The impact of unmet community service demand on the loneliness of older adults: based on CLHLS (2008-2018)

PURPOSE

To explore the impact of unmet community service demands on loneliness among older adults.

METHODS

Based on the longitudinal tracking data of CLHLS (2008-2018), latent growth curve model (LGCM) was used to describe the trajectory of loneliness among older adults. Panel regression was used to analyze the impact of unmet community service demands on loneliness, and latent classification analysis (LCA) was used to classify the older adults and analyze the differences in loneliness among different types of older adults.

RESULTS

A total of 1445 older people participated in all four surveys, and 22.4% of them reported feeling lonely. From 2008 to 2018, there was a significant non-linear increase in loneliness, with average values of 1.77, 1.81, 1.83, and 1.96, respectively. The level of community service supply (1.31) was far from meeting the demand level (5.11). Unmet community service demands were associated with a higher prevalence of loneliness (β = 0.012, P = 0.003, 95% CI = [0.004, 0.020]). In addition, according to the demand difference for community services, older adults were classified into the comprehensive demand type (Type I) and the medical demand type (Type II). The loneliness of Type I older adults was significantly higher than that of Type II (P < 0.05).

CONCLUSIONS

With the passage of time, loneliness of older adults is showing an accelerating upward trend. Unmet community services can lead to enhanced loneliness among older adults, and the higher the demand for community services, the stronger the loneliness. The government should increase the supply of community services to meet the basic and socio-emotional needs of the older adults to reduce loneliness.

Remote Relaxation and Acceptance Training for the Management of Stress in Cancer Patients: A Study Protocol

Background: Cancer patients are now facing a double distinctive challenge of survival against both the disease and fear of contracting COVID-19. This challenge has resulted in the forced adoption of social distancing measures and reorganization of the delivery of medical and psychological treatments. The perceived loneliness and uncertainty increased distress and symptoms burden. In the current period, eHealth interventions might provide valuable benefits in the field of cancer care. Objective: The overall goal of the study protocol will be to provide an innovative intervention for cancer patients based on an online platform, to help them manage and prevent psychological problems related to social isolation. Specifically, the efficacy of two web-based interventions aimed at lowering stress in cancer patients will be tested and compared. Methods: One hundred and fifty participants (75 per group) will be enrolled in a two-group randomized trial. The two interventions will be composed either by exercises on relaxation and meditation practices, presented in both automated online content and interactive group sessions or by fixed psychoeducational online content. Stress, anxiety, and depressive symptoms, distress, resilience, and perceived social isolation will be measured before the start of the interventions (T0), 2 weeks (T1), 4 weeks (T2), and 2 months (T3) after the beginning of the interventions in both groups. A repeated measures ANOVA will be performed to test differences in the questionnaires' scores between groups across the four-time points. Expected Results: We hypothesized greater improvement in the specific domain of stress symptoms (IES-R) assessed in the group receiving the interactive intervention, compared to the group which will receive only fully automated psychoeducational content. Secondarily, we expect the same trend of improvement across all the psychological variables in the blended intervention group. Conclusions: Implementing these practices on people who are forced into mandatory social isolation may help them become more aware of their mind-body condition and reduce negative effects. Moreover, relaxation techniques help individuals in achieving a greater state of well-being, increasing the ability to cope with stressful situations (resilience), and strengthening the immune system.

Chemotherapy in the Covid-19 era: the patient's perception

Background

The Covid-19 pandemic poses significant challenges for the management of patients with cancer. In our institution, we adapted our delivery of outpatient systemic anti-cancer therapy (SACT) by introducing a number of ‘risk-reducing’ measures including pre-assessment screening.

Aims

We sought to evaluate the experience and perceptions of patients with cancer undergoing SACT during the Covid-19 pandemic.

Methods

Patients on SACT during the Covid-19 pandemic were eligible for participation. Data were collected by anonymous survey over a 1 week period during the most intensive phase of government restrictions. Patients were asked questions under three headings: perceived risk of infection exposure, changes to treatment plan and psychological impact of Covid-19.

Results

One hundred patients were assessed, 60% were male, 41% were > 65 years of age and 67% had advanced cancer. Eleven percent of patients were living alone. Fifty-seven percent reported feeling at increased risk in general of contracting Covid-19. Sixty-eight percent of patients did not feel worried about contracting Covid-19 in the hospital. Ninety-two percent of patients reported wanting to continue on SACT as originally planned. Fifty-eighty percent felt isolated and 40% reported increased anxiety.

Conclusion

Though patients on active treatment for cancer during the Covid-19 pandemic reported increased anxiety and feelings of isolation due to Covid-19, the majority of patients wanted to continue SACT as originally planned. Patients would benefit from enhanced psycho-oncological supports in the event of a prolonged Covid-19 pandemic.

Recommendations for triage, prioritization and treatment of breast cancer patients during the COVID-19 pandemic

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) associated disease (COVID-19) outbreak seriously challenges globally all health care systems and professionals. Expert projections estimate that despite social distancing and lockdown being practiced, we have yet to feel the full impact of COVID-19. In this manuscript we provide guidance to prepare for the impact of COVID-19 pandemic on breast cancer patients and advise on how to triage, prioritize and organize diagnostic procedures, surgical, radiation and medical treatments.

Oncology during the COVID-19 pandemic: challenges, dilemmas and the psychosocial impact on cancer patients

COVID-19 has caused unprecedented societal turmoil, triggering a rapid, still ongoing, transformation of healthcare provision on a global level. In this new landscape, it is highly important to acknowledge the challenges this pandemic poses on the care of the particularly vulnerable cancer patients and the subsequent psychosocial impact on them. We have outlined our clinical experience in managing patients with gastrointestinal, hematological, gynaecological, dermatological, neurological, thyroid, lung and paediatric cancers in the COVID-19 era and have reviewed the emerging literature around barriers to care of oncology patients and how this crisis affects them. Moreover, evolving treatment strategies and novel ways of addressing the needs of oncology patients in the new context of the pandemic are discussed.