1
|
Brkic E, Prichard I, Daly A, Dudley S, Beatty L. Testing the efficacy of a brief online writing intervention on body image and distress in female cancer survivors. PATIENT EDUCATION AND COUNSELING 2024; 127:108356. [PMID: 38944983 DOI: 10.1016/j.pec.2024.108356] [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: 11/10/2023] [Revised: 05/01/2024] [Accepted: 06/15/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE This study tested the feasibility and efficacy of two iterations of a low-intensity online writing intervention, Expand Your Horizon (EYH), in improving body image and distress in a cancer population. METHODS In study 1 (3-session version of EYH), adult female cancer survivors (N = 201) were randomised to EYH, where they described their body functionality, or a creative writing control. Outcomes assessed at baseline and one-week follow-up included body appreciation, body dissatisfaction, and distress. In study 2 (1 session version of EYH), adult female cancer survivors (N = 65) were randomised to EYH or a neutral writing control. Outcomes (assessed at baseline, immediately post-intervention and one-week follow-up) included body appreciation, body functionality appreciation, body dissatisfaction and distress. RESULTS Study 1 experienced severe attrition; only 14 participants (7 %) completed the intervention and follow-up. Study 2 had higher retention, with 74 % completing the study. In study 2, while no significant differences emerged between EYH or control, both groups significantly improved immediately post-intervention across all outcomes. No differences were found at follow-up. CONCLUSIONS A single-session online writing intervention for cancer survivors appears to be more feasible than multi-session, however the efficacy of EYH for this population remains to be established.
Collapse
Affiliation(s)
- Elizabeta Brkic
- Flinders University, College of Education, Psychology and Social Work, Flinders Institute for Mental Health & Wellbeing, South Australia, Australia
| | - Ivanka Prichard
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, South Australia, Australia
| | | | - Sareya Dudley
- Flinders University, College of Education, Psychology and Social Work, Flinders Institute for Mental Health & Wellbeing, South Australia, Australia
| | - Lisa Beatty
- Flinders University, College of Education, Psychology and Social Work, Flinders Institute for Mental Health & Wellbeing, South Australia, Australia.
| |
Collapse
|
2
|
Miller TE, Dickens NE, Rehmel MR, Jones BE, Hamlin NJ, Robbins QC. The Impact of a Pandemic on a Military Oral and Maxillofacial Pathology Biopsy Service. Mil Med 2024; 189:e1797-e1804. [PMID: 38536204 DOI: 10.1093/milmed/usae102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/18/2024] [Accepted: 03/04/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) and the resulting societal reaction presented new challenges to the medical community by limiting patient access to care in 2020 and 2021. The Navy Postgraduate Dental School (NPDS) oral and maxillofacial pathology biopsy service is dependent on in-office physician or dentist appointments and patient biopsies. The purpose of this study was to understand the regulatory and societal impacts of COVID-19 restrictions on biopsy service submissions by assessing NPDS biopsy submission quantities and disease distribution. MATERIALS AND METHODS All NPDS oral and maxillofacial pathology biopsy submissions from calendar years 2015 to 2016 and 2019 to 2021 were evaluated, and patient demographics and biopsy diagnoses were recorded in a biopsy registry. Data collected included age, sex, biopsy site, and diagnosis. Data from 2015, 2016, and 2019 were defined as pre-COVID and 2020 and 2021 as COVID. Biopsy reports for each year were organized in quarters. Diagnoses were categorized as malignant, pre-malignant, or benign. Categorical and continuous data were evaluated and presented as counts with percentages and means or medians with standard deviations, respectively. Significant differences in proportions or means were assessed using chi-square analysis or Student t-test, respectively. Cases were aggregated by quarter and year and assessed for temporal trends using linear regression analysis. RESULTS The study evaluated 9,351 biopsy submission reports. The annual pre-COVID count mean (± standard deviation) and yearly counts for 2020 and 2021 were 2,063 ± 33.3, 1,421, and 1,742, respectively. The mean (± standard deviation) percentage of diagnoses classified as malignant from pre-COVID, 2020, and 2021 were 2.46 ± 0.005%, 3.59%, and 3.04%, respectively. Case counts and representation as a percentage of all biopsy diagnoses for Human Papillomavirus (HPV)-associated squamous cell carcinoma increased significantly during COVID compared to pre-COVID years (P < .05). CONCLUSIONS Overall, preventative COVID-19 health measures and protocols resulted in a reduction in biopsy submission frequency, particularly during the second quarter (April to June) of 2020. However, case counts for malignant biopsies remained consistent between pre-COVID and COVID time intervals, suggesting that the identification and analysis of cases requiring follow-on care were unaffected by COVID-19 protocols.
Collapse
Affiliation(s)
- Trevor E Miller
- Department of Oral Pathology, William Beaumont Army Medical Center-Fort Bliss, Fort Bliss, TX 79918, USA
- Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command, Bethesda, MD 20889, USA
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Noel E Dickens
- Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command, Bethesda, MD 20889, USA
| | - Matthew R Rehmel
- Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command, Bethesda, MD 20889, USA
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Department of Oral Pathology, Womack Army Medical Center, Fort Liberty, NC 28310, USA
| | - Bradley E Jones
- Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command, Bethesda, MD 20889, USA
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Department of Pathology, Naval Medical Center San Diego, San Diego, CA 92134, USA
| | - Nicholas J Hamlin
- Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command, Bethesda, MD 20889, USA
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Quinn C Robbins
- Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command, Bethesda, MD 20889, USA
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| |
Collapse
|
3
|
Otto AK, Prinsloo S, Natori A, Wagner RW, Gomez TI, Ochoa JM, Tworoger SS, Ulrich CM, Ahmed S, McQuade JL, Peoples AR, Antoni MH, Bower JE, Cohen L, Penedo FJ. Impact of COVID-19-related experiences on health-related quality of life in cancer survivors in the United States. PLoS One 2024; 19:e0297077. [PMID: 38484002 PMCID: PMC10939216 DOI: 10.1371/journal.pone.0297077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 12/27/2023] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE Little evidence exists on the impact of the COVID-19 pandemic on cancer survivors, limiting recommendations to improve health-related quality of life (HRQoL) in this population. We describe survivors' pandemic experiences and examine associations between COVID-19-related exposures, psychosocial experiences, and HRQoL. METHODS Between May 2020-April 2021, survivors completed cross-sectional questionnaires capturing COVID-19-related exposures (e.g., exposure to virus, job loss); psychosocial experiences (i.e., COVID-19-related anxiety/depression, disruptions to health care and daily activities/social interactions, satisfaction with providers' response to COVID, financial hardship, perceived benefits of the pandemic, social support, and perceived stress management ability); and HRQoL. RESULTS Data were collected from N = 11,325 survivors in the United States. Participants were mostly female (58%), White (89%) and non-Hispanic (88%), and age 63 on average. Breast cancer was the most common diagnosis (23%). Eight percent of participants reported being exposed to COVID-19; 1% tested positive. About 6% of participants lost their jobs, while 24% lost household income. Nearly 30% avoided attending in-person oncology appointments because of the pandemic. Poorer HRQoL was associated with demographic (younger age; female; non-Hispanic White), clinical (Medicare; stage IV disease; hematologic/digestive/respiratory system cancer), and psychosocial factors (low perceived benefits and stress management ability; more disruption to health care and daily activities/social interactions; financial hardship). CONCLUSIONS COVID-19-related stressors were associated with various psychosocial experiences in cancer survivors, and these psychosocial experiences were associated with HRQoL above and beyond demographic and clinical factors.
Collapse
Affiliation(s)
- Amy K. Otto
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States of America
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Sarah Prinsloo
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
- Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Akina Natori
- Division of Medical Oncology, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Richard W. Wagner
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Telma I. Gomez
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Jewel M. Ochoa
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Shelley S. Tworoger
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Cornelia M. Ulrich
- Huntsman Cancer Institute, University of Utah, Salt Lake City, CT, United States of America
- Department of Population Health Sciences, University of Utah, Salt Lake City, CT, United States of America
| | - Sairah Ahmed
- Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Jennifer L McQuade
- Department of Melanoma Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Anita R. Peoples
- Huntsman Cancer Institute, University of Utah, Salt Lake City, CT, United States of America
- Department of Population Health Sciences, University of Utah, Salt Lake City, CT, United States of America
| | - Michael H. Antoni
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States of America
- Department of Psychology, University of Miami, Miami, FL, United States of America
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| | - Julienne E. Bower
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States of America
- Department of Psychiatry/Biobehavioral Sciences, University of California Los Angeles, CA, United States of America
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Frank J. Penedo
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States of America
- Department of Psychology, University of Miami, Miami, FL, United States of America
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, United States of America
| |
Collapse
|
4
|
Levkovich I, Shinan-Altman S. The influence of emotional reactions and compliance with Ministry of Health guidelines during the COVID-19 pandemic in Israel: a longitudinal study of gender differences. Glob Health Promot 2024:17579759231218004. [PMID: 38293755 DOI: 10.1177/17579759231218004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
This study sought to examine gender differences in emotional reactions and compliance with Ministry of Health (MOH) guidelines during the COVID-19 pandemic in Israel, with the goal of gaining a deeper understanding of these gender-related variations throughout the lockdown periods. A longitudinal study comprising 2509 participants was conducted during two of Israel's lockdowns: 1424 participants completed a questionnaire during the first lockdown (23 April-5 May 2020); of these, 1085 completed a follow-up questionnaire during the second lockdown (September 30-October 10, 2020). Participants exhibited higher levels of compliance with MOH guidelines (e.g., wearing face masks, maintaining social distancing) and knowledge about COVID-19 during the second lockdown, whereas they exhibited more negative emotional reactions during the first lockdown. Female participants scored higher than male participants on all measures. Multiple regression results showed that about 21% of the variance in compliance with MOH guidelines was explained by lockdown type (i.e., first or second), gender, and age, while knowledge and negative emotional reactions added another 19% to the explained variance. The results suggest that the impact of the pandemic on emotional reactions decreased over time, with people exhibiting greater compliance with MOH guidelines and more knowledge about COVID-19. Moreover, the behavioral and psychological impact of the pandemic was greater on women than on men. The results suggest that healthcare professionals should pay more attention to mental health issues during a pandemic. Moreover, policymakers should focus on women as a vulnerable group and suggest appropriate solutions to reduce their emotional distress. Furthermore, governments and employers should provide greater flexibility and support for single mothers during the pandemic. In addition, gender inequality during lockdowns may place women at greater risk of psychological distress.
Collapse
Affiliation(s)
- Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Tivon, Israel
| | - Shiri Shinan-Altman
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Tel Aviv, Israel
| |
Collapse
|
5
|
Elmer NA, Bustos VP, Veeramani A, Hassell N, Comer CD, Manstein SM, Kinney J, Lee BT, Lin SJ. Trends of Autologous Free-Flap Breast Reconstruction and Safety during the Coronavirus Disease 2019 Pandemic. J Reconstr Microsurg 2023; 39:715-726. [PMID: 36928904 DOI: 10.1055/a-2056-0729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Autologous free-flap breast reconstruction (ABR) is a valuable surgical option for patients following mastectomy. The coronavirus disease 2019 (COVID-19) pandemic has led to a myriad of factors that have affected access to care, hospital logistics, and postoperative outcomes. This study aims to identify differences in patient selection, hospital course and severity, and postoperative outcomes for patients who underwent ABR during and prior to the COVID-19 pandemic. METHODS Patients undergoing ABR from the American College of Surgeons National Surgical Quality Improvement Program 2019 to 2020 database were analyzed to compare sociodemographics, hospital course, and outcomes over the first postoperative month. Multivariable logistic regression was used to identify factors predictive of complications based on the operative year. RESULTS In total, 3,770 breast free flaps were stratified into two groups based on the timing of reconstruction (prepandemic and pandemic groups). Patients with a diagnosis of disseminated cancer were significantly less likely to undergo ABR during the COVID-19 pandemic. On univariate analysis, there were no significant differences in postoperative complications between the two groups. When controlling for potentially confounding sociodemographic and clinical risk factors, the COVID-19 group was significantly more likely to undergo reoperation compared with the prepandemic group (p < 0.05). CONCLUSION When comparing outcomes for patients who underwent ABR prior to and during the COVID-19 pandemic, we found a significant increase in the odds of reoperation for those who had ABR during the pandemic. Debridement procedures and exploration for postoperative hemorrhage, thrombosis, or infection increased in the prepandemic group compared to the COVID-19 group. Notably, operative times decreased.
