and lifestyles around the world. This has led to the emergence of the Fear of Missing Out (FoMO), which consists of the need to constantly check social media and the anguish that comes from feeling a lack of rewarding experiences. The impact derived from the use of technologies in a digital environment has been widely studied in young people but not so much in older adults. The main aim of this study was to analyze FoMO levels in older adults and their relationships with sociodemographic and formative factors. Another aim of this study was to analyze whether the dimensions of emotional intelligence, the different forms of attachment and psychological symptomatology affect the FoMO levels of older adults. A total of 690 older adults from Argentina aged between 60 and 90 years (M = 69.01; SD = 5.48) participated, 54.5% of whom were women, responding using a geolocated online questionnaire. The main results confirmed that older people show FoMO levels similar to other general samples. In addition, results show several predictor variables with respect to FoMO: emotional attention, insecure attachment, depression and difficulties in interpersonal relationships. The implications of the results observed in older adults are discussed.

A Rapid Systematic Review on the Experiences of Cancer Survivors Residing in Rural Areas during the COVID-19 Pandemic

The COVID-19 pandemic has caused considerable disruption to cancer care and may have exacerbated existing challenges already faced by cancer survivors from rural areas. This has created a need for a rapid evidence synthesis to inform the development of tailored interventions that address the specific needs of rural cancer survivors who continue to be affected by the pandemic. The review was conducted following guidance from the Cochrane Rapid Review Methods Group. Database searches were performed via the EBSCOHost interface (includes MEDLINE, CINAHL, PsycINFO) on 25 May 2022 and supplemented with searches on Google Scholar. Peer-reviewed articles published after March 2020 that reported primary data on the experiences of cancer survivors residing in rural and remote settings during the pandemic were included. Findings were tabulated and written up narratively. Fourteen studies were included. The COVID-19 pandemic had a mostly detrimental impact on the experiences of rural cancer survivors. People's individual coping mechanisms were challenging for a range of reasons. Specifically, the pandemic impacted on their ability to access testing, treatment, check-ups and supportive care, their ability to maintain and access social support with close friends and family, as well as negative consequences to their finances and emotional wellbeing with some reporting feelings of psychological distress including depression and anxiety. This review provides important insight into the experiences of rural cancer survivors that may help inform tailored support in line with the needs and challenges faced because of the pandemic.

"Double whammy": a rapid review of rural vs urban psychosocial cancer experiences and telehealth service in five countries during the COVID-19 pandemic

Background

Cancer is a long-term condition with biopsychosocial components. People with cancer living in rural areas can have poorer treatment outcomes and higher rates of unmet psychosocial needs than those in urban areas. Cancer, as opposed to other chronic conditions, poses a unique challenge in this current COVID-19 pandemic context, given immunocompromised states of patients and long-term survivor treatment effects. The disaggregated impact of psychosocial issues potentiated by the pandemic on rural vs. urban cancer populations is yet to be quantified. This rapid review investigates whether (i) people with cancer are experiencing pandemic-related psychosocial impacts, (ii) these impacts are equivalent in urban and rural locations, and (iii) whether the rapid uptake of telehealth mitigates or reinforces any identified impacts.

Method

A rapid review was conducted for literature published between December 2019 and 13 August 2021.

Results

Fifteen papers were included, incorporating evidence from five countries. The available literature suggests people affected by cancer living in rural areas are evidencing disproportionate psychosocial impacts of COVID-19, compounding cancer experiences. Despite its widespread and necessary use during the pandemic, telehealth was identified as an additional challenge for rural people with cancer.

Conclusions

Clinicians working with rural people affected by cancer should ensure recognition of the greater risks of psychosocial concerns in their rural patients, and reduced access to health services. Whilst telehealth and other remote technologies are useful and necessary in this pandemic era, clinicians should consider whether its use benefits their rural clients or reinforces existing disparities.

