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Alsahli S, Hor SY, Lam M. Factors Influencing the Acceptance and Adoption of Mobile Health Apps by Physicians During the COVID-19 Pandemic: Systematic Review. JMIR Mhealth Uhealth 2023; 11:e50419. [PMID: 37938873 PMCID: PMC10666016 DOI: 10.2196/50419] [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: 06/30/2023] [Revised: 09/13/2023] [Accepted: 10/04/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the provision of and access to health care have been uniquely challenging, particularly during lockdowns or when dealing with COVID-19 cases. Health care professionals have had to provide patients with the necessary health care. However, delivering health care services while reducing face-to-face interaction puts an immense strain on health systems that are already overburdened. Against this backdrop, it is now more critical than ever to ensure the accessibility of health care services. Such access has been made increasingly available through mobile health (mHealth) apps. These apps have the potential to significantly improve health care outcomes and expectations and address some of the challenges confronting health care systems worldwide. Despite the advantages of mHealth, its acceptance and adoption remain low. Hence, health care organizations must consider the perceptions and opinions of physicians if the technology is to be successfully implemented. OBJECTIVE The objective of this systematic review was to explore and synthesize the scientific literature on the factors influencing the acceptance and adoption of mHealth among physicians during the COVID-19 pandemic. METHODS A systematic review of the studies published between March 2020 and December 2022 was conducted using the MEDLINE, Scopus, Embase, and ProQuest databases. The database search yielded an initial sample of 455 potential publications for analysis, of which 9 (2%) met the inclusion criteria. The methodology of this review was based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). RESULTS The factors influencing mHealth acceptance and adoption by physicians were divided into perceived barriers and perceived facilitators, which were further grouped into the following 3 major thematic categories: technological, individual, and organizational barriers and facilitators, respectively. The technological barriers were accessibility, technical issues, usefulness, and data management; individual barriers were perceived patient barriers, time and workload pressure, technical literacy, knowledge of mHealth, and peer support; and organizational barriers were financial factors, management support and engagement, data security, telemonitoring policy, and collaboration. The technological facilitators of uptake were technical factors, clinical usefulness, and data management; individual facilitators were patient-related care, intrinsic motivation, collaboration, and data sharing (individual); and organizational facilitators were workflow-related determinants, organizational financial support, recommendation of mHealth services, and evidence-based guidelines. CONCLUSIONS This review summarized the evidence on the factors influencing mHealth acceptance and adoption by physicians during the COVID-19 pandemic. The main findings highlighted the importance of addressing organizational readiness to support physicians with adequate resources, shifting the focus from technological to patient-centered factors, and the seamless integration of mHealth into routine practice during and beyond the pandemic. TRIAL REGISTRATION PROSPERO CRD42022356125; https://tinyurl.com/2mmhn5yu.
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Affiliation(s)
- Sultan Alsahli
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
- Department of Health Information Technology and Management, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Su-Yin Hor
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Mary Lam
- Department of Health and Biomedical Sciences, STEM College, RMIT University, Melbourne, Australia
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Lewnard JA, B CM, Kang G, Laxminarayan R. Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city. Nat Commun 2023; 14:3563. [PMID: 37322091 PMCID: PMC10272147 DOI: 10.1038/s41467-023-39322-7] [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: 05/18/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023] Open
Abstract
Globally, excess deaths during 2020-21 outnumbered documented COVID-19 deaths by 9.5 million, primarily driven by deaths in low- and middle-income countries (LMICs) with limited vital surveillance. Here we unravel the contributions of probable COVID-19 deaths from other changes in mortality related to pandemic control measures using medically-certified death registrations from Madurai, India-an urban center with well-functioning vital surveillance. Between March, 2020 and July, 2021, all-cause deaths in Madurai exceeded expected levels by 30% (95% confidence interval: 27-33%). Although driven by deaths attributed to cardiovascular or cerebrovascular conditions, diabetes, senility, and other uncategorized causes, increases in these attributions were restricted to medically-unsupervised deaths, and aligned with surges in confirmed or attributed COVID-19 mortality, likely reflecting mortality among unconfirmed COVID-19 cases. Implementation of lockdown measures was associated with a 7% (0-13%) reduction in all-cause mortality, driven by reductions in deaths attributed to injuries, infectious diseases and maternal conditions, and cirrhosis and other liver conditions, respectively, but offset by a doubling in cancer deaths. Our findings help to account for gaps between documented COVID-19 mortality and excess all-cause mortality during the pandemic in an LMIC setting.
