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Cornall G, Zhao E, Luckett T, Erciyas E, Monck D, Glare P, Wang A, Lee YC. Management of pain in cancer patients- lessons from practices during the COVID-19: a qualitative study of cancer care providers' perspectives. BMC Health Serv Res 2024; 24:232. [PMID: 38388905 PMCID: PMC10885360 DOI: 10.1186/s12913-024-10710-z] [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: 09/13/2023] [Accepted: 02/12/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The ongoing COVID-19 pandemic has impacted health systems globally and affected managing many chronic conditions, including cancer. This study aimed to explore the perceptions of multi-disciplinary cancer care providers on how cancer pain management was affected by the COVID-19 pandemic. METHODS Participants were eligible if they were cancer care providers of any specialty and discipline from two tertiary hospitals in Australia. Data were collected using semi-structured interviews to explore cancer care providers' perspectives on cancer pain management within COVID-19. Thematic analysis of interview transcripts used an integrated approach that started with inductive coding before coding deductively against a behaviour framework called the COM-B Model, which proposes that 'capability', 'motivation' and 'opportunity' are requisites for any behaviour. RESULTS Twenty-three providers participated. Five themes were developed and interpreted from the analysis of data, namely: "Telehealth enables remote access to cancer pain management but also created a digital divide", "Access to cancer pain management in the community is compromised due to the pandemic", "COVID-19 negatively impacts hospital resource allocation", "Patients were required to trade off cancer pain management against other health priorities" and "Hospital restrictions result in decreased social and psychological support for patients with cancer pain". CONCLUSIONS The landscape of cancer pain management in the Australian health system underwent substantial shifts during the COVID-19 pandemic, with lasting impacts. Cancer care providers perceived the pandemic to have significant adverse effects on pain management across multiple levels, with repercussions for patients experiencing cancer-related pain. A more adaptive health system model needs to be established in the future to accommodate vulnerable cancer patients.
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Affiliation(s)
- Georgina Cornall
- Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Emma Zhao
- Sydney Nursing School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia.
- Department of Anaesthetics and Pain Management Centre, Royal Prince Alfred Hospital, Sydney, Australia.
- Department of Anaesthesia and Pain Service, Chris O'Brien Lifehouse, Sydney, Australia.
| | - Tim Luckett
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia
| | - Ertugrul Erciyas
- Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - David Monck
- Department of Anaesthetics and Pain Management Centre, Royal Prince Alfred Hospital, Sydney, Australia
| | - Paul Glare
- Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Andy Wang
- Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
- Department of Anaesthetics and Pain Management Centre, Royal Prince Alfred Hospital, Sydney, Australia
- Department of Anaesthesia and Pain Service, Chris O'Brien Lifehouse, Sydney, Australia
| | - Yi-Ching Lee
- Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
- Department of Anaesthetics and Pain Management Centre, Royal Prince Alfred Hospital, Sydney, Australia
- Department of Anaesthesia and Pain Service, Chris O'Brien Lifehouse, Sydney, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia
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Mabire-Yon R, Le Bonniec A, Arnaud S, Préau M. Organization of psychosocial factors associated with worry about acquiring SARS-CoV-2 among women undergoing cancer treatment: an empirical network comparison approach. J Psychosoc Oncol 2023; 42:315-332. [PMID: 37632453 DOI: 10.1080/07347332.2023.2246126] [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] [Indexed: 08/28/2023]
Abstract
OBJECTIVES Pandemic-induced anxiety can have adverse mental and somatic health consequences on cancer patients (CP). This study aimed to (1) explore the intricate relationships between worry related to potential SARS-CoV-2 infection, COVID-19 perception, sociodemographic factors, and the perceived effectiveness of lockdown measures and (2) investigate if these relationships differ between cancer patients and individuals without a history of cancer (IWHC). METHODS We conducted a cross-sectional quantitative study in France between December 1 and 14, 2020. Network analysis was employed on a sample of 1889 women, including 282 cancer patients and 1607 noncancer individuals. RESULTS Our findings indicate that CP were 20% more likely to express worry than IWHC. Anxiety is embedded within a complex network involving sociodemographic, cognitive, and emotional factors. The emotional components related to COVID-19 perception were found to play a crucial role. The networks for both groups were observed to be identical. CONCLUSIONS Our study underscores the heightened vulnerability of cancer patients to pandemic-induced anxiety, emphasizing the crucial role of emotional components related to COVID-19 perception. The observed similarities in the anxiety network between cancer patients and those without a history of cancer suggest that universal approaches might be effective across groups. IMPLICATIONS Utilizing the Causal Attitude Network Model, we propose potential methods for managing and reducing individual anxiety levels.