The changing face of HR professionals' expectations amidst COVID-19: a comparison in between Sri Lanka and foreign context

The COVID-19 has brought significant transformation to organizations throughout the world in expediting the sudden transition to digital business operations for business continuity. Thus, businesses need to examine the expectations of Human Resource (HR) professionals to adapt to the unexpected changes aroused by the novel COVID-19 pandemic. The study aimed to compare HR professionals' expectations from the workplace in Sri Lanka and foreign countries during the COVID-19 pandemic. The researchers utilized the qualitative research method and applied the thematic analysis in order to analyze the gathered data from 28 semi-structured interviews. According to the findings, HR professionals in Sri Lanka anticipate returning to work at office premises, and if this work transition continues in the future, they expect more incentives and strategies for work-life balance. In contrast, HR professionals in foreign countries anticipate a hybrid work culture with employee wellbeing sessions. Accordingly, the study implies that organizations should facilitate the expected requirements to continue work in the current and future crises. The HR policymakers will be able to carry out more precise planning activities in the future when developing policies related to managing HR functions in crises.

Experiences of cancer care in COVID-19: A longitudinal qualitative study

Purpose

This study aimed to explore the cancer care experiences of people living with and beyond cancer during COVID-19 in Ireland.

Methods

The study adopted a longitudinal qualitative design using semi-structured interviews with sixteen participants. Interviews were undertaken on three occasions over six months (January–June 2021). The National Comprehensive Cancer Network Distress Thermometer (NCCN DT), and Connor-Davidson-Resilience Scale (CD-RISC2) were also used as part of the interviews to measure distress and resilience. Thematic analysis of interview data was conducted and participants' self-rating for distress and resilience was analysed using descriptive statistics.

Results

Sixteen patients participated. The findings revealed participants' constant fear of COVID-19 over time and efforts to stay safe by following the ‘rules’. Isolation was a common experience as COVID-19 restrictions resulted in being alone when attending the hospital for treatment and limited support from family and friends. Telephone follow-up was limited in terms of support and patients' opportunity to ask questions. For a minority, COVID-19 restrictions meant they were ‘not missing out’. On average, participants reported moderate to high levels of resilience at all time points. Distress scores were low but trended upwards from T1 to T2.

Conclusions

The findings highlight the need to avoid restrictions on carers accompanying their close relatives to the hospital for treatment. An evaluation of the effects of the rapid introduction of telephone follow-up on patient outcomes is warranted.

Covid-19-related ruminations: A qualitative study based on the perspectives of the cancer survivors

Cancer survivors can develop repetitive ruminations due to the unexpected and challenging effects of Covid-19. This qualitative descriptive design study aimed to comprehend the Covid-19-related ruminations from the subjective perspective of cancer survivors (n = 33), accessed via online Facebook self-help groups of a cancer association. A semi-structured interview guide was used for data collection followed by systematic analysis. Based on the descriptive analysis of the data, three main themes emerged-"Welcome to my life," "Cancer versus Covid-19," and "Fight versus lose"-based on cancer survivors' experience and having two subthemes each. The findings suggested that cancer survivors have many ruminations about cancer and the pandemic. Their ruminations were mainly concerned with the possibility of suffering from cancer again and catching Covid-19. Nonetheless, participants also had positive cognitions that they could overcome the pandemic as they have previously beat cancer. The findings may also offer a promising resource for nurses to understand the ruminations of cancer survivors and develop novel approaches and interventions to help cancer survivors replace their intrusive ruminations with deliberate ones.

There must be a way out: The consensual qualitative analysis of best coping practices during the COVID-19 pandemic

Despite the continuous efforts to understand coping processes, very little is known about the utilization of best coping strategies during the COVID-19 pandemic. In this study, we aimed to analyze the coping strategies of individuals who scored high on an adaptive coping questionnaire in order to understand the most adaptive coping strategies during the COVID-19 pandemic. We used consensual qualitative analysis in a team of four researchers and one auditor. The convenience sample from which we identified the high scorers comprised 1,683 participants (67% women, 32.35% men, and 0.65% did not report their gender) with a mean age of 31.02 years (SD = 11.99) ranging between 18 and 77 years old. Based on their scoring in the COPE Inventory, nine participants were selected from the sample with the highest scores in coping skills in at least two out of its 15 subscales. In-depth repeated interviews with six participants for the main analysis were conducted, and three were added to check the data saturation. The results showed that the most adaptive coping strategies used during the COVID-19 pandemic could be categorized into four main domains: self-compassion, compassion to others, compassion from others, and mutual compassion. The most frequently mentioned and the most elaborated upon by our respondents was the domain of self-compassion. The most interesting finding was the emergence of the fourth type of compassion, labeled mutual compassion, which referred to deliberate attempts to take care of oneself and others while suffering together in order to elevate the suffering for both. This kind of compassion might arise in the situations of collective suffering, such as a catastrophe or a pandemic and might have the additional benefit of bringing people closer to each other in difficult times.