Collapse
Affiliation(s)
- Nicholas A Elmer
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Valeria P Bustos
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Anamika Veeramani
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Natalie Hassell
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Carly D Comer
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Samuel M Manstein
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Jacquelyn Kinney
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Bernard T Lee
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Samuel J Lin
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
6
|
Gaughan AA, MacEwan SR, Rush LJ, Gatti‐Mays ME, Pariser AC, McAlearney AS. Perspectives of patients undergoing neoadjuvant chemotherapy for breast cancer during the COVID-19 pandemic. Cancer Rep (Hoboken) 2023; 6:e1882. [PMID: 37584345 PMCID: PMC10598258 DOI: 10.1002/cnr2.1882] [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: 05/09/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic resulted in a lapse in routine health care and cancer screenings for many individuals. This study sought to improve our understanding of the impact of the COVID-19 pandemic on women being treated for breast cancer, both in general, and specifically related to their diagnosis. METHODS Semi-structured interviews were conducted between August 2021 and February 2022 with women who were receiving neoadjuvant chemotherapy for early-stage breast cancer at the Stefanie Spielman Comprehensive Breast Center in Columbus, Ohio. Interviews were recorded and transcribed verbatim. Transcripts were coded using deductive dominant thematic analysis and inductive coding that allowed for categorization of data as well as identification of emergent themes. RESULTS Data collected from our 19 interviews revealed that the COVID-19 pandemic posed important challenges for breast cancer patients including fear of COVID-19 infection and feelings of isolation. Most interviewees noted they had been vaccinated against COVID-19 because of a desire to protect themselves and others from getting sick. Some women also expressed concerns about having delayed their screening mammograms due to the pandemic. Several patients described unexpected positive aspects of the pandemic such as being able to spend more time with family and having the ability to continue working because of the option to work from home during their cancer treatment. CONCLUSIONS Our findings provide important insight about the impact of COVID-19 on breast cancer patients. We highlight the positives that have been reported because of the pandemic, as well as the need to address delayed breast cancer screening.
Collapse
Affiliation(s)
- Alice A. Gaughan
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of MedicineThe Ohio State UniversityColumbusOHUSA
| | - Sarah R. MacEwan
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of MedicineThe Ohio State UniversityColumbusOHUSA
- Division of General Internal MedicineCollege of Medicine, The Ohio State UniversityColumbusOHUSA
| | - Laura J. Rush
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of MedicineThe Ohio State UniversityColumbusOHUSA
| | - Margaret E. Gatti‐Mays
- Pelotonia Institute for Immuno‐Oncology, Division of Medical OncologyThe Ohio State University Comprehensive Cancer Center – The JamesColumbusOhioUSA
| | - Ashley C. Pariser
- Pelotonia Institute for Immuno‐Oncology, Division of Medical OncologyThe Ohio State University Comprehensive Cancer Center – The JamesColumbusOhioUSA
| | - Ann Scheck McAlearney
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of MedicineThe Ohio State UniversityColumbusOHUSA
- Department of Family and Community MedicineCollege of Medicine, The Ohio State UniversityColumbusOHUSA
- Department of Biomedical InformaticsCollege of Medicine, The Ohio State UniversityColumbusOHUSA
| |
Collapse
|
7
|
Harju E, Speierer A, Jungo KT, Levati S, Baggio S, Tancredi S, Noor N, Rodondi PY, Cullati S, Imboden M, Keidel D, Witzig M, Frank I, Kohler P, Kahlert C, Crivelli L, Amati R, Albanese E, Kaufmann M, Frei A, von Wyl V, Puhan MA, Probst-Hensch N, Michel G, Rodondi N, Chocano-Bedoya P. Changes in Healthcare Utilization During the COVID-19 Pandemic and Potential Causes-A Cohort Study From Switzerland. Int J Public Health 2023; 68:1606010. [PMID: 37663371 PMCID: PMC10469983 DOI: 10.3389/ijph.2023.1606010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/05/2023] [Indexed: 09/05/2023] Open
Abstract
Objectives: To describe the frequency of and reasons for changes in healthcare utilization in those requiring ongoing treatment, and to assess characteristics associated with change, during the second wave of the pandemic. Methods: Corona Immunitas e-cohort study (age ≥20 years) participants completed monthly questionnaires. We compared participants reporting a change in healthcare utilization with those who did not using descriptive and bivariate statistics. We explored characteristics associated with the number of changes using negative binomial regression. Results: The study included 3,190 participants from nine research sites. One-fifth reported requiring regular treatment. Among these, 14% reported a change in healthcare utilization, defined as events in which participants reported that they changed their ongoing treatment, irrespective of the reason. Reasons for change were medication changes and side-effects, specifically for hypertension, or pulmonary embolism treatment. Females were more likely to report changes [Incidence Rate Ratio (IRR) = 2.15, p = 0.002]. Those with hypertension were least likely to report changes [IRR = 0.35, p = 0.019]. Conclusion: Few of those requiring regular treatment reported changes in healthcare utilization. Continuity of care for females and chronic diseases besides hypertension must be emphasized.
Collapse
Affiliation(s)
- Erika Harju
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
- Clinical Trial Unit, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Alexandre Speierer
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | | | - Sara Levati
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Stéphanie Baggio
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Population Health Laboratory (#PopHealthLab), Department of Community Health, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Stefano Tancredi
- Population Health Laboratory (#PopHealthLab), Department of Community Health, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Nazihah Noor
- Population Health Laboratory (#PopHealthLab), Department of Community Health, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | | | - Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), Department of Community Health, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
- Quality of Care Service, Geneva University Hospitals, Geneva, Switzerland
| | - Medea Imboden
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- Department of Public Health, University of Basel, Basel, Switzerland
| | - Dirk Keidel
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- Department of Public Health, University of Basel, Basel, Switzerland
| | - Melissa Witzig
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- Department of Public Health, University of Basel, Basel, Switzerland
| | - Irène Frank
- Clinical Trial Unit, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Philipp Kohler
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Christian Kahlert
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Infectious Diseases and Hospital Epidemiology, Children’s Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Luca Crivelli
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Rebecca Amati
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Viktor von Wyl
- Epidemiology, Biostatistics and Prevention Institute, Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zürich, Switzerland
| | - Milo A. Puhan
- Epidemiology, Biostatistics and Prevention Institute, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- Department of Public Health, University of Basel, Basel, Switzerland
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Patricia Chocano-Bedoya
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Population Health Laboratory (#PopHealthLab), Department of Community Health, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| |
Collapse
|
8
|
Myers C, Bennett K, Cahir C. Breast cancer care amidst a pandemic: a scoping review to understand the impact of coronavirus disease 2019 on health services and health outcomes. Int J Qual Health Care 2023; 35:mzad048. [PMID: 37497806 PMCID: PMC10373113 DOI: 10.1093/intqhc/mzad048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 05/19/2023] [Accepted: 06/28/2023] [Indexed: 07/28/2023] Open
Abstract
Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, health services for breast cancer (BC) have been disrupted. Our scoping review examines the impact of the COVID-19 pandemic on BC services, health outcomes, and well-being for women. Additionally, this review identifies social inequalities specific to BC during the pandemic. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines, the literature search was conducted using scientific databases starting from March 2020 through November 2021. Studies were identified and selected by two researchers based on inclusion criteria, and the relevant data were extracted and charted to summarize the findings. Ninety-three articles were included in this review. Main themes included are as follows: (i) the impact of COVID-19 on BC services; (ii) the impact of COVID-19 on health outcomes and well-being in women with BC; and (iii) any variation in the impact of COVID-19 on BC by social determinants of health. There were apparent disruptions to BC services across the cancer continuum, especially screening services. Clinical repercussions were a result of such disruptions, and women with BC experienced worsened quality of life and psychosocial well-being. Finally, there were social inequalities dependent on social determinants of health such as age, race, insurance status, and region. Due to the disruption of BC services during the COVID-19 pandemic, women were impacted on their health and overall well-being. The variation in impact demonstrates how health inequities have been exacerbated during the pandemic. This comprehensive review will inform timely health-care changes to minimize long-term impacts of the pandemic and improve evidence-based multidisciplinary needs.
Collapse
Affiliation(s)
- Charlotte Myers
- School of Population Health, RCSI University of Medicine and Health Science, Dublin D02 DH60, Ireland
| | - Kathleen Bennett
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Science, Dublin D02 DH60, Ireland
| | - Caitriona Cahir
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Science, Dublin D02 DH60, Ireland
| |
Collapse
|
9
|
Becerra MB, Gumasana RJ, Mitchell JA, Sami S, Truong JB, Becerra BJ. Triple Jeopardy of Minority Status, Social Stressors, and Health Disparities on Academic Performance of College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6243. [PMID: 37444091 PMCID: PMC10341237 DOI: 10.3390/ijerph20136243] [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: 05/04/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023]
Abstract
Objective: In this study, we evaluated the role of minority status, as well as pandemic-related social stressors and health disparities on short- and long-term academic performances of college students. Methods: Cross-sectional analysis using descriptive and bivariate statistics were used to identify participants of minority status as well as pandemic-related prevalence of social stressors and health disparities and their roles on academic performance. Results: Poor academic performance was significantly related to being food insecure, experiences of discrimination, serious psychological distress, and low daytime wakefulness during the pandemic but only significantly based on minority status. Grade point average was significantly associated with serious psychological problems among males, independent of race/ethnicity identity. Conclusions: Institutes of higher education, when tasked with developing post-pandemic policies to address equity gaps in academic success, may benefit their students by integrating system-wide holistic approach to support, including interventions on basic needs support and health and resilience building.
Collapse
Affiliation(s)
- Monideepa B. Becerra
- Center for Health Equity, Department of Health Science and Human Ecology, California State University-San Bernardino, 5500 University Parkway, San Bernardino, CA 92407, USA; (R.J.G.); (J.A.M.); (S.S.)
| | | | | | | | | | | |
Collapse
|
10
|
Blasbalg U, Sinai D, Arnon S, Hermon Y, Toren P. Mental health consequences of the COVID-19 pandemic: Results from a large-scale population-based study in Israel. Compr Psychiatry 2023; 123:152383. [PMID: 36933388 PMCID: PMC9997062 DOI: 10.1016/j.comppsych.2023.152383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/26/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Contemporary evidence notes the COVID-19 pandemic greatly impacted the utilization of physical and mental health services worldwide. The present study was therefore designed to evaluate the changes in the utilization of mental health services during the first year of the COVID-19 pandemic compared to previous years as well as to estimate the moderating role age had on these changes. MATERIALS AND METHODS Psychiatric data was collected from n = 928,044 individuals living in Israel. Rates of receipt of psychiatric diagnoses and purchases of psychotropic medication were extracted for the first year of the COVID-19 pandemic and for two comparison years. The odds of receiving a diagnosis or of purchasing a psychotropic medication during the pandemic were compared to control years using uncontrolled logistic regression models and controlled and logistic regression that accounted for differences between ages. RESULTS There was a general reduction of about 3-17% in the odds of receiving a psychiatric diagnosis or purchasing psychotropic medications during the pandemic year compared to control years. The bulk of tests conducted showed that reduction in the rates of receiving diagnoses and purchasing medications during the pandemic were evident or more profound in the older age groups. An analysis of a combined measure conclusive of all other measures revealed decreased rates of utilizing any service examined during 2020, with rates decreasing as age increases up to a decrease of 25% in the oldest age group (80-96). DISCUSSION AND CONCLUSION Changes in utilization of mental health services reveal the interplay between psychological distress that has been documented to increase during the pandemic and people's reluctance to seek professional assistance. This appears to be especially prominent among the vulnerable elderly, who may have received even less professional help for their emerging distress. The results obtained in Israel are likely to be replicated in other countries as well, given the global impact of the pandemic on adults' mental health and individuals' readiness to utilize mental healthcare services. Future research on the long-term impact of the pandemic on utilization of mental healthcare services is warranted, with an emphasis on the response of different populations to emergency situations.
Collapse
Affiliation(s)
- Uri Blasbalg
- Ramat-Chen Brüll Mental Health Center, Tel-Aviv District, Clalit Health Services Community Division. 9 Hatzvi St., Tel-Aviv, Israel.
| | - Dana Sinai
- Ramat-Chen Brüll Mental Health Center, Tel-Aviv District, Clalit Health Services Community Division. 9 Hatzvi St., Tel-Aviv, Israel
| | - Shay Arnon
- Ramat-Chen Brüll Mental Health Center, Tel-Aviv District, Clalit Health Services Community Division. 9 Hatzvi St., Tel-Aviv, Israel
| | - Yehonathan Hermon
- Ramat-Chen Brüll Mental Health Center, Tel-Aviv District, Clalit Health Services Community Division. 9 Hatzvi St., Tel-Aviv, Israel
| | - Paz Toren
- Ramat-Chen Brüll Mental Health Center, Tel-Aviv District, Clalit Health Services Community Division. 9 Hatzvi St., Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| |
Collapse
|
11
|
Velasco Yanez R, Frota Goyanna N, Carvalho Fernandes A, Moura Barbosa Castro R, Holanda da Cunha G, Silva Ferreira I, Miranda Mattos S, Magalhães Moreira T. Palliative Care in Breast Cancer During the COVID-19 Pandemic: A Scoping Review. Am J Hosp Palliat Care 2023; 40:351-364. [PMID: 35581537 PMCID: PMC9127630 DOI: 10.1177/10499091221101879] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has harmed the provision of palliative care (PC) services for women with breast cancer due to all the restrictions that came along with the virus. OBJECTIVE To map the available evidence on the situation of PC in breast cancer during the COVID-19 pandemic. METHODS A scoping review was carried out based on the methodology proposed by the Joanna Briggs Institute. The search was conducted in nine databases, one electronic repository, and one library, using controlled vocabularies. RESULTS Twenty-nine articles and seven documents were included. The majority (11.4% each) were published in the United Kingdom, Italy, and the United States, 38.9% addressed palliative radiotherapy (RT), and 47.2% consisted of recommendations. From the content analysis, five categories were obtained focused on the recommendations on changes in palliative treatment guidelines and the response of PC teams to the evolving crisis. CONCLUSIONS The evidence pointed to the management of general PC, palliative RT, palliative chemotherapy, management of metastatic breast cancer, and use of technologies in palliative care. No recommendations were found to manage frequent symptoms in PC, indicating the need to develop primary studies that investigate these aspects in detail in this vulnerable group. IMPLICATIONS The results contained in this document can provide professionals working in this field of care with a global view of how other teams have dealt with the pandemic, thereby identifying the best guidelines to apply in their reality, taking into account the clinical and social situation of each patient.