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Affiliation(s)
- Joseph A Lewnard
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
- Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
- Center for Computational Biology, College of Engineering, University of California, Berkeley, Berkeley, CA, USA.
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Bal P, Mantri N, Goel AD, Joshi NK, Jain YK, Pareek P, Gupta MK, Devnani B, Solanki A, Bhardwaj P. Challenges Faced by Cancer Patients in Receiving Health Services During the COVID-19 Pandemic in a Tertiary Care Hospital in Rajasthan. Cureus 2023; 15:e34491. [PMID: 36874300 PMCID: PMC9983044 DOI: 10.7759/cureus.34491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Amidst the COVID-19 pandemic, cancer patients may have faced difficulty accessing health care. This study explored the challenges experienced by cancer patients in availing of healthcare during the pandemic, as well as the vaccination status and prevalence of COVID-19 infection among cancer patients in the year 2021. METHOD A cross-sectional study was conducted in a tertiary care hospital in Jodhpur, Rajasthan, to interview 150 patients from the oncology department using convenience sampling. Face-to-face interviews lasted for 20-30 minutes. The first segment of the pretested semi-structured questionnaire was directed at obtaining the patient's socio-demographic characteristics, while the second segment focused on the problems that patients encountered during the pandemic in receiving cancer care. The data were analyzed using Statistical Packages for Social Sciences (SPSS) software (IBM Corp., Armonk, NY). RESULTS Several constraints, such as a lack of transportation services, difficulty in availing outpatient department (OPD) and teleconsultation services, long waiting times, and deferred surgeries and therapies, have hampered cancer care. COVID-19 mitigation measures further imposed additional stress and financial burden on cancer patients. Moreover, there was low vaccination coverage among cancer patients, which increases their probability of acquiring an infection. CONCLUSION Policy reforms must prioritize cancer care in India to maintain a continuum of care by ensuring medication, teleconsultation, uninterrupted treatment, and complete vaccination to decrease the risk of COVID-19 infection and facilitate patient compliance with the healthcare delivery system.
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Affiliation(s)
- Prasannajeet Bal
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Neha Mantri
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Akhil D Goel
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Nitin K Joshi
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Yogesh K Jain
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Puneet Pareek
- Radiation Oncology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Manoj K Gupta
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Bharti Devnani
- Radiation Oncology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Akanksha Solanki
- Radiation Oncology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Pankaj Bhardwaj
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
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Ma H, Zhao T, Wan C, Liu F, Christensen M. 'And I thought having a cancer diagnosis was hard': A descriptive phenomenological study of family caregiver experiences navigating the pre-hospital system during COVID-19. Eur J Oncol Nurs 2023; 62:102255. [PMID: 36603492 PMCID: PMC9763208 DOI: 10.1016/j.ejon.2022.102255] [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: 10/20/2022] [Revised: 11/30/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Cancer patients usually need frequent hospitalization for diagnosis and treatment. However, the unprecedented outbreak of the Omicron wave in Shanghai pressured local communities and hospitals to enforce strict control measures. This qualitative study aimed to investigate cancer family caregivers' experiences of navigating the pre-hospital system during the lockdown in Shanghai. METHOD This is a substudy of a larger study investigating the experience of 20 caregivers of hospitalized cancer patients during the lockdown in Shanghai. This study was based on findings from a subset of 14 semi-structured face-to-face interviews with cancer family caregivers. Inductive thematic analysis was used to analyze the data. RESULTS The outbreak of the epidemic and lockdown measures created additional challenges for caregivers, which extended beyond their daily concerns. Uncertainties of the situation, risks of infection, and income loss, along with the strict restrictions in their community and hospitals, added to their burden and compromised their abilities to seek help for their significant others. Yet, in an attempt to reduce undue concern and worry, caregivers were eventually allowed to accompany their family member to the hospital using reliable information, and telemedicine techniques based on an updated governmental policy governing access to care and support for cancer patients. CONCLUSIONS The lockdown in Shanghai significantly affected cancer family caregivers' experience navigating the pre-hospital system. Policy support for cancer care, reliable information, and telemedicine techniques have been identified as essential facilitators of improved access to cancer care.
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Affiliation(s)
- Haixia Ma
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China,The Interdisciplinary Centre for Qualitative Research, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Tuan Zhao
- Department of Hepatobiliary Medicine, Third Affiliated Hospital of Naval Medical University, Shanghai, 200438, China
| | - Chuchu Wan
- Department of Hepatobiliary Medicine, Third Affiliated Hospital of Naval Medical University, Shanghai, 200438, China
| | - Fang