Palliative care delivery changes during COVID-19 and enduring implications in oncology nursing: a rapid review

PURPOSE OF REVIEW

A rapid review was conducted to synthesize evidence of palliative care delivery changes during the COVID-19 pandemic. Changes were synthesized according to the eight domains of high-quality palliative care and enduring implications for oncology nurses beyond the pandemic discussed.

RECENT FINDINGS

The most significant changes occurred in the structure and processes of palliative care (Domain 1), where increased utilization of telehealth was critical in circumventing barriers imposed by COVID-19 mitigation. The suboptimal availability of community-based psychosocial supports for patients and caregivers and inadequate health system-based psychosocial supports for healthcare providers were highlighted (Domains 3-5). The pandemic also ushered in an increased emphasis on the need for advance care planning (ACP), where integrating its delivery earlier in the outpatient setting and shifting policy to promote subsequent virtual documentation (Domain 8) were essential to ensure care preferences were clarified and accessible before health crises occurred.

SUMMARY

Continuing to embrace and sustain systems-level changes with respect to telehealth, psychosocial supports, and ACP are critical to bridging gaps in palliative care delivery underscored by the pandemic. Oncology nurses are well positioned to fill these gaps in care beyond the pandemic by providing evidence-based, palliative care throughout the cancer continuum.

Coping Strategies Used by Older Cancer Survivors During the COVID-19 Pandemic: A Longitudinal Qualitative Study

Objectives: The objective of this study is to longitudinally examine the coping strategies used by older cancer survivors (≥60 years of age) during COVID-19. Methods: An interpretive descriptive approach was used to collect and analyse qualitative data collected via 1:1 telephone interviews at three timepoints: June/July 2020, January 2021, and March 2021. Main Findings: Coping strategies used by older adults reflected the resources available to them, and their agency in self-triaging and deciding on resources to support their coping. These decisions were impacted by pandemic-imposed restrictions and necessitated readjustment over time. Three themes were developed to describe coping strategies (including any changes): adapting means and methods to connect with others; being intentional about outlook; and taking actions toward a brighter future. Conclusion: Older adults used a variety of coping strategies, though their reliance on resources beyond themselves (e.g., family/friends) indicates a need to add tailored resources to existing professional services.

Biobehavioral Implications of Covid-19 for Transplantation and Cellular Therapy Recipients

A growing body of literature has emphasized the importance of biobehavioral processes - defined as the interaction of behavior, psychology, socioenvironmental factors, and biological processes - for clinical outcomes among transplantation and cellular therapy (TCT) patients. TCT recipients are especially vulnerable to distress associated with pandemic conditions and represent a notably immunocompromised group at greater risk for SARS-CoV-2 infection with substantially worse outcomes. The summation of both the immunologic and psychologic vulnerability of TCT patients renders them particularly susceptible to adverse biobehavioral sequelae associated with the Covid-19 pandemic. Stress and adverse psychosocial factors alter neural and endocrine pathways through sympathetic nervous system and hypothalamic-pituitary-adrenal axis signaling that ultimately affect gene regulation in immune cells. Reciprocally, global inflammation and immune dysregulation related to TCT contribute to dysregulation of neuroendocrine and central nervous system function, resulting in the symptom profile of depression, fatigue, sleep disturbance, and cognitive dysfunction. In this article, we draw upon literature on immunology, psychology, neuroscience, hematology and oncology, Covid-19 pathophysiology, and TCT processes to discuss how they may intersect to influence TCT outcomes, with the goal of providing an overview of the significance of biobehavioral factors in understanding the relationship between Covid-19 and TCT, now and for the future. We discuss the roles of depression, anxiety, fatigue, sleep, social isolation and loneliness, and neurocognitive impairment, as well as specific implications for sub-populations of interest, including pediatrics, caregivers, and TCT donors. Finally, we address protective psychological processes that may optimize biobehavioral outcomes affected by Covid-19.