Collapse
Affiliation(s)
- Romel Velasco Yanez
- Universidade Federal do Ceará, Fortaleza, Brazil,Romel Velasco Yanez, Department of Nursing, Universidade Federal do Ceará, 1115 Alexandre Baraúna St, Rodolfo Teófilo, Fortaleza 60020-181, Brazil.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Prodhan AHMSU, Islam DZ, Khandker SS, Jamiruddin MR, Abdullah A, Godman B, Opanga S, Kumar S, Sharma P, Adnan N, Pisana A, Haque M. Breast Cancer Management in the Era of Covid-19; Key Issues, Contemporary Strategies, and Future Implications. BREAST CANCER (DOVE MEDICAL PRESS) 2023; 15:51-89. [PMID: 36733464 PMCID: PMC9888303 DOI: 10.2147/bctt.s390296] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/19/2023] [Indexed: 01/28/2023]
Abstract
During the COVID-19 pandemic, several priority diseases were not getting sufficient attention. Whilst breast cancer is a fatal disease affecting millions worldwide, identification and management of these patients did not initially attract critical attention to minimize the impact of lockdown, post-lockdown, and other measures. Breast cancer patients' conditions may not remain stable without proper care, worsening their prognosis. Proper care includes the timely instigation of surgery, systemic therapy, and psychological support. This includes low-and middle-income countries where there are already concerns with available personnel and medicines to adequately identify and treat these patients. Consequently, there was a need to summarize the current scenario regarding managing breast cancer care during COVID-19 across all countries, including any guidelines developed. We systematically searched three scientific databases and found 76 eligible articles covering the medical strategies of high-income countries versus LMICs. Typically, diagnostic facilities in hospitals were affected at the beginning of the pandemic following the lockdown and other measures. This resulted in more advanced-stage cancers being detected at initial presentation across countries, negatively impacting patient outcomes. Other than increased telemedicine, instigating neo-adjuvant endocrine therapy more often, reducing non-essential visits, and increasing the application of neo-adjuvant chemotherapy to meet the challenges, encouragingly, there was no other significant difference among patients in high-income versus LMICs. Numerous guidelines regarding patient management evolved during the pandemic to address the challenges posed by lockdowns and other measures, which were subsequently adopted by various high-income countries and LMICs to improve patient care. The psychological impact of COVID-19 and associated lockdown measures, especially during the peak of COVID-19 waves, and the subsequent effect on the patient's mental health must also be considered in this high-priority group. We will continue to monitor the situation to provide direction in future pandemics.
Collapse
Affiliation(s)
| | - Dewan Zubaer Islam
- Department of Microbiology, Jahangirnagar University, Dhaka, 1342, Bangladesh
| | - Shahad Saif Khandker
- Department of Biochemistry, Gonoshasthaya Samaj Vittik Medical College, Dhaka, 1344, Bangladesh
| | | | - Adnan Abdullah
- Unit of Occupational Medicine, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK,Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates,Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
| | - Sylvia Opanga
- Department of Pharmacy, University of Nairobi, Nairobi, Kenya
| | - Santosh Kumar
- Department of Periodontology and Implantology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, Gujarat, India
| | - Paras Sharma
- Department of Pharmacognosy, BVM College of Pharmacy, Gwalior, Madhya Pradesh, 474006, India
| | - Nihad Adnan
- Department of Microbiology, Jahangirnagar University, Dhaka, 1342, Bangladesh,Correspondence: Nihad Adnan, Department of Microbiology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh, Email ;Mainul Haque, The Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sugai Besi, Kuala Lumpur 57000, Malaysia, Tel +60109265543, Email
| | - Alice Pisana
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Mainul Haque
- The Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
| |
Collapse
|
13
|
Wind G, Vedsegaard HW, Marsaa K, True TS, Konradsen H. The significance of the COVID-19 pandemic for family caregivers of non-COVID-19 patients in need of specialized palliative care at home: a qualitative study. Int J Qual Stud Health Well-being 2022; 17:2113021. [PMID: 35979626 PMCID: PMC9397423 DOI: 10.1080/17482631.2022.2113021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose It is well known that being a family caregiver of a palliative patient in general is rewarding as well as burdensome. The COVID-19 pandemic may have exacerbated this situation. We therefore explored the significance of the COVID-19 pandemic for family caregivers of non-COVID-19 patients in need of specialized palliative care at home. Methods Open-ended, semi-structured telephone interviews were conducted with 15 family caregivers of patients treated by a specialized palliative outpatient unit in a Danish hospital. Interviews were analysed using inductive thematic analysis. Results Four themes concerning the significance of the COVID-19 pandemic were identified: 1) being a family caregiver of a patient whose lifespan is already limited, 2) dealing with the risk of passing on COVID-19 oneself, 3) dealing with the risk of others passing on COVID-19 to the patient at home, and 4) living with modified specialized palliative care. Conclusion The COVID-19 pandemic had a radical impact on some family caregivers causing emotional despair. They feared not only infecting the patient with SARS-CoV-2 to cause an untimely death but also being unable to be there for the patient during hospitalization, especially in the patient’s final days.
Collapse
Affiliation(s)
- Gitte Wind
- Faculty of Health, University College Copenhagen, Denmark
| | | | | | | | - Hanne Konradsen
- Department of Gastroenterology, Herlev and Gentofte University Hospital, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Sweden
| |
Collapse
|
14
|
Charos D, Andriopoulou M, Vivilaki V. Breast cancer and COVID-19: The need for enhanced psychological support for women with breast cancer during the pandemic. Eur J Midwifery 2022; 6:69. [PMID: 36591333 PMCID: PMC9773269 DOI: 10.18332/ejm/156899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 11/24/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Dimitrios Charos
- Department of Midwifery, University of West Attica, Athens, Greece,General Anticancer- Oncology Hospital ‘Agios Savvas’, Athens, Greece
| | | | | |
Collapse
|
15
|
Finkelstein LB, Fishbein JN, Bright EE, Nealis M, Schmiege SJ, Arch JJ. Cancer survivors' cancellations of healthcare appointments during the COVID-19 pandemic: Associations with anxiety and depression. Psychooncology 2022; 31:2104-2112. [PMID: 36209390 PMCID: PMC9874902 DOI: 10.1002/pon.6044] [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: 03/30/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Though it is well-documented that cancer survivors experienced healthcare delays during the COVID-19 pandemic, who initiated those delays has not been examined. This longitudinal study distinguishes rates of patient-from provider-cancelled healthcare appointments at three timepoints during the pandemic, and examines psychosocial factors associated with patient-cancelled appointments. METHODS Cancer survivors (N = 147) in the United States completed psychosocial and health behavior measures three times between May and December 2020. We examined rates of patient- and provider-cancelled healthcare appointments, including cancer screening appointments, at each timepoint and change between timepoints. Logistic regression was used to determine if anxiety symptoms, depression symptoms, and COVID-19 fears were associated with self-cancelled healthcare appointments. RESULTS In May 2020, one third (33.79%) of participants reported one or more self-cancelled appointments within the prior 2 months and nearly half (45.89%) reported one or more provider-cancelled appointments. Rates of provider-cancelled appointments decreased to 35.71% in June/July 2020 and to 9.24% in November/December 2020 (both reflected p < 0.05 reductions compared to the previous timepoint). Rates of self-cancelled appointments, however, remained more stable (ps > 0.144). In June/July and November/December 2020, higher depression and anxiety symptoms, but not COVID-19 fears, were associated with greater likelihood of self-cancelled appointments. CONCLUSIONS Cancer survivors cancelled their healthcare appointments at a stable rate even as provider-cancelled appointments declined. Depression and anxiety symptoms, but not COVID-19 concerns, were associated with patient cancellations. Interventions that address anxiety and depression symptoms may help to promote adherence to cancer survivorship care during the pandemic.
Collapse
Affiliation(s)
- Lauren B. Finkelstein
- Department of Psychology and NeuroscienceUniversity of Colorado BoulderBoulderColoradoUSA
| | - Joel N. Fishbein
- Department of Psychology and NeuroscienceUniversity of Colorado BoulderBoulderColoradoUSA
| | - Emma E. Bright
- Department of Psychology and NeuroscienceUniversity of Colorado BoulderBoulderColoradoUSA
| | - Madeline Nealis
- Department of Psychology and NeuroscienceUniversity of Colorado BoulderBoulderColoradoUSA
| | - Sarah J. Schmiege
- Department of Biostatistics and InformaticsColorado School of Public Health at the Anschutz Medical CampusUniversity of Colorado DenverAuroraColoradoUSA
| | - Joanna J. Arch
- Department of Psychology and NeuroscienceUniversity of Colorado BoulderBoulderColoradoUSA,Cancer Prevention and ControlUniversity of Colorado Cancer CenterAuroraColoradoUSA
| |
Collapse
|
16
|
Paladino AJ, Pebley K, Kocak M, Krukowski RA, Waters TM, Vidal G, Schwartzberg LS, Curry AN, Graetz I. An examination of health care utilization during the COVID-19 pandemic among women with early-stage hormone receptor-positive breast cancer. BMC Health Serv Res 2022; 22:1403. [PMID: 36419005 PMCID: PMC9684812 DOI: 10.1186/s12913-022-08705-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/11/2022] [Accepted: 10/19/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Women undergoing treatment for breast cancer require frequent clinic visits for maintenance of therapy. With COVID-19 causing health care disruptions, it is important to learn about how this population's access to health care has changed. This study compares self-reported health care utilization and changes in factors related to health care access among women treated at a cancer center in the mid-South US before and during the pandemic. METHODS Participants (N = 306) part of a longitudinal study to improve adjuvant endocrine therapy (AET) adherence completed pre-intervention baseline surveys about their health care utilization prior to AET initiation. Questions about the impact of COVID-19 were added after the pandemic started assessing financial loss and factors related to care. Participants were categorized into three time periods based on the survey completion date: (1) pre-COVID (December 2018 to March 2020), (2) early COVID (April 2020 - December 2020), and later COVID (January 2021 to June 2021). Negative binomial regression analyses used to compare health care utilization at different phases of the pandemic controlling for patient characteristics. RESULTS Adjusted analyses indicated office visits declined from pre-COVID, with an adjusted average of 17.7 visits, to 12.1 visits during the early COVID period (p = 0.01) and 9.9 visits during the later COVID period (p < 0.01). Hospitalizations declined from an adjusted average 0.45 admissions during early COVID to 0.21 during later COVID, after vaccines became available (p = 0.05). Among COVID period participants, the proportion reporting changes/gaps in health insurance coverage increased from 9.5% participants during early-COVID to 14.8% in the later-COVID period (p = 0.05). The proportion reporting financial loss due to the pandemic was similar during both COVID periods (34.3% early- and 37.7% later-COVID, p = 0.72). The proportion of participants reporting delaying care or refilling prescriptions decreased from 15.2% in early-COVID to 4.9% in the later-COVID period (p = 0.04). CONCLUSION COVID-19 caused disruptions to routine health care for women with breast cancer. Patients reported having fewer office visits at the start of the pandemic that continued to decrease even after vaccines were available. Fewer patients reported delaying in-person care as the pandemic progressed.
Collapse
Affiliation(s)
- Andrew J. Paladino
- grid.267301.10000 0004 0386 9246College of Medicine, The University of Tennessee Health Science Center, Memphis, TN USA
| | - Kinsey Pebley
- grid.56061.340000 0000 9560 654XDepartment of Psychology, University of Memphis, Memphis, TN USA
| | - Mehmet Kocak
- grid.411781.a0000 0004 0471 9346International School of Medicine, Biostatistics and Medical Informatics, Istanbul Medipol University, Uskudar, Istanbul, Turkey
| | - Rebecca A. Krukowski
- grid.27755.320000 0000 9136 933XDepartment of Public Health Sciences, University of Virginia, University of Virginia Cancer Center, Charlottesville, VA USA
| | - Teresa M. Waters
- grid.266539.d0000 0004 1936 8438Department of Health Management and Policy, University of Kentucky College of Public Health, Lexington, KY USA
| | - Gregory Vidal
- grid.488536.40000 0004 6013 2320West Cancer Center and Research Institute, Department of Medical Oncology, Germantown, TN USA
| | - Lee S. Schwartzberg
- grid.488536.40000 0004 6013 2320West Cancer Center and Research Institute, Department of Medical Oncology, Germantown, TN USA ,Medical Oncology and Hematology, Renown Institute for Cancer, Reno, USA
| | - Andrea N. Curry
- grid.488536.40000 0004 6013 2320West Cancer Center and Research Institute, Department of Medical Oncology, Germantown, TN USA
| | - Ilana Graetz
- grid.189967.80000 0001 0941 6502Department of Health Policy and Management, Emory University Rollins School of Public Health, Atlanta, GA USA
| |
Collapse
|
17
|
Oyewola DO, Dada EG, Misra S. Machine learning for optimizing daily COVID-19 vaccine dissemination to combat the pandemic. HEALTH AND TECHNOLOGY 2022; 12:1277-1293. [PMCID: PMC9646469 DOI: 10.1007/s12553-022-00712-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022]
Abstract
Abstract
Introduction
Vaccines are the most important instrument for bringing the pandemic to a close and saving lives and helping to reduce the risks of infection. It is important that everyone has equal access to immunizations that are both safe and effective. There is no one who is safe until everyone gets vaccinated. COVID-19 vaccinations are a game-changer in the fight against diseases. In addition to examining attitudes toward these vaccines in Africa, Asia, Oceania, Europe, North America, and South America, the purpose of this paper is to predict the acceptability of COVID-19 vaccines and study their predictors.