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Affiliation(s)
- Renaud Mabire-Yon
- Unit Inserm U1296, Radiations: Defense, Health and Environment, Institute of Psychology - University Lumière Lyon 2, Bron, France
| | - Alice Le Bonniec
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Siméone Arnaud
- Unit Inserm U1296, Radiations: Defense, Health and Environment, Institute of Psychology - University Lumière Lyon 2, Bron, France
| | - Marie Préau
- Unit Inserm U1296, Radiations: Defense, Health and Environment, Institute of Psychology - University Lumière Lyon 2, Bron, France
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Kenny K, Williams Veazey L, Broom A, Peterie M, Page A, Prainsack B, Wakefield CE, Itchins M, Khasraw M, Lwin Z. Hope in the era of precision oncology: a qualitative study of informal caregivers' experiences. BMJ Open 2023; 13:e065753. [PMID: 37130677 PMCID: PMC10163471 DOI: 10.1136/bmjopen-2022-065753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVES To explore informal caregivers' perspectives on precision medicine in cancer care. DESIGN Semi-structured interviews with the informal caregivers of people living with cancer and receiving targeted/immunotherapies. Interview transcripts were analysed thematically using a framework approach. SETTING Recruitment was facilitated by two hospitals and five Australian cancer community groups. PARTICIPANTS Informal caregivers (n=28; 16 men, 12 women; aged 18-80) of people living with cancer and receiving targeted/immunotherapies. RESULTS Thematic analysis identified three findings, centred largely on the pervasive theme of hope in relation to precision therapies including: (1) precision as a key component of caregivers' hope; (2) hope as a collective practice between patients, caregivers, clinicians and others, which entailed work and obligation for caregivers; and (3) hope as linked to expectations of further scientific progress, even if there may be no personal, immediate benefit. CONCLUSIONS Innovation and change in precision oncology are rapidly reconfiguring the parameters of hope for patients and caregivers, creating new and difficult relational moments and experiences in everyday life and in clinical encounters. In the context of a shifting therapeutic landscape, caregivers' experiences illustrate the need to understand hope as collectively produced, as emotional and moral labour, and as entangled in broader cultural expectations of medical advances. Such understandings may help clinicians as they guide patients and caregivers through the complexities of diagnosis, treatment, emerging evidence and possible futures in the precision era. Developing a better understanding of informal caregivers' experiences of caring for patients receiving precision therapies is important for improving support to patients and their caregivers.
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Affiliation(s)
- Katherine Kenny
- Sydney Centre for Healthy Societies; School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Leah Williams Veazey
- Sydney Centre for Healthy Societies; School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Alex Broom
- Sydney Centre for Healthy Societies; School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Michelle Peterie
- Sydney Centre for Healthy Societies; School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Alexander Page
- Sydney Centre for Healthy Societies; School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Wien, Austria
| | - Claire E Wakefield
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine and Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW, Sydney, New South Wales, Australia
| | - Malinda Itchins
- Northern Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- Department of Medical Oncology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Mustafa Khasraw
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Zarnie Lwin
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
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Lupton D, Lewis S. Australians' experiences of COVID-19 during the early months of the crisis: A qualitative interview study. Front Public Health 2023; 11:1092322. [PMID: 36908481 PMCID: PMC9995885 DOI: 10.3389/fpubh.2023.1092322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction The COVID-19 crisis has wrought major changes to people's lives across the globe since the beginning of the outbreak in early 2020. The "Australians' Experiences of COVID-19" qualitative descriptive study was established to explore how Australians from different geographical areas and social groups experienced the COVID-19 crisis. Methods Three sets of semi-structured interviews, each with a diverse group of 40 adults across Australia, were completed between 2020 and 2022. This article reports findings from the first set of interviews, conducted by telephone in mid-2020. Results The participants discussed their experiences of living through this period, which was characterized by strong public health measures to contain the spread of COVID, including a national lockdown and border closures. Interview fieldnotes and verbatim transcripts were used to conduct an interpretive thematic analysis. The analysis is structured around the following five themes covering the quotidian and affective aspects of participants' lives in the early months of the COVID crisis: "disruption to routines;" "habituating to preventive measures;" "social isolation and loneliness;" "changes to work and education;" and "little change to life." A sixth theme concerns how participants responded to our question about what they imagined their lives would be like after the pandemic: "imagining post-COVID life." Discussion The crisis affected participants' experience of daily life variously according to such factors as their social circumstances and obligations as well as their histories of illness, making visible some of the unequal social and economic effects of the pandemic across different genders, ages, localities and socioeconomic groups. Our participants fell into three roughly equal groups: (i) those who found the lockdown and associated restrictions very difficult; (ii) those who reported feeling barely affected by these conditions; and (iii) those who found benefits to the "slowing down" of life during this period.