The needs of cancer patients during the COVID-19 pandemic-psychosocial, ethical and spiritual aspects-systematic review

The COVID-19 pandemic resulted in unprecedented changes in the functioning of the health care system, which were connected with the occurrence of new challenges for both the health care system's employees and for the patients. The purpose of the present article is to analyze the needs of persons with oncological diseases. Taking into account the multiple aspects of the term health, psychological, social, and existential needs of the patients were analyzed. This article is directed mainly at persons who remain in a direct therapeutic relation with a patient. It is to facilitate recognizing the needs of ill people and to increase sensitivity to the issue of maintaining or improving the well-being of patients which requires paying special attention to their psychological, social, and existential needs during the period of hindered access to the health care system. This systematic review takes advantage of quantitative and qualitative methods of text analysis with phenomenological analysis factored in. The COVID-19 pandemic resulted in the appearance of new problems in the population of oncological patients or it made the existing problems more severe. As a consequence, it made it significantly more difficult to meet their needs on various levels and sometimes it even made it impossible. It seems necessary to determine and introduce strategies to ensure that patients with oncological diseases have access to psychological and spiritual support in the period of the pandemic.

Self-care Behaviours and Technology utilised during COVID-19: Systematic Review

Background

Self-care behaviors are essential for people living with chronic conditions; however, the outbreak of the COVID-19 pandemic has imposed additional complications on their daily routines. Few studies have analyzed how self-care behaviors have changed during COVID-19 and the role of digital technology, especially among people with chronic conditions.

Objective

This study aims to review how self-care behaviors have changed for people with chronic conditions during the COVID-19 pandemic, and what technology they have adopted to manage their conditions during that period.

Methods

A systematic review was conducted using narrative synthesis. Data were extracted from PubMed, MEDLINE, EMBASE, PsycINFO, CINAHL, and Google Scholar, including articles from December 2019 onward. Eligible studies focused on adults diagnosed with chronic conditions undertaking any self-care tasks in line with the middle-range theory of self-care of chronic illness (ie, self-care maintenance, monitoring, and management). The methodological quality of the included articles was assessed with the McMaster Critical Review Forms for Quantitative or Qualitative Studies.

Results

In total, 36 primary research articles were included. Changes to self-care behaviors during COVID-19 among people with chronic conditions were organized according to the middle-range theory of self-care of chronic illness focusing on self-care maintenance (ie, medication adherence, physical activity, and diet control), self-care monitoring (ie, monitoring signs and symptoms), and self-care management (ie, consultations with health care providers). Positive self-care behaviors observed include the following: individuals trying to maintain good glycemic control during COVID-19 increased their medication adherence in 27% (10/36) of studies; and diet control improved in 50% (18/36) of studies. Negative self-care behaviors observed include the following: decline in physical activities and increased sedentariness were observed in 65% (23/36) of studies; poor diet control was observed in 57% (21/36) of studies; and self-monitoring of health status dropped in 43% (15/36) of studies. The use of technology to support self-care of chronic conditions during COVID-19 was reported in 72% (26/36) of studies. The actual use of telehealth in place of physical consultations during COVID-19 was observed in 50% (18/36) of studies, and other digital technologies (eg, social media apps, smartphone apps, web-based platforms, and web browsing) were used in 50% (18/36) of studies. Telehealth was discussed and recommended as the default technology in delivering future health care services during COVID-19 and beyond in 77% (28/36) of studies.

Conclusions

This review highlighted the necessity to rethink how models of self-care should continue to address the demands of chronic conditions while being responsive to the imminent threats of infectious diseases. Perhaps the silver lining of COVID-19 is that adoption of digital technology (especially telehealth) among a vast cross-section of people with chronic conditions is possible. Future research should investigate effective ways to incorporate evidence-based digital health tools into these new models of self-care that address the challenges of chronic and infectious conditions.

Challenges of Survivorship for Older Adults Diagnosed with Cancer

Purpose of Review

The purpose of this brief review is to highlight significant recent developments in survivorship research and care of older adults following cancer treatment. The aim is to provide insight into care and support needs of older adults during cancer survivorship as well as directions for future research.

Recent Findings

The numbers of older adult cancer survivors are increasing globally. Increased attention to the interaction between age-related and cancer-related concerns before, during, and after cancer treatment is needed to optimize outcomes and quality of life among older adult survivors. Issues of concern to older survivors, and ones associated with quality of life, include physical and cognitive functioning and emotional well-being. Maintaining activities of daily living, given limitations imposed by cancer treatment and other comorbidities, is of primary importance to older survivors. Evidence concerning the influence of income and rurality, experiences in care coordination and accessing services, and effectiveness of interventions remains scant for older adults during survivorship.