Materials and methods
Kaggle datasets are used to estimate the prediction outcomes of the daily COVID-19 vaccination to prevent a pandemic. The Kaggle data sets are classified into training and testing datasets. The training dataset is comprised of COVID-19 daily data from the 13th of December 2020 to the 13th of June 2021, while the testing dataset is comprised of COVID-19 daily data from the 14th of June 2021 to the 14th of October 2021. For the prediction of daily COVID-19 vaccination, four well-known machine learning algorithms were described and used in this study: CUBIST, Gaussian Process (GAUSS), Elastic Net (ENET), Spikes, and Slab (SPIKES).
Results
Among the models considered in this paper, CUBIST has the best prediction accuracy in terms of Mean Absolute Scaled Error (MASE) of 9.7368 for Asia, 2.8901 for America, 13.2169 for Oceania, and 3.9510 for South America respectively.
Conclusion
This research shows that machine learning can be of great benefit for optimizing daily immunization of citizens across the globe. And if used properly, it can help decision makers and health administrators to comprehend immunization rates and create strategies to enhance them.
Collapse
Affiliation(s)
- David Opeoluwa Oyewola
- Department of Mathematics and Computer Science, Federal University Kashere, Gombe, Nigeria
| | - Emmanuel Gbenga Dada
- Department of Mathematical Sciences, University of Maiduguri, Maiduguri, Nigeria
| | - Sanjay Misra
- Department of Computer Science and Communication, Østfold University College, Halden, Norway
| |
Collapse
|
18
|
Impact of the COVID-19 pandemic on care and psychological impact on cancer patients. Curr Opin Support Palliat Care 2022; 16:138-143. [DOI: 10.1097/spc.0000000000000614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Teng H, Dang W, Curpen B. Impact of COVID-19 and Socioeconomic Factors on Delays in High-Risk MRI Breast Cancer Screening. Tomography 2022; 8:2171-2181. [PMID: 36136878 PMCID: PMC9498669 DOI: 10.3390/tomography8050182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study is to investigate if there was a delay in high-risk MRI breast cancer screening in our local region, if this delay is ongoing despite COVID-19 vaccinations, and if demographic and socioeconomic factors are associated with these delays. Six-hundred and sixty-five high-risk breast patients from 23 January 2018–30 September 2021 were included. Delays were determined by comparing the time in between each patients’ MRI screening exams prior to the COVID-19 pandemic to the time in between MRI screening exams during the height of the COVID-19 pandemic as well as the time in between exams when our patients started receiving vaccinations. Delays were analyzed via logistical regression with demographic and socioeconomic factors to determine if there was an association between these factors and delays. Significant time delays in between MRI screening exams were found between the pre-COVID timeframe compared to during the height of COVID. Significant time delays also persisted during the timeframe after patients started getting vaccinations. There were no associations with delays and socioeconomic or demographic factors. Significant time delays were found in between MRI high-risk breast cancer screening examinations due to the COVID-19 pandemic. These delays were not exacerbated by demographic or socioeconomic factors.
Collapse
Affiliation(s)
- Helena Teng
- Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, ON L8N 3Z5, Canada
- Correspondence:
| | - Wilfred Dang
- Department of Medical Imaging, Sunnybrook Health Sciences, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada
| | - Belinda Curpen
- Department of Medical Imaging, Sunnybrook Health Sciences, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada
| |
Collapse
|
20
|
Ding Y, Liu C, Xu H, Wang M, Zhang J, Gu J, Cui Y, Wei L, Zhang Y. Effect of social support on illness perception in patients with atrial fibrillation during "Blanking Period": Mediating role of sense of mastery. Nurs Open 2022; 10:115-122. [PMID: 35855521 PMCID: PMC9748061 DOI: 10.1002/nop2.1284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/12/2022] [Accepted: 06/05/2022] [Indexed: 01/04/2023] Open
Abstract
AIM To explore whether sense of mastery can mediate the relationship between social support and illness perception in patients with atrial fibrillation (AF) who were at the "Blanking Period." DESIGN A cross-sectional design. METHODS 405 patients with AF who were at the "Blanking Period" in the Affiliated Hospital of Qingdao University were recruited; they completed a set of questionnaires, including the Perceived Social Support Scale, the Personal Mastery Scale and the Brief Illness Perception Questionnaire. RESULTS Social support and sense of mastery were both adversely connected to illness perception. The indirect effect of social support on illness perception through sense of mastery was negative, accounting for 86.04% of the total effect. CONCLUSION During the "Blanking Period," better social support and sense of mastery contribute to a positive illness perception of AF patients. Social support also can influence patients' illness perception indirectly via the mediator of sense of mastery.
Collapse
Affiliation(s)
- Yun‐Mei Ding
- School of NursingQingdao UniversityQingdaoChina,Affiliated Hospital of Qingdao UniversityQingdaoChina
| | | | - Hong‐Xuan Xu
- Department of Health SciencesLund UniversityLundSweden
| | - Mao‐Jing Wang
- Affiliated Hospital of Qingdao UniversityQingdaoChina
| | | | - Jia‐Yun Gu
- School of NursingQingdao UniversityQingdaoChina
| | - Yan Cui
- Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Lili Wei
- Department of NursingAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yan Zhang
- Department of NursingAffiliated Hospital of Qingdao UniversityQingdaoChina
| |
Collapse
|
21
|
Street RL, Treiman K, Wu Q, Kranzler EC, Moultrie R, Mack N, Garcia R. Managing uncertainty and responding to difficult emotions: Cancer patients' perspectives on clinician response during the COVID-19 pandemic. PATIENT EDUCATION AND COUNSELING 2022; 105:2137-2144. [PMID: 35393231 PMCID: PMC8968177 DOI: 10.1016/j.pec.2022.03.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/24/2022] [Accepted: 03/08/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Patients undergoing cancer treatment during the COVID-19 pandemic have experienced stress and uncertainty with respect to disruptions in cancer care and COVID-19 related risks. We examined whether clinicians' responsiveness to patients' uncertainty and difficult emotions were associated with better health and well-being. METHODS Patients were recruited from cancer support communities and a market research firm. Respondents assessed clinicians communication that addressed uncertainty and difficult emotions. Health status measures included mental and physical health, coping during the pandemic, and psychological distress. RESULTS 317 respondents participated in the study. Patients' perceptions of their clinicians responsiveness to patient uncertainty and negative emotions were associated with better mental health, physical health, coping, and less psychological distress (all p-values <0.001). Respondents with greater self-efficacy and social support also reported better health. CONCLUSION Even when controlling for patients' personal and health-related characteristics, clinicians' communication addressing patients' uncertainty and difficult emotions predicted better health, better coping, and less psychological distress. Access to social support and self-efficacy also were associated with better health status. PRACTICE IMPLICATIONS Clinicians' communication focused on helping with uncertainty and difficult emotions is important to cancer patients, especially during the pandemic. Clinicians should also direct patients to resources for social support and patient empowerment.
Collapse
Affiliation(s)
| | | | | | - Elissa C Kranzler
- Cancer Support Community (Formerly), Currently Fors Marsh Group, USA
| | | | | | | |
Collapse
|
22
|
Park K, Byeon J, Yang Y, Cho H. Healthcare utilisation for elderly people at the onset of the COVID-19 pandemic in South Korea. BMC Geriatr 2022; 22:395. [PMID: 35524173 PMCID: PMC9072758 DOI: 10.1186/s12877-022-03085-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 04/25/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND At the onset of the coronavirus disease 2019 (COVID-19) pandemic, health care systems were severely disrupted in many countries and in particular, elderly people vulnerable to COVID-19 may have been reluctant to receive their medical treatment. METHODS We conducted interrupted time series analyses (ITSA) using nationwide medical claim data between January 2020 and July 2020, with focus on different disease categories for the patients of 65 to 84-year-olds, i.e., acute upper respiratory infections (AURIs) vs. chronic diseases. RESULTS AURIs and chronic diseases showed a sharp contrast with respect to the change in healthcare service utilisation. First, the utilisation rate for chronic diseases changed little whereas for AURIs it dropped by 20.4% year-over-year (yoy) at the onset of the pandemic (week 6, 2020). Second, as social distancing relaxed (week 17, 2020), the AURIs patients trended up and even reached to 7.8% above yoy whereas no significant change found for chronic diseases. CONCLUSIONS The uninterrupted treatment for chronic diseases in contrast to the AURIs implies that the governmental and public responses to the pandemic outbreak worked for efficient healthcare provision to patients in needs of regular check-ups and treatment in the middle of an infectious disease crisis.
Collapse
Affiliation(s)
- K. Park
- Health Insurance Research Institute, National Health Insurance Service, Wonju, 26464 South Korea
| | - J. Byeon
- Health Insurance Research Institute, National Health Insurance Service, Wonju, 26464 South Korea
| | - Y. Yang
- Health Insurance Research Institute, National Health Insurance Service, Wonju, 26464 South Korea
| | - H. Cho
- Health Insurance Research Institute, National Health Insurance Service, Wonju, 26464 South Korea
| |
Collapse
|
23
|
Berger NF, Zimmerman BS, Seidman D, Cascetta KP, Moshier E, Nezolosky M, Trlica K, Ryncarz A, Keeton C, Tiersten A. Impact of the COVID-19 Pandemic on Cancer Care and Quality of Life for Patients With Breast and Gynecologic Malignancies: A Single-Center Survey-Based Study. J Patient Exp 2022; 9:23743735221077543. [PMID: 35187223 PMCID: PMC8850998 DOI: 10.1177/23743735221077543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
This study evaluated the mental health and cancer treatment-related impact of the first wave of the COVID-19 pandemic on patients with breast and gynecologic cancers. An 18-question survey was administered in June 2020 at a New York City-based cancer center to assess the quality of life (QOL) and overall health (OH) during both the pandemic time period from March 1, 2020, through June 30, 2020, and the pre-pandemic period (prior to March 1, 2020). Survey questions were answered on a 5-point Likert scale and a 7-point EORTC QLQ-C30 QOL scale. Differences in mean QOL and OH scores were evaluated using a paired t-test. QOL and OH were significantly worsened by the pandemic, with significant increases in anxiety, depression, and mood swings.
Collapse
Affiliation(s)
- Natalie F. Berger
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Natalie F. Berger, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY 10029, USA.
| | - Brittney S. Zimmerman
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Danielle Seidman
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Krystal P. Cascetta
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Erin Moshier
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michelle Nezolosky
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kara Trlica
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alisa Ryncarz
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Caitlin Keeton
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Amy Tiersten
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| |
Collapse
|
24
|
Changes in Access to Health Services during the COVID-19 Pandemic: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031749. [PMID: 35162772 PMCID: PMC8834942 DOI: 10.3390/ijerph19031749] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/28/2022] [Accepted: 01/30/2022] [Indexed: 02/01/2023]
Abstract
The COVID-19 pandemic and the measures adopted are having a profound impact on a major goal of public healthcare systems: universal access to health services. The objective is to synthesize the available knowledge on access to health care for non-COVID-19 conditions and to identify knowledge gaps. A scoping review was conducted searching different databases (Medline, Google Scholar, etc.) for original articles published between December 2019 and September 2021. A total of 53 articles were selected and analyzed using the Aday and Andersen framework as a guide. Of these, 37 analyzed changes in levels of use of health services, 15 focused on the influencing factors and barriers to access, and 1 studied both aspects. Most focused on specific diseases and the early stages of the pandemic, based on a review of records. Analyses of the impact on primary care services' use, unmet needs or inequalities in access were scarce. A generalized reduction in the use of health services was described. The most frequent access barrier described for non-COVID-19 conditions related to the services was a lack of resources, while barriers related to the population were predisposing (fear of contagion, stigma, or anticipating barriers) and enabling characteristics (worse socioeconomic status and an increase in technological barriers). In conclusion, our results show a general reduction in services' use in the early stages of the pandemic, as well as new barriers to access and the exacerbation of existing ones. In view of these results, more studies are required on the subsequent stages of the pandemic, to shed more light on the factors that have influenced access and the pandemic's impact on equity of access.