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Affiliation(s)
- Deborah Lupton
- Vitalities Lab, Centre for Social Research in Health, Social Policy Research Centre, UNSW Sydney, Kensington, NSW, Australia
| | - Sophie Lewis
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
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Dowling M, Eicher M, Drury A. Experiences of cancer care in COVID-19: A longitudinal qualitative study. Eur J Oncol Nurs 2022; 61:102228. [PMID: 36334337 PMCID: PMC9576914 DOI: 10.1016/j.ejon.2022.102228] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/09/2022] [Indexed: 11/25/2022]
Abstract
Purpose This study aimed to explore the cancer care experiences of people living with and beyond cancer during COVID-19 in Ireland. Methods The study adopted a longitudinal qualitative design using semi-structured interviews with sixteen participants. Interviews were undertaken on three occasions over six months (January–June 2021). The National Comprehensive Cancer Network Distress Thermometer (NCCN DT), and Connor-Davidson-Resilience Scale (CD-RISC2) were also used as part of the interviews to measure distress and resilience. Thematic analysis of interview data was conducted and participants' self-rating for distress and resilience was analysed using descriptive statistics. Results Sixteen patients participated. The findings revealed participants' constant fear of COVID-19 over time and efforts to stay safe by following the ‘rules’. Isolation was a common experience as COVID-19 restrictions resulted in being alone when attending the hospital for treatment and limited support from family and friends. Telephone follow-up was limited in terms of support and patients' opportunity to ask questions. For a minority, COVID-19 restrictions meant they were ‘not missing out’. On average, participants reported moderate to high levels of resilience at all time points. Distress scores were low but trended upwards from T1 to T2. Conclusions The findings highlight the need to avoid restrictions on carers accompanying their close relatives to the hospital for treatment. An evaluation of the effects of the rapid introduction of telephone follow-up on patient outcomes is warranted.
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Affiliation(s)
- Maura Dowling
- School of Nursing and Midwifery, National University of Ireland, University Road, Galway, Ireland,Corresponding author
| | - Manuela Eicher
- Department of Oncology, Lausanne University Hospital (CHUV), Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Amanda Drury
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
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Hou SHJ, Tran A, Cho S, Forbes C, Forster VJ, Stokoe M, Allapitan E, Wakefield CE, Wiener L, Heathcote LC, Michel G, Patterson P, Reynolds K, Schulte FSM. The Perceived Impact of COVID-19 on the Mental Health Status of Adolescent and Young Adult Survivors of Childhood Cancer and the Development of a Knowledge Translation Tool to Support Their Information Needs. Front Psychol 2022; 13:867151. [PMID: 35846688 PMCID: PMC9285488 DOI: 10.3389/fpsyg.2022.867151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022] Open
Abstract
Background Adolescent and young adult (AYA; 13 to 39 years) survivors of childhood cancer may be especially vulnerable to physical health and mental health concerns during the pandemic. We investigated the impact of COVID-19 on the mental health status of AYA survivors (Aim 1) and shared tailored, evidence-based health-related information on COVID-19 (Aim 2). Methods Between May and June 2020, participants completed a cross-sectional online survey assessing their cancer history, current mental health status, and their COVID-19 information needs. Results Ninety-four participants (78 females, 13 males, 2 non-binary) with a mean age of 26.9 years (SD = 6.2) were included in the final sample. Participants reported residing from 10 countries and 94% identified as White. Nearly half of the participants (49%) described their mental health status as worse now than before the pandemic. Thirty-nine participants (41%) that indicated their current mental health status was tied to fears/worries about their past cancer and treatment experienced a higher level of anxiety and PTSS than those who did not report the same. Most participants (77%) had not received any information related to the potential risks of COVID-19 and expressed an interest in receiving this information. In response, an infographic detailing recommended strategies for coping with mental health problems in the pandemic, along with preliminary study findings, was developed. Discussion AYA survivors reporting their mental health status was linked to their past cancer experienced poorer mental health. There is a value to educating survivors on their potential health risks, but accounting for their perceived mental health vulnerabilities should be considered when disseminating knowledge. The use of an infographic is a unique contribution towards the development of innovative and personalized means of sharing health education to this vulnerable yet resilient group. This research on the mental health status of AYA survivors very early in the pandemic informs continued initiatives investigating the rapidly changing nature of how COVID-19 may impact AYA survivors today and in the future.
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Affiliation(s)
- Sharon H J Hou
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Psychology, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Andrew Tran
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sara Cho
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Caitlin Forbes
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Mehak Stokoe
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Elleine Allapitan
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Claire E Wakefield
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Lori Wiener
- Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD, United States
| | - Lauren C Heathcote
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Gisela Michel
- Department Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Pandora Patterson
- Research, Evaluation and Policy Unit, Canteen Australia, Sydney, NSW, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Kathleen Reynolds
- Long Term Survivor's Clinic, Alberta Children's Hospital, Calgary, AB, Canada.,Department of Medicine, Faculty of Family Medicine, University of Calgary, Calgary, AB, Canada
| | - Fiona S M Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Long Term Survivor's Clinic, Alberta Children's Hospital, Calgary, AB, Canada
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