Summary

There is a clear need for further research relating to tailored intervention and health care provider knowledge and education. Emerging issues, such as the use of medical assistance in dying, must be considered in this population.

The Psychosocial Impact of COVID-19 on Older Adults with Cancer: A Rapid Review

Background: Older adults with cancer are amongst the most vulnerable population to be negatively impacted by COVID-19 due to their likelihood of comorbidities and compromised immune status. Considering the longevity of the pandemic, understanding the subjective perceptions and psychosocial concerns of this population may help ameliorate the psychological aftermath. In this review, we systematically analyze the literature surrounding the psychosocial impact and coping strategies among older adults with cancer within the context of COVID-19. Methods: We conducted a rapid review of literature following PRISMA guidelines between January 2020 to August 2021 using (1) MEDLINE, (2) Embase, (3) CINAHL, and (4) PsychINFO and keyword searches for “cancer” and “COVID-19” focused on adults 65 years or older. Results: Of the 6597 articles screened, 10 met the inclusion criteria. Based on the included articles, the psychosocial impact of COVID-19 was reported under four domains, (1) impact of COVID-19 on quality of life (QoL), (2) concerns related to COVID-19, (3) coping with the impact of COVID-19, and (4) recommendations for future care. Results pertaining to perceived quality of life were inconsistent across the included articles. The most common concerns related to: contracting COVID-19, survivorship transitions, and feelings of isolation. Coping strategies reported by older adults included: spiritual care, lived experience, acceptance, and positive reinterpretation. Conclusions: We found many psychosocial impacts of the pandemic on older adults with cancer. The findings from this review can inform interventions related to shared decision-making and tailored patient care in the future.

The Needs of Older Adult Cancer Survivors During COVID-19: Implications for Oncology Nursing

OBJECTIVES

Older adults living with cancer have been described as more susceptible to coronavirus disease 2019 (COVID-19) and in need of special attention during the COVID-19 pandemic. For cancer survivors, the first year post-treatment is a critical time because many individuals transition back to their primary care provider and adjust to physical and psychosocial changes that occurred during their cancer treatment. In this longitudinal qualitative study, we followed a cohort of older adult cancer survivors through the first three waves of the pandemic to describe their experiences as a means for providing recommendations for how oncology nurses can tailor support to this unique population.

DATA SOURCES

We conducted individual, semi-structured qualitative interviews with 24 older adults at three time points during the pandemic. Data were analyzed drawing from interpretive descriptive methodologies.

CONCLUSION

Older adult cancer survivors' needs shifted during the pandemic from feeling confident and self-assured during the early days of COVID-19 to growing uncertainty and unease about their health and well-being. The main survivorship concerns included a preference for in-person appointments (as opposed to virtual), barriers to caregiver attendance at appointments, and diminished access to health care services.

IMPLICATIONS FOR NURSING PRACTICE

Oncology nurses play a critical role providing care to older adult cancer survivors and are most familiar with unique patient needs and the gaps in services they face. We provide recommendations for oncology nursing practice that consider the shifting needs of older adult cancer survivors during COVID-19 and beyond.

Cannabis Use among Cancer Survivors amid the COVID-19 Pandemic: Results from the COVID-19 Cannabis Health Study