Collapse
|
25
|
Haji Mukhti MI, Ibrahim MI, Tengku Ismail TA, Nadal IP, Kamalakannan S, Kinra S, Musa KI. Family Caregivers' Experiences and Coping Strategies in Managing Stroke Patients during the COVID-19 Pandemic: A Qualitative Exploration Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020942. [PMID: 35055764 PMCID: PMC8775342 DOI: 10.3390/ijerph19020942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/29/2021] [Accepted: 01/13/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Stroke is a chronic disease that requires stroke survivors to be supported long-term by their families. This is especially because of the inaccessibility to post-stroke rehabilitation outside hospitals. The Corona Virus Disease 2019 (COVID-19) crisis and the pandemic restrictions in Malaysia are expected to exponentially increase the demand from family caregivers in supporting stroke survivors. Thus, this study aims to explore the burden, experience, and coping mechanism of the family caregivers supporting stroke survivors during the COVID-19 pandemic. METHODOLOGY A phenomenological qualitative study was conducted from November 2020 to June 2021 in Malaysia. A total of 13 respondents were recruited from two public rehabilitation centers in Kota Bharu, Kelantan. In-depth interviews were conducted with the participants. Comprehensive representation of perspectives from the respondents was achieved through purposive sampling. The interviews were conducted in the Kelantanese dialect, recorded, transcribed, and analyzed using thematic analysis. RESULTS Three themes on burdens and experiences were identified. They were worsening pre-existing issues, emerging new issues, and fewer burdens and challenges. Two themes on coping strategies were also identified. They were problem-focused engagement and emotion-focused engagement. CONCLUSIONS The COVID-19 pandemic has changed the entire system of stroke management. While family caregivers mostly faced the extra burden through different experiences, they also encountered some positive impacts from the pandemic. The integrated healthcare system, especially in the era of digitalization, is an important element to establish the collaborative commitment of multiple stakeholders to compensate burden and sustain the healthcare of stroke survivors during the pandemic.
Collapse
Affiliation(s)
- Muhammad Iqbal Haji Mukhti
- Department of Community Medicine, Health Campus, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (M.I.H.M.); (T.A.T.I.); (K.I.M.)
| | - Mohd Ismail Ibrahim
- Department of Community Medicine, Health Campus, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (M.I.H.M.); (T.A.T.I.); (K.I.M.)
- Correspondence: ; Tel.: +60-97-676-621
| | - Tengku Alina Tengku Ismail
- Department of Community Medicine, Health Campus, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (M.I.H.M.); (T.A.T.I.); (K.I.M.)
| | - Iliatha Papachristou Nadal
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK; (I.P.N.); (S.K.); (S.K.)
| | - Sureshkumar Kamalakannan
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK; (I.P.N.); (S.K.); (S.K.)
- Department of Social Work, Education and Wellbeing, Faculty of Health and Life Sciences, Northumbria University, New Castle NE7 7XA, UK
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK; (I.P.N.); (S.K.); (S.K.)
| | - Kamarul Imran Musa
- Department of Community Medicine, Health Campus, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (M.I.H.M.); (T.A.T.I.); (K.I.M.)
| |
Collapse
|
26
|
Tuczyńska M, Matthews-Kozanecka M, Baum E. Accessibility to Non-COVID Health Services in the World During the COVID-19 Pandemic: Review. Front Public Health 2022; 9:760795. [PMID: 34976922 PMCID: PMC8716399 DOI: 10.3389/fpubh.2021.760795] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/10/2021] [Indexed: 01/05/2023] Open
Abstract
Background: COVID-19 pandemic caused by SARS-CoV2 has seriously impacted the global economy. Medical facilities around the world were not prepared for the enormous challenges posed by the growing number of patients each day, the shortage of personal protective equipment, and insufficient numbers of medical staff. Governments have tried to counteract the impact of the pandemic, but the measures taken have not always been sufficient to maintain access to and quality of health services at the same level as before the pandemic. The disruption of health services has resulted in more and more research reports from different parts of the world on the accessibility of health services during the COVID-19 pandemic. Methodology: This review article presents 21 selected scientific studies on access to health services in different regions of the world. Articles were found in PubMed, GoogleScholar, Medline, and ScienceDirect databases, then grouped, and significant data were extracted from each article. The results were summarized in a table. Results: The range of limited health services included a variety of specialties, including primary care, psychiatry, orthopedics, cardiology, neurosurgery, and more. Methods used in the studies were based on retrospective analysis or on the subjective assessment of patients in the form of a questionnaire or interview. Most authors claimed a decrease in accessibility to health services during the COVID-19 pandemic compared to the pre-pandemic period, including a decrease in planned surgeries, doctor appointments, patient admission to hospital or ER, and access to medicines. Additionally, some authors observed an increase in the mortality rate. One of the few medical services that have expanded rapidly during the pandemic was online appointments. Conclusions: The COVID-19 pandemic has most certainly affected the accessibility of health services worldwide. Lessons should be learned to prevent inaccessibility to medical services, especially as experts predict another wave of COVID-19 cases.
Collapse
Affiliation(s)
- Magdalena Tuczyńska
- Student Scientific Circle of Maxillofacial Orthopaedics and Orthodontics, Poznan University of Medical Sciences, Poznań, Poland
| | - Maja Matthews-Kozanecka
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznań, Poland
| | - Ewa Baum
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznań, Poland
| |
Collapse
|
27
|
Borno HT, Kim MO, Hong JC, Yousefi S, Lin A, Tolstykh I, Zhang S, McKay RR, Harismendy O, Cinar P, Rugo H, Koshkin VS, Rabow M, Wang C, Bailey A, Small EJ. OUP accepted manuscript. Oncologist 2022; 27:398-406. [PMID: 35348771 PMCID: PMC9074994 DOI: 10.1093/oncolo/oyac038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 01/07/2022] [Indexed: 11/21/2022] Open
Abstract
Background The risks associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated illness, coronavirus disease 2019 (COVID-19), among patients with a cancer diagnosis have not been fully characterized. This study leverages data from a multi-institutional cohort study, the University of California Cancer COVID Consortium, to evaluate outcomes associated with SARS-CoV-2 infection among patients with cancer. Methods Clinical data were collected from March to November 2020 and included patient demographics, cancer history and treatment, SARS-CoV-2 exposure and testing, and COVID-19 clinical management and outcomes. Multivariate ordinal logistic regression permitting unequal slopes was used to evaluate the impact of demographic, disease, and treatment factors on SARS-CoV-2 related hospitalization, intensive care unit (ICU) admission, and mortality. Findings Among all evaluated patients (n = 303), 147 (48%) were male, 118 (29%) were older adults (≥65 years old), and 104 (34%) were non-Hispanic white. A subset (n = 63, 21%) had hematologic malignancies and the remaining had solid tumors. Patients were hospitalized for acute care (n = 79, 26%), ICU-level care (n = 28, 9%), or died (n = 21, 7%) due to COVID-19. Patients with ≥2 comorbidities were more likely to require acute care (odds ratio [OR] 2.09 [95% confidence interval (CI), 1.23-3.55]). Cough was identified as a significant predictor of ICU hospitalization (OR 2.16 [95% CI, 1.03-4.57]). Importantly, mortality was associated with an active cancer diagnosis (OR 3.64 [95% CI, 1.40-9.5]) or advanced age (OR 3.86 [95% CI, 1.2-12.44]). Interpretation This study observed that patients with active cancer or advanced age are at an increased risk of death from COVID-19. These study observations can inform risk counseling related to COVID-19 for patients with a cancer diagnosis.
Collapse
Affiliation(s)
- Hala T Borno
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- Corresponding author: Hala T. Borno, MD 550 16th Street, 6th Floor, Box 3211 San Francisco, CA 94158.
| | - Mi-Ok Kim
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Julian C Hong
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
- Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA, USA
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Sasha Yousefi
- Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA, USA
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Amy Lin
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Irina Tolstykh
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Sylvia Zhang
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Rana R McKay
- Department of Medicine, University of California, San Diego, San Diego, CA, USA
- Moores Cancer Center, University of California, San Diego, San Diego, CA, USA
| | - Olivier Harismendy
- Moores Cancer Center, University of California, San Diego, San Diego, CA, USA
- Division of Biomedical Informatics, Department of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Pelin Cinar
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Hope Rugo
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Vadim S Koshkin
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Maya Rabow
- College of Science, Northeastern University, Boston, MA, USA
| | | | - Adina Bailey
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Eric J Small
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| |
Collapse
|
28
|
Kirby A, Drummond FJ, Lawlor A, Murphy A. Counting the social, psychological, and economic costs of COVID-19 for cancer patients. Support Care Cancer 2022; 30:8705-8731. [PMID: 35690662 PMCID: PMC9188420 DOI: 10.1007/s00520-022-07178-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/25/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Cancer patients were particularly vulnerable to the adverse impacts of the COVID-19 pandemic given their reliance on the healthcare system, and their weakened immune systems. This systematic review examines the social, psychological, and economic impacts of COVID-19 on cancer patients. METHODS The systematic search, conducted in March 2021, captures the experience of COVID-19 Wave I, when the most severe restrictions were in place globally, from a patient perspective. RESULTS The search yielded 56 studies reporting on the economic, social, and psychological impacts of COVID-19. The economic burden associated with cancer for patients during the pandemic included direct and indirect costs with both objective (i.e. financial burden) and subjective elements (financial distress). The pandemic exasperated existing psychological strain and associated adverse outcomes including worry and fear (of COVID-19 and cancer prognosis); distress, anxiety, and depression; social isolation and loneliness. National and institutional public health guidelines to reduce COVID-19 transmission resulted in suspended cancer screening programmes, delayed diagnoses, postponed or deferred treatments, and altered treatment. These altered patients' decision making and health-seeking behaviours. CONCLUSION COVID-19 compounded the economic, social, and psychological impacts of cancer on patients owing to health system adjustments and reduction in economic activity. Identification of the impact of COVID-19 on cancer patients from a psychological, social, and economic perspective following the pandemic can inform the design of timely and appropriate interventions and supports, to deal with the backlog in cancer care and enhance recovery.
Collapse
Affiliation(s)
- Ann Kirby
- Department of Economics, Cork University Business School, University College Cork, Aras na Laoi, Western Rd, Cork, Ireland
| | | | - Amy Lawlor
- Department of Economics, Cork University Business School, University College Cork, Aras na Laoi, Western Rd, Cork, Ireland
| | - Aileen Murphy
- Department of Economics, Cork University Business School, University College Cork, Aras na Laoi, Western Rd, Cork, Ireland
| |
Collapse
|
29
|
Kim GJ, Kim H, Fletcher J, Voelbel GT, Goverover Y, Chen P, O'Dell MW, Genova HM. The differential impact of the COVID-19 pandemic on healthcare utilization disruption for community-dwelling individuals with and without acquired brain injury. Arch Rehabil Res Clin Transl 2021; 4:100176. [PMID: 34934940 PMCID: PMC8677629 DOI: 10.1016/j.arrct.2021.100176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
All groups experienced notable disruption in health care utilization. Disruption in care for traumatic brain injury or mental health was associated with decreased health-related quality of life. Telehealth was a viable alternative to in-person visits. Telehealth is not a panacea and should be adopted using a nuanced approach.
Objective To delineate health care disruption for individuals with acquired brain injury (ABI) during the peak of the pandemic and to understand the impact of health care disruption on health-related quality of life (HRQoL). Design Cross-sectional survey. Setting General community. Participants Volunteer sample of adults with traumatic brain injury (TBI; n=33), adults with stroke (n=66), and adults without TBI or stroke (n=108) with access to the internet and personal technology (N=207). Interventions Not applicable. Main Outcome Measures Not applicable. Results Participants with TBI and stroke reported high rates of disruption in care specific to their diagnosis (53%-54.5%), while participants across all groups reported disruption for major medical care (range, 68.2%-80%), general health care (range, 60.3%-72.4%), and mental health care (range, 31.8%-83.3%). During the pandemic, participants with TBI and stroke used telehealth for care specific to their diagnosis (40.9%-42.4%), whereas all participants used telehealth for major medical care (range, 50%-86.7%), general health care (range, 31.2%-53.3%), and mental health care (range, 53.8%-72.7%). Disruption in TBI or stroke care and type of ABI explained 27.1% of the variance in HRQoL scores (F2,95=16.82, P<.001, R2=0.262), and disruption in mental health care explained 14.8% of the variance (F1,51=8.86, P=.004, R2=0.148). Conclusions Individuals with and without ABI experienced pronounced disruption in health care utilization overall. However, individuals who experienced a disruption in care specific to TBI or mental health care were most vulnerable to decreased HRQoL. Telehealth was a viable alternative to in-person visits for individuals with and without ABI, but limitations included difficulty with technology, difficulty with comprehensive examination, and decreased rapport with providers.
Collapse
Affiliation(s)
- Grace J Kim
- Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY.,Department of Rehabilitation Medicine, NYU Langone Health, New York, NY
| | - Hayejin Kim
- Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY
| | | | - Gerald T Voelbel
- Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY.,Department of Rehabilitation Medicine, NYU Langone Health, New York, NY
| | - Yael Goverover
- Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY
| | - Peii Chen
- Kessler Foundation, West Orange and East Hanover, New Jersey.,Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, New Jersey
| | - Michael W O'Dell
- Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, NY
| | - Helen M Genova
- Kessler Foundation, West Orange and East Hanover, New Jersey.,Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, New Jersey
| |
Collapse
|
30
|
Acquati C, Chen TA, Martinez Leal I, Connors SK, Haq AA, Rogova A, Ramirez S, Reitzel LR, McNeill LH. The Impact of the COVID-19 Pandemic on Cancer Care and Health-Related Quality of Life of Non-Hispanic Black/African American, Hispanic/Latina and Non-Hispanic White Women Diagnosed with Breast Cancer in the U.S.: A Mixed-Methods Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413084. [PMID: 34948695 PMCID: PMC8702073 DOI: 10.3390/ijerph182413084] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic has had critical consequences for cancer care delivery, including altered treatment protocols and delayed services that may affect patients’ quality of life and long-term survival. Breast cancer patients from minoritized racial and ethnic groups already experience worse outcomes, which may have been exacerbated by treatment delays and social determinants of health (SDoH). This protocol details a mixed-methods study aimed at comparing cancer care disruption among a diverse sample of women (non-Hispanic White, non-Hispanic Black/African American, and Hispanic/Latina) and assessing how proximal, intermediate, and distal SDoH differentially contribute to care continuity and health-related quality of life. An embedded mixed-methods design will be implemented. Eligible participants will complete an online survey, followed by a semi-structured interview (with a subset of participants) to further understand factors that influence continuity of care, treatment decision-making, and self-reported engagement. The study will identify potentially modifiable factors to inform future models of care delivery and improve care transitions. These data will provide the necessary evidence to inform whether a subsequent, multilevel intervention is warranted to improve quality of care delivery in the COVID-19 aftermath. Additionally, results can be used to identify ways to leverage existing social resources to help manage and support patients’ outcomes.
Collapse
Affiliation(s)
- Chiara Acquati
- Graduate College of Social Work, University of Houston, 3511 Cullen Blvd, Houston, TX 77204, USA
- Department of Health Disparities Research, The UT MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA;
- Correspondence: ; Tel.: +1-713-743-4343
| | - Tzuan A. Chen
- HEALTH Research Institute, University of Houston, 4849 Calhoun Road, Houston, TX 77204, USA; (T.A.C.); (I.M.L.); (L.R.R.)
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Isabel Martinez Leal
- HEALTH Research Institute, University of Houston, 4849 Calhoun Road, Houston, TX 77204, USA; (T.A.C.); (I.M.L.); (L.R.R.)
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Shahnjayla K. Connors
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
- Department of Social Sciences, University of Houston-Downtown, Houston, TX 77002, USA
| | - Arooba A. Haq
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Anastasia Rogova
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Stephanie Ramirez
- College of Natural Sciences and Mathematics, University of Houston, 3507 Cullen Blvd, Houston, TX 77204, USA;
| | - Lorraine R. Reitzel
- HEALTH Research Institute, University of Houston, 4849 Calhoun Road, Houston, TX 77204, USA; (T.A.C.); (I.M.L.); (L.R.R.)
- Department of Psychological, Health and Learning Sciences, University of Houston, 491 Farish Hall, Houston, TX 77204, USA; (S.K.C.); (A.A.H.); (A.R.)
| | - Lorna H. McNeill
- Department of Health Disparities Research, The UT MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA;
| |
Collapse
|
31
|
Levkovich I, Shinan-Altman S. The impact of gender on emotional reactions, perceived susceptibility and perceived knowledge about COVID-19 among the Israeli public. Int Health 2021; 13:555-561. [PMID: 33449111 PMCID: PMC7928893 DOI: 10.1093/inthealth/ihaa101] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/09/2020] [Accepted: 12/23/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The current COVID-19 outbreak is seriously affecting the lives and health of people across the globe. While gender remains a key determinant of health, attempts to address the gendered dimensions of health face complex challenges. METHODS In a cross-sectional study 482 participants (men=237, women=245) completed questionnaires on precautionary behaviour, perceived knowledge about COVID-19 risk factors, emotional reactions toward COVID-19 and perceived susceptibility. We examined gender differences in perceived knowledge about COVID-19 risk factors, healthy behaviours, threat perceptions and emotional responses, as well as the role of gender as a moderating factor. RESULTS Women reported higher levels of precautionary behaviour (t(475)=3.91, p<0.001) and more negative emotional reactions toward COVID-19 (t(475)=6.07, p<0.001). No gender differences emerged in perceived susceptibility or knowledge about COVID-19. The multiple regression model is significant and explains 30% of the variance in precautionary behaviour, which was found to be higher among women and older participants, those with higher perceived knowledge about COVID-19 risk factors and those with higher emotional reactions. Gender exhibited a significant moderating role in the relationship between perceived knowledge and precautionary behaviour (B=0.16, SE=0.07, β=0.13, p=0.02, 95% CI 0.03 to 0.30). CONCLUSION Women exhibited higher levels of precautionary behaviour and emotional responses.
Collapse
Affiliation(s)
| | - Shiri Shinan-Altman
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Israel
| |
Collapse
|
32
|
Abstract
OBJECTIVES This study investigated the factors influencing unmet healthcare needs of people during the early stage of the COVID-19 pandemic in Seoul, South Korea. The findings help to identify people who have difficulty accessing healthcare services during a pandemic situation. DESIGN We conducted a cross-sectional study using a proportionate quota sampling method according to five major districts, sex and age, using an online survey. We analysed the key characteristics of influencing factors of unmet healthcare needs based on the Andersen behavioural model of healthcare utilisation: predisposing factors (eg, sex, age), need factors (eg, health status, illness) and enabling factors (eg, income, efficacy belief). SETTING The questionnaire was sent via email and mobile text messages from the end of April to the beginning of May 2020 during the first wave of the COVID-19 pandemic. PARTICIPANTS A sample of 813 respondents was used, and the respondent information was anonymised in the analysis process. RESULTS For the predisposing factors, sex, age, education level and occupational cluster were associated with unmet needs for healthcare. Chronic diseases and mental health were the influencing factors as an enabling factor that exerted an influence on the unmet need for healthcare in South Korea. Women, younger persons, those with lower education and persons with white-collar jobs were more likely to experience unmet healthcare needs. In addition, the more chronic diseases people had, the more COVID-19 negatively affected them mentally; and the more people felt fear of COVID-19, the higher chances they experienced unmet healthcare needs. CONCLUSION Government and policymakers are guided to draw out measures such as health communication and telemedicine to reduce the unmet healthcare needs during the pandemic and to recognise the different influencing factors.
Collapse
Affiliation(s)
- Jungah Kim
- Urban Society Research, The Seoul Institute, Seoul, Republic of Korea
| | - Myoungsoon You
- Health care Management and Policy, School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Changwoo Shon
- Urban Society Research, The Seoul Institute, Seoul, Republic of Korea
| |
Collapse
|
33
|
Luxenburg O, Saban M, Myers V, Vaknin S, Boldor N, Wilf-Miron R. National and regional trends in MRI utilization in the face of the ongoing COVID-19 pandemic. Isr J Health Policy Res 2021; 10:40. [PMID: 34266476 PMCID: PMC8280577 DOI: 10.1186/s13584-021-00472-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 05/04/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND AND PURPOSE Marked reductions in imaging exams have been documented during the COVID-19 pandemic. The study aimed to examine the effect of the two waves of COVID-19 on magnetic resonance imaging (MRI) utilization at the national and regional level. MATERIALS AND METHODS A retrospective-archive study was conducted in Israel, comparing March-December 2020 with March-December 2018 and 2019. Data on MRI utilization were obtained from the national MRI registry, while data on confirmed COVID-19 cases, by place of residence, were obtained from the Israeli Ministry of Health open COVID-19 database. RESULTS The number and rate of MRI examinations decreased during the first COVID-19 wave, with the steepest drop in April 2020: 47.5% relative decrease compared to April 2019, and 42.2% compared to 2018. This was followed by a compensatory increase between the waves and a return to almost pre-pandemic levels of use, with just a modest decrease, during the second, more intense COVID wave, compared with the previous year. Existing differences between regions increased during the pandemic. The rate ratio of MRI exams between Tel-Aviv and the Northern periphery increased from 2.89 in April 2019 to 3.94 in April 2020. Jerusalem metropolitan region, with the largest burden of COVID disease, demonstrated only a modest decrease (1%) in MRI utilization during the first 10 months of the pandemic. CONCLUSIONS At the national level, time trends in reduced MRI utilization followed the first wave of COVID-19, and were accompanied by increased regional disparities. These changes were not explained by differences in the burden of COVID-19 disease but might be explained by unequal distribution of MRI scanners among regions. Reduced utilization was not evident during the second wave, nor at the beginning of the third wave, despite higher COVID-19 case load, demonstrating adaptation to the new normal. Patterns of MRI utilization might help policy-makers and healthcare managers predict the behavior of imaging as well as other sectors, such as elective surgical procedures, during an ongoing pandemic. This forecast might help to manage the lasting effects of the pandemic, including extended waiting times, in the months and years following its remission. In preparation for future national emergencies, timely and detailed data on MRI utilization can serve as a "sensor" for a wide array of diagnostic and interventional medical activities, providing policy-makers with an updated snapshot to guide their response at the regional and national levels.
Collapse
Affiliation(s)
- Osnat Luxenburg
- Medical Technology, Health Information and Research Directorate, Ministry of Health, Jerusalem, Israel
| | - Mor Saban
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 1 Emek dotan Street, 5262100 Ramat-Gan, Israel
| | - Vicki Myers
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 1 Emek dotan Street, 5262100 Ramat-Gan, Israel
| | - Sharona Vaknin
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 1 Emek dotan Street, 5262100 Ramat-Gan, Israel
| | - Noga Boldor
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 1 Emek dotan Street, 5262100 Ramat-Gan, Israel
| | - Rachel Wilf-Miron
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 1 Emek dotan Street, 5262100 Ramat-Gan, Israel
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
34
|
Levkovich I, Shinan-Altman S. Impact of the COVID-19 pandemic on stress and emotional reactions in Israel: a mixed-methods study. Int Health 2021; 13:358-366. [PMID: 33049782 PMCID: PMC7665529 DOI: 10.1093/inthealth/ihaa081] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/08/2020] [Accepted: 09/22/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a profound impact worldwide. This study sought to assess the pandemic's psychological impact on the Israeli public. METHODS Using mixed methods we assessed Israeli adults during the COVID-19 outbreak. In the quantitative study, participants (N=1407) completed an online battery of measures assessing psychological variables and perceived threat related to COVID-19. Statistical analyses included tests for between-group differences and Pearson correlations. The qualitative study entailed in-depth, semistructured interviews conducted by telephone (N=38). RESULTS The quantitative findings indicate that about 48% of the public had negative emotional reactions and 20% perceived they were liable to contract the virus. Moreover, a positive correlation was found between these feelings and the degree of perceived threat. Three major themes emerged from the qualitative study: 1) a sense of shock and chaos; 2) gradual adjustment to the new reality; and 3) fears and concerns for self and family members. The study's results revealed the following sources of participants' emotional responses and sense of threat: health concerns regarding themselves and their loved ones; employment concerns; problems with children and spouses caused by being together at home; and difficulties entailed in working at home. CONCLUSIONS The study reveals many of the psychological variables and perceived threats related to COVID-19 in Israel. While social distancing may make people feel safer, it can also increase their feelings of isolation, stress and frustration and cause difficulties in many life situations. The findings point to the necessity of addressing the public's perceived susceptibility and emotional reactions about COVID-19.
Collapse
Affiliation(s)
- Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Kiryat Tivon 36006, Israel
| | - Shiri Shinan-Altman
- The Louis and Gabi Weisfeld School of Social Work Bar Ilan University, Max and Anna Web st., Ramat Gan 5290002, Israel
| |
Collapse
|
35
|
Saban M, Myers V, Luxenburg O, Wilf-Miron R. Tipping the scales: a theoretical model to describe the differential effects of the COVID-19 pandemic on mortality. Int J Equity Health 2021; 20:140. [PMID: 34134710 PMCID: PMC8206897 DOI: 10.1186/s12939-021-01470-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 05/05/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has resulted in changes in almost every aspect of life. The fatal consequences of the pandemic have been clearly reported, with direct and indirect effects; however, there is some evidence of a positive secondary impact, such as fewer motor accidents, lower influenza burden and reduced air pollution. METHODS/MODEL We present a model to describe the differing effects of the COVID-19 pandemic on mortality, taking into account external pressures and internal resources and their relationship with resilience and health behaviors, which affect mortality risk, inspired by elements of the salutogenic model. Individuals with lower resources and from more deprived communities are likely to be more negatively affected by the external changes occurring, while those with more resources may be more likely to experience the benefits. Both individual and community resources affect coping and influence both mental and physical health. CONCLUSIONS Decision makers should consider ways to incorporate the positive changes which occurred as part of the exit strategy. Societies should invest in building resources to improve both individual and community resilience to help people be better prepared and more able to cope and adapt in times of crisis. Special emphasis should be given to weaker populations most affected by external changes, including older people, low socioeconomic groups, those with mental health issues and minority groups, in order to reduce disparities.