Clinical indications for medicinal cannabis use include those with cancer, a subgroup advised to avoid exposure to COVID-19. This study aims to identify changes to cannabis use, methods of cannabis delivery, and coping strategies among cancer survivors since the pandemic by cancer status. Chi-squared tests were used for univariate comparisons of demographic characteristics, cannabis use patterns, COVID-19 symptoms, and coping behaviors by cancer survivor status. Data included 158 responses between 21 March 2020 and 23 March 2021, from medicinal cannabis users, categorized as cancer survivors (n = 79) along with age-matched medicinal cannabis users without a history of cancer (n = 79). Compared to adults without a history of cancer, cancer survivors were more likely to report use of cannabis as a way of managing nausea/vomiting (40.5% versus 20.3%, p = 0.006), headaches or migraines (35.4% versus 19.0%, p = 0.020), seizures (8.9% versus 1.3%, p = 0.029), and sleep problems (70.9% versus 54.4%, p = 0.033), or as an appetite stimulant (39.2% versus 17.7%, p = 0.003). Nearly 23% of cancer survivors reported an advanced cannabis supply of more than 3 months compared to 14.3% of adults without a history of cancer (p = 0.002); though the majority of cancer survivors reported less than a one-month supply. No statistically significant differences were observed by cancer survivor status by cannabis dose, delivery, or sharing of electronic vaping devices, joints, or blunts. Cancer survivors were more likely to report a fear of being diagnosed with COVID-19 compared to adults without a history of cancer (58.2% versus 40.5%, p = 0.026). Given the frequency of mental and physical health symptoms reported among cancer survivors, clinicians should consider conversations about cannabis use with their patients, in particular among cancer survivors.

Older Adults' Experiences and Adaptation Strategies during the Midst of COVID-19 Crisis: A Qualitative Instrumental Case Study

BACKGROUND

This study aimed to validate one of the propositions of the Need-Threat Internal Resiliency Theory.

METHODS

This study used an instrumental case study of five participants to qualitatively explore older adults' experiences and adapting strategies during the coronavirus disease 2019 (COVID-19) crisis. We selected participants based on parameters and conducted in-depth interviews of 15-30 minutes. The transcribed responses were then analyzed using a phenomenological holistic description.

RESULTS

Five major themes emerged to explain and describe the various experiences of coping with COVID-19, known as internal resiliency, developed by the older adult participants in response to the perceived threat from this crisis.

CONCLUSION

These findings showed that older adult participants had established internal resiliency in response to changes caused by the COVID-19 crisis, resulting in adaptation and coping with the situation, consistent with one proposition of the Need-Threat Internal Resiliency Theory.

Older Adults' Experiences With Using Technology for Socialization During the COVID-19 Pandemic: Cross-sectional Survey Study

BACKGROUND

Technology use has become the most critical approach to maintaining social connectedness during the COVID-19 pandemic. Older adults (aged >65 years) are perceived as the most physiologically susceptible population to developing COVID-19 and are at risk of secondary mental health challenges related to the social isolation that has been imposed by virus containment strategies. To mitigate concerns regarding sampling bias, we analyzed a random sample of older adults to understand the uptake and acceptance of technologies that support socialization during the pandemic.

OBJECTIVE

We aimed to conduct a population-based assessment of the barriers and facilitators to engaging in the use of technology for web-based socialization among older adults in the Canadian province of British Columbia during the COVID-19 pandemic.

METHODS

We conducted a cross-sectional, population-based, regionally representative survey by using the random-digit dialing method to reach participants aged >65 years who live in British Columbia. Data were analyzed using SPSS (IBM Corporation), and open-text responses were analyzed via thematic analysis.

RESULTS

Respondents included 400 older adults aged an average of 72 years, and 63.7% (n=255) of respondents were female. Most respondents (n=358, 89.5%) were aware of how to use technology to connect with others, and slightly more than half of the respondents (n=224, 56%) reported that, since the beginning of the pandemic, they used technology differently to connect with others during the pandemic. Additionally, 55.9% (n=223) of respondents reported that they adopted new technology since the beginning of the pandemic. Older adults reported the following key barriers to using technology: (1) a lack of access (including finance-, knowledge-, and age-related issues); (2) a lack of interest (including a preference for telephones and a general lack of interest in computers); and (3) physical barriers (resultant of cognitive impairments, stroke, and arthritis). Older adults also reported the following facilitators: (1) a knowledge of technologies (from self-teaching or external courses); (2) reliance on others (family, friends, and general internet searches); (3) technology accessibility (including appropriate environments, user-friendly technology, and clear instructions); and (4) social motivation (everyone else is doing it).

CONCLUSIONS

Much data on older adults' use of technology are limited by sampling biases, but this study, which used a random sampling method, demonstrated that older adults used technology to mitigate social isolation during the pandemic. Web-based socialization is the most promising method for mitigating potential mental health effects that are related to virus containment strategies. Providing telephone training; creating task lists; and implementing the facilitators described by participants, such as facilitated socialization activities, are important strategies for addressing barriers, and these strategies can be implemented during and beyond the pandemic to bolster the mental health needs of older adults.