Collapse
Affiliation(s)
- Mor Saban
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat-Gan, Israel.
| | - Vicki Myers
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat-Gan, Israel
| | - Osnat Luxenburg
- Medical Technology, Health Information and Research Directorate, Ministry of Health, Jerusalem, Israel
| | - Rachel Wilf-Miron
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat-Gan, Israel
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Sackler, Israel
| |
Collapse
|
36
|
Mifsud A, Pehlivan MJ, Fam P, O’Grady M, van Steensel A, Elder E, Gilchrist J, Sherman KA. Feasibility and pilot study of a brief self-compassion intervention addressing body image distress in breast cancer survivors. Health Psychol Behav Med 2021; 9:498-526. [PMID: 34104572 PMCID: PMC8158280 DOI: 10.1080/21642850.2021.1929236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/09/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The majority of breast cancer survivors (BCSs) experience body image concerns following treatment. Body Image distress (BID) is associated with psychological distress and diminished quality of life. A web-based self-compassion focused writing activity (My Changed Body - MyCB) reduces BID in BCSs, yet limited research exists on participant characteristics associated with such intervention adherence. Self-compassion-based meditations are also efficacious in reducing BID in non-BCS populations. This parallel, double-blind pilot randomised controlled trial aimed to assess the feasibility and acceptability of MyCB, with and without an additional meditation component, on BID and related psychological outcomes in BCSs. The trial was registered with the Australian and New Zealand Clinical Trials Registry (#ACTRN12619001693112). METHODS BCSs were randomly allocated to MyCB (n = 39), MyCB + Meditation (MyCB + M) (n = 17) or an expressive writing (EW) active control arm (n = 23). The primary outcome was BID. Secondary outcomes were body appreciation, affect (positive and negative), psychological distress (depression, anxiety and stress) and self-compassion (state and trait). Assessments were completed online at baseline, post-intervention and 1-month. RESULTS Adherence to the MyCB writing (45%) and meditation (50%) was modest, and acceptability was high for both MyCB and MyCB + M. Intent to treat linear mixed model analyses indicated: Post-intervention - state self-compassion and positive affect increased for MyCB compared to EW; 1-month: BID scores decreased across all conditions; trait self-compassion increased and anxiety decreased for MyCB + M compared to MyCB and EW. CONCLUSION These findings provide preliminary evidence for the efficacy and potential clinical use of the MyCB brief web-based self-compassion intervention alone and with the addition of meditation, to increase self-compassion and psychological wellbeing in BCSs.
Collapse
Affiliation(s)
- Angela Mifsud
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Melissa J. Pehlivan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Paul Fam
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Maddison O’Grady
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Annamiek van Steensel
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Elisabeth Elder
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia
| | | | - Kerry A. Sherman
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| |
Collapse
|
37
|
Pifarré i Arolas H, Vidal-Alaball J, Gil J, López F, Nicodemo C, Saez M. Missing Diagnoses during the COVID-19 Pandemic: A Year in Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5335. [PMID: 34067807 PMCID: PMC8156815 DOI: 10.3390/ijerph18105335] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/10/2021] [Accepted: 05/14/2021] [Indexed: 12/31/2022]
Abstract
The COVID-19 pandemic has had major impacts on population health not only through COVID-positive cases, but also via the disruption of healthcare services, which in turn has impacted the diagnosis and treatment of all other diseases during this time. We study changes in all new registered diagnoses in ICD-10 groups during 2020 with respect to a 2019 baseline. We compare new diagnoses in 2019 and 2020 based on administrative records of the public primary health system in Central Catalonia, Spain, which cover over 400,000 patients and 3 million patient visits. We study the ratio of new diagnoses between 2019 and 2020 and find an average decline of 31.1% in new diagnoses, with substantial drops in April (61.1%), May (55.6%), and November (52%). Neoplasms experience the largest decline (49.7%), with heterogeneity in the magnitudes of the declines across different types of cancer diagnoses. While we find evidence of temporal variation in new diagnoses, reductions in diagnoses early in the year are not recouped by the year end. The observed decline in new diagnoses across all diagnosis groups suggest a large number of untreated and undetected cases across conditions. Our findings provide a year-end summary of the impact of the pandemic on healthcare activities and can help guide health authorities to design evidence-based plans to target under-diagnosed conditions in 2021.
Collapse
Affiliation(s)
- Héctor Pifarré i Arolas
- Centre for Research in Health Economics, Universitat Pompeu Fabra, 08002 Barcelona, Spain; (H.P.iA.); (F.L.)
| | - Josep Vidal-Alaball
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, 08272 Barcelona, Spain
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, 08007 Barcelona, Spain
- Faculty of Medicine, University of Vic-Central University of Catalonia, 08500 Vic, Spain
| | - Joan Gil
- Barcelona Economic Analysis Team, Department of Economics, Universitat de Barcelona, 08007 Barcelona, Spain;
| | - Francesc López
- Centre for Research in Health Economics, Universitat Pompeu Fabra, 08002 Barcelona, Spain; (H.P.iA.); (F.L.)
| | - Catia Nicodemo
- Centre of Organisation, Department of Primary Economics, University of Oxford, Oxford OX1 3UQ, UK;
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health, Department of Economics, Universitat de Girona, 17004 Girona, Spain;
- Epidemiology and Public Health Networking Biomedical Research Centre, 28029 Madrid, Spain
| |
Collapse
|
38
|
Shinan-Altman S, Levkovich I. Emotional reactions towards COVID-19 among persons with diabetes. Int Health 2021; 14:170-175. [PMID: 33974703 PMCID: PMC8136032 DOI: 10.1093/inthealth/ihab024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/25/2021] [Accepted: 04/23/2021] [Indexed: 12/23/2022] Open
Abstract
The emotional impact of the coronavirus disease 2019 (COVID-19) pandemic on populations at large is emerging in the literature. However, the emotional response of persons with diabetes to the pandemic is only now beginning to emerge. Therefore this study aimed to identify factors contributing to emotional reactions towards this pandemic among persons with diabetes. A total of 205 persons with diabetes participated in this cross-sectional online survey between 14 May and 22 June 2020. Participants completed measures of emotional reactions towards COVID-19, perceived diabetes status, perceived susceptibility, knowledge about COVID-19, sense of mastery and sociodemographic questionnaires. Statistical analyses included Pearson correlations and regression analysis. According to the results, the mean score of negative emotional reactions towards COVID-19 was 3.45 (standard deviation 1.11, range 1–5), meaning that the score was relatively high. Higher levels of negative emotional reactions towards COVID-19 were associated with higher perceived susceptibility, greater knowledge about COVID-19 and a lower sense of mastery. The study's findings emphasize the need to communicate ongoing knowledge regarding COVID-19 and diabetes as well as to provide persons with diabetes with the necessary emotional support related to coping with diabetes and COVID-19.
Collapse
Affiliation(s)
- Shiri Shinan-Altman
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat-Gan 52900, Israel
| | - Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Israel
| |
Collapse
|
39
|
Depression and Anxiety Among Patients with Cancer During COVID-19 Pandemic: A Systematic Review and Meta-analysis. J Gastrointest Cancer 2021; 52:499-507. [PMID: 33950368 PMCID: PMC8096890 DOI: 10.1007/s12029-021-00643-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Investigations about the impact and consequences of the COVID-19 infection on the mental health of patients with chronic diseases and those with immunosuppressive conditions are growing. The current study aimed to systematically review and meta-analysis of studies that evaluated the level of depression and anxiety in cancer patients during the COVID-19 pandemic. METHODS The PubMed, Scopus and Web of Sciences databases were searched to retrieve potential studies from January 2020 to 3 January 2021. Summary data on frequency and mean of depression and anxiety were extracted. Random-effect meta-analysis was conducted to estimate overall prevalence, mean and standardized mean difference. RESULTS Thirty-four studies were included in the systematic review, of them 21 studies included in meta-analysis. Overall depression and anxiety were 0.37 (0.27, 0.47); I2 = 99.05%, P value < 0.001 and 0.38 (0.31, 0.46); I2 = 99.08%, P value < 0.001, respectively. Compared to controls, cancer patients had higher anxiety level [standard mean difference (SMD 0.25 (95% CI 0.08, 0.42)]. CONCLUSION Overall, the findings of this study suggest that the prevalence of depression and anxiety among patients with cancer during the COVID-19 pandemic can reach considerable levels, although observed substantial heterogeneity should be considered when interpreting the results.
Collapse
|
40
|
Dehghan M, Namjoo Z, Zarei A, Tajedini H, Bahrami A, Zakeri MA. The Relationship between Coronavirus Anxiety, Mindfulness and Spiritual Health in Patients with Cancer: A Survey in Southeast Iran. Psychiatry Investig 2021; 18:443-452. [PMID: 34053210 PMCID: PMC8169327 DOI: 10.30773/pi.2020.0441] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/09/2021] [Accepted: 02/20/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The sudden outbreak of COVID-19 has caused major health problems, including anxiety in cancer patients worldwide. Spiritual health and mindfulness are considered as factors affecting anxiety. This study addressed the relationship between COVID-19 anxiety, spiritual health and mindfulness in patients with cancer. METHODS One hundred and eighty-four cancer patients participated in this cross-sectional study. The data were collected with convenience sampling method from two oncology centers from 15 June to 15 July 2020 in the southeast Iran. Patients completed the Demographic and Clinical Characteristics Form, Corona Disease Anxiety Scale (CDAS), The Freiburg Mindfulness inventory-Short Form (FMI-SF) and Spiritual Health Scale. RESULTS According to the psychological symptom subscale (CDAS), 61.4% of the participants had moderate to severe anxiety. According to the physical symptom subscale, 38% of the participants had moderate to severe anxiety. No significant association was found between corona disease anxiety and mindfulness/spiritual health (p>0.05). CONCLUSION The results of this study showed high levels of mental and physical anxiety and worries about COVID-19 disease in cancer patients, which led to challenges in their lives. It is necessary to review and implement effective interventions in future studies to prevent anxiety and its consequences in cancer patients.
Collapse
Affiliation(s)
- Mahlagha Dehghan
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Zakieh Namjoo
- Student Research Committee, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Ahmad Zarei
- Student Research Committee, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Hanieh Tajedini
- Student Research Committee, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Amir Bahrami
- Student Research Committee, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Ali Zakeri
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Social Determinants of Health Research Centre, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| |
Collapse
|
41
|
Slivjak ET, Fishbein JN, Nealis M, Schmiege SJ, Arch JJ. Cancer survivors' perceived vulnerability to COVID-19 and impacts on cognitive, affective, and behavioral responses to the pandemic. J Psychosoc Oncol 2021; 39:366-384. [PMID: 33886442 PMCID: PMC8788202 DOI: 10.1080/07347332.2021.1887430] [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] [Indexed: 10/21/2022]
Abstract
STUDY OBJECTIVES Given the uncertainty COVID-19 has caused for individuals with prior medical conditions, we examined the extent to which cancer survivors consider themselves at risk for the global COVID-19 pandemic (henceforth COVID), both in general and due to their cancer history. Additionally, we evaluated whether perceived vulnerability to COVID among cancer survivors predicts their cognitive/affective and behavioral responses to the pandemic. DESIGN/SAMPLE Cancer survivors who completed primary cancer treatment (median months since treatment = 33.00) and were enrolled in prior behavioral trials with our research team (N = 146) completed two surveys in May-July 2020 (95.89% retention). METHODS Participants rated perceived next-year risk of infection and of dying from COVID. We adapted established scales to assess perceived vulnerability to COVID generally versus as a cancer survivor, catastrophizing about possible COVID symptoms, COVID-related contamination fears, and adherence to COVID prevention behaviors. FINDINGS In May 2020, on a 1-100 scale with 0 = no chance and 100 = definitely will occur, cancer survivors reported a chance in the next year of contracting COVID of M = 39.94 (SD = 23.90), and dying from COVID of M = 24.46 (SD = 24.84). Cancer survivors reported somewhat greater vulnerability to COVID compared to same-aged peers, increased contamination fears, and high adherence to COVID prevention measures. Similar findings emerged six weeks later, suggesting stability over time. In simple linear regression models, both general and cancer survivor-specific perceived COVID vulnerability predicted COVID symptom catastrophizing and contamination fears; in multivariable models, only general vulnerability remained a significant predictor. General perceived vulnerability and contamination fears predicted greater adherence to COVID prevention behaviors. CONCLUSIONS Cancer survivors perceived elevated vulnerability to COVID even years after treatment, which predicted adherence to COVID prevention behaviors. Future research should identify the optimal balance between supporting cancer survivors' concerns and minimizing negative impacts on quality of life.
Collapse
Affiliation(s)
- Elizabeth T. Slivjak
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Joel N. Fishbein
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Madeline Nealis
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Sarah J. Schmiege
- Department of Biostatistics & Informatics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Joanna J. Arch
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
- Cancer Prevention and Control, University of Colorado Cancer Center, Aurora, Colorado, USA
| |
Collapse
|
42
|
She R, Luo S, Lau MM, Lau JTF. The mechanisms between illness representations of COVID-19 and behavioral intention to visit hospitals for scheduled medical consultations in a Chinese general population. J Health Psychol 2021; 27:1846-1860. [PMID: 33878946 DOI: 10.1177/13591053211008217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Testing the Common-Sense Model, this random telephone survey examined the associations between illness representations of COVID-19 and behavioral intention to visit hospitals for scheduled medical consultations (BI-VHSMC), and the mediations via coping and fear of nosocomial infection among 300 Chinese adults. The prevalence of BI-VHSMC was 62.3%. Mediation analysis found that maladaptive coping (rumination and catastrophizing) and fear of nosocomial infection mediated the associations between various dimensions of illness representations of COVID-19 (e.g. consequence and controllability) and BI-VHSMC, both indirectly and serially. Illness representations, coping, and fear should be considered when planning related health promotion during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Rui She
- Centre for Health Behaviours Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Sitong Luo
- Centre for Health Behaviours Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Mason Mc Lau
- Centre for Health Behaviours Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Joseph Tak Fai Lau
- Centre for Health Behaviours Research, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
43
|
Gualano MR, Corradi A, Voglino G, Bert F, Siliquini R. Beyond COVID-19: a cross-sectional study in Italy exploring the covid collateral impacts on healthcare services. Health Policy 2021; 125:869-876. [PMID: 33840478 PMCID: PMC7987502 DOI: 10.1016/j.healthpol.2021.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/27/2021] [Accepted: 03/03/2021] [Indexed: 01/17/2023]
Abstract
With COVID-19, populations are facing unmet health needs due to fear of contagion, lockdown measures and overload of Healthcare services (HCS). The COCOS study aimed to investigate reduced healthcare access among Italian citizens, additionally looking for specific subgroups that will primarily need health services in the next future. A cross-sectional online survey was performed during the Italian lockdown between April and May 2020. Descriptive, univariable and multivariable (logistic regression models) analyses were performed: results are expressed as Odd Ratios and Adjusted Odd Ratios (ORs and AdjORs). Totally, 1,515 questionnaires were collected. Median age was 42 years (IQR 23), 65.6% were females. Around 21.8% declared to suffer from chronic diseases. About 32.4% faced a delay of a scheduled Medical Service (MS) by provider decision, 13.2% refused to access scheduled MS for the fear of contagion, and 6.5% avoided HCS even if having an acute onset issue. Alarmingly, 1.5% avoided Emergency Department when in need and 5.0% took medications without consulting any physician: patients suffering from chronic conditions resulted to be more prone to self-medication (AdjOR [95% CI]: 2.16 [1.16-4.02]). This study demonstrated that indirect effects of COVID-19 are significant. Large groups of population suffered delays and interruptions of medical services, and the most vulnerable were the most affected. Immediate efforts are needed to reduce the backlog that HCSs incurred in.
Collapse
Affiliation(s)
- Maria Rosaria Gualano
- University of Turin, Department of Public Health Sciences and Paediatrics, Turin, Italy
| | - Alessio Corradi
- University of Turin, Department of Public Health Sciences and Paediatrics, Turin, Italy
| | - Gianluca Voglino
- University of Turin, Department of Public Health Sciences and Paediatrics, Turin, Italy.
| | - Fabrizio Bert
- University of Turin, Department of Public Health Sciences and Paediatrics, Turin, Italy; AOU City of Health and Science of Turin, Turin, Italy
| | - Roberta Siliquini
- University of Turin, Department of Public Health Sciences and Paediatrics, Turin, Italy; AOU City of Health and Science of Turin, Turin, Italy
| |
Collapse
|
44
|
Riera R, Bagattini ÂM, Pacheco RL, Pachito DV, Roitberg F, Ilbawi A. Delays and Disruptions in Cancer Health Care Due to COVID-19 Pandemic: Systematic Review. JCO Glob Oncol 2021; 7:311-323. [PMID: 33617304 PMCID: PMC8081532 DOI: 10.1200/go.20.00639] [Citation(s) in RCA: 256] [Impact Index Per Article: 85.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
PURPOSE There has been noteworthy concern about the impact of COVID-19 pandemic on health services including the management of cancer. In addition to being considered at higher risk for worse outcomes from COVID-19, people with cancer may also experience disruptions or delays in health services. This systematic review aimed to identify the delays and disruptions to cancer services globally. METHODS This is a systematic review with a comprehensive search including specific and general databases. We considered any observational longitudinal and cross-sectional study design. The selection, data extraction, and methodological assessment were performed by two independent reviewers. The methodological quality of the studies was assessed by specific tools. The delays and disruptions identified were categorized, and their frequency was presented. RESULTS Among the 62 studies identified, none exhibited high methodological quality. The most frequent determinants for disruptions were provider- or system-related, mainly because of the reduction in service availability. The studies identified 38 different categories of delays and disruptions with impact on treatment, diagnosis, or general health service. Delays or disruptions most investigated included reduction in routine activity of cancer services and number of cancer surgeries; delay in radiotherapy; and delay, reschedule, or cancellation of outpatient visits. Interruptions and disruptions largely affected facilities (up to 77.5%), supply chain (up to 79%), and personnel availability (up to 60%). CONCLUSION The remarkable frequency of delays and disruptions in health care mostly related to the reduction of the COVID-19 burden unintentionally posed a major risk on cancer care worldwide. Strategies can be proposed not only to mitigate the main delays and disruptions but also to standardize their measurement and reporting. As a high number of publications continuously are being published, it is critical to harmonize the upcoming reports and constantly update this review.
Collapse
Affiliation(s)
- Rachel Riera
- Centre of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, Brazil.,Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.,Oxford-Brazil EBM Alliance, Petrópolis, Brazil
| | | | - Rafael Leite Pacheco
- Centre of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, Brazil.,Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.,Oxford-Brazil EBM Alliance, Petrópolis, Brazil.,Centro Universitário São Camilo, São Paulo, Brazil
| | | | - Felipe Roitberg
- Instituto do Câncer do Estado de São Paulo/HCFMUSP, São Paulo, Brazil.,Department of Noncommunicable Diseases, World Health Organization (WHO), Geneva, Switzerland.,European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - Andre Ilbawi
- Department of Noncommunicable Diseases, World Health Organization (WHO), Geneva, Switzerland
| |
Collapse
|
45
|
Levkovich I, Shinan-Altman S, Essar Schvartz N, Alperin M. Depression and Health-Related Quality of Life Among Elderly Patients during the COVID-19 Pandemic in Israel: A Cross-sectional Study. J Prim Care Community Health 2021; 12:2150132721995448. [PMID: 33576290 PMCID: PMC7883147 DOI: 10.1177/2150132721995448] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/20/2020] [Accepted: 01/23/2021] [Indexed: 12/14/2022] Open
Abstract
AIM This study aims to assess how optimism, social support, and perceived susceptibility are associated with depressive symptoms and health-related quality of life among elderly patients during the COVID-19 pandemic in Israel. METHODS In a cross-sectional study, 256 participants age 60 through 95 completed the following self-administered questionnaires: Perceived Susceptibility, Life Orientation Test (LOT-R), Multidimensional Scale of Perceived Social Support (MSPSS), Symptoms of Depression (CES-D) and health-related quality of life (SF-12v2 Health Survey). Data were collected from June to July 2020, 3 months after the COVID-19 state of emergency was declared in Israel. Participants were interviewed by family medicine residents via telephone. Statistical analyses included Pearson correlations, t-tests between groups, regression analyses, and Hayes' PROCESS to analyze a moderated mediation model. RESULTS Of the elderly participants, 37.5% were classified as having depression. Optimism, social support and health-related quality of life were positively associated. Higher optimism and social support were related to lower perceived susceptibility and lower depression. Results of a multivariate regression explained 29% of the variance in depression and 19% of the variance in health-related quality of life. The relationships assessed by 4 Process models were significant, such that higher optimism and social support were related to lower perceived susceptibility, which in turn was related to higher depression and lower health-related quality of life. CONCLUSIONS Optimism and social support may be effective in coping with challenges and buffering depression. Perceived susceptibility may mediate the association of optimism and social support with higher depression and lower health-related quality of life. The conclusions of this study underscore the need to treat depression among older adults during this period. Hence, healthcare providers should also support elderly patients living at home. In giving this type of help, healthcare providers should strive to increase social support and optimism among older adults.
Collapse
Affiliation(s)
| | | | | | - Mordechai Alperin
- Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel
| |
Collapse
|
46
|
Inbar L, Shinan-Altman S. Emotional reactions and subjective health status during the COVID-19 pandemic in Israel: the mediating role of perceived susceptibility. PSYCHOL HEALTH MED 2020; 26:75-84. [PMID: 33315513 DOI: 10.1080/13548506.2020.1858490] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The general consensus is that COVID-19, the virus spreading rapidly across the globe, affects physical health but also mental health and mental well-being. This study aimed to assess the associations among emotional reactions toward COVID-19, knowledge about COVID-19, perceived susceptibility to this disease, and subjective health status. This study was a cross-sectional study conducted among 1,085 Israeli adults who completed an online survey between April 23 and May 5, 2020. The self-administered questionnaire included questions about emotional reactions to COVID-19, knowledge about COVID-19, perceived susceptibility, subjective health status, and sociodemographic variables. Participants (aged 18-96) reported high levels of emotional reactions to COVID-19. Most respondents were worried (77.4%), afraid (62.8%) or stressed (55.3%). Emotional reaction scores were higher among women than among men. In the regression model, emotional reactions were higher for older participants, those who rated their subjective health status as poorer, and those who were employed, with the final model explaining 11.6% of the variance in emotional reactions. Perceived susceptibility significantly mediated the relationship between subjective health status and emotional reactions. The high prevalence of emotional responses among women, older people and those with lower subjective health ratings points to the need for intervention programs primarily targeting these groups.
Collapse
Affiliation(s)
- Levkovich Inbar
- Faculty of Graduate Studies, Oranim Academic College of Education , Kiryat Tiv'on, Israel
| | - Shiri Shinan-Altman
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University , Ramat Gan, Israel
| |
Collapse
|
47
|
Isautier JM, Copp T, Ayre J, Cvejic E, Meyerowitz-Katz G, Batcup C, Bonner C, Dodd R, Nickel B, Pickles K, Cornell S, Dakin T, McCaffery KJ. People's Experiences and Satisfaction With Telehealth During the COVID-19 Pandemic in Australia: Cross-Sectional Survey Study. J Med Internet Res 2020; 22:e24531. [PMID: 33156806 PMCID: PMC7732356 DOI: 10.2196/24531] [Citation(s) in RCA: 126] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/25/2020] [Accepted: 10/31/2020] [Indexed: 12/22/2022] Open
Abstract
Background In response to the COVID-19 pandemic, telehealth has rapidly been adopted to deliver health care services around the world. To date, studies have not compared people’s experiences with telehealth services during the pandemic in Australia to their experiences with traditional in-person visits. Objective This study aimed to compare participants’ perceptions of telehealth consults to their perceptions of traditional in-person visits and investigate whether people believe that telehealth services would be useful after the pandemic. Methods A national, cross-sectional, community survey was conducted between June 5 and June 12, 2020 in Australia. In total, 1369 participants who were aged ≥18 years and lived in Australia were recruited via targeted advertisements on social media (ie, Facebook and Instagram). Participants responded to survey questions about their telehealth experience, which included a free-text response option. A generalized linear model was used to estimate the adjusted relative risks of having a poorer telehealth experience than a traditional in-person visit experience. Content analysis was performed to determine the reasons why telehealth experiences were worse than traditional in-person visit experiences. Results Of the 596 telehealth users, the majority of respondents (n=369, 61.9%) stated that their telehealth experience was “just as good as” or “better than” their traditional in-person medical appointment experience. On average, respondents perceived that telehealth would be moderately useful to very useful for medical appointments after the COVID-19 pandemic ends (mean 3.67, SD 1.1). Being male (P=.007), having a history of both depression and anxiety (P=.016), and lower patient activation scores (ie, individuals’ willingness to take on the role of managing their health/health care) (P=.036) were significantly associated with a poor telehealth experience. In total, 6 overarching themes were identified from free-text responses for why participants’ telehealth experiences were poorer than their traditional in-person medical appointment experiences, as follows: communication is not as effective, limitations with technology, issues with obtaining prescriptions and pathology results, reduced confidence in their doctor, additional burden for complex care, and inability to be physically examined. Conclusions Based on our sample’s responses, telehealth appointment experiences were comparable to traditional in-person medical appointment experiences. Telehealth may be worthwhile as a mode of health care delivery while the pandemic continues, and it may continue to be worthwhile after the pandemic.
Collapse
Affiliation(s)
- Jennifer Mj Isautier
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Tessa Copp
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Julie Ayre
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Erin Cvejic
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Gideon Meyerowitz-Katz
- Population Wellbeing and Environment Research Lab, School of Health and Society, University of Wollongong, Wollongong, Australia.,Western Sydney Diabetes, Western Sydney Local Health District, Sydney, Australia
| | - Carys Batcup
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Carissa Bonner
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Rachael Dodd
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Brooke Nickel
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Kristen Pickles
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Samuel Cornell
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Thomas Dakin
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - Kirsten J McCaffery
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| |
Collapse
|
48
|
Levkovich I. The Impact of Age on Negative Emotional Reactions, Compliance With Health Guidelines, and Knowledge About the Virus During the COVID-19 Epidemic: A Longitudinal Study From Israel. J Prim Care Community Health 2020; 11:2150132720981540. [PMID: 33349117 PMCID: PMC7758568 DOI: 10.1177/2150132720981540] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 01/11/2023] Open
Abstract
In a longitudinal study we examined the impact of age on negative emotional reactions, compliance with health guidelines and knowledge about the virus during the COVID-19 epidemic. A total of 2509 people participated in a two-phase study: 1424 participants in the first phase (March 12-21) and 1085 participants in the second phase (April 23 to May 5). Age was categorized into 4 groups: age 18 to 30, age 31 to 40, age 41 to 50, and age 51 and over. In the first and second phase, compliance with health guidelines was highest among participants over the age of 50. Knowledge was significantly higher in the second phase than in the first among participants over age 50 and those between the ages of 40 and 50. In the second phase, knowledge did not differ by age group. Negative emotional reactions were significantly higher in the first phase than in the second. Moreover, negative emotional reactions were higher among participants up to age 30 than among all other participants. Perceived susceptibility did not differ by phase or by age group. The paper underscores the impact of age during the COVID-19 epidemic and points to the necessity of taking the needs of different age groups into consideration.
Collapse
Affiliation(s)
- Inbar Levkovich
- Faculty of Graduate Studies, Oranim
Academic College of Education, Kiryat Tiv’on, Israel
| |
Collapse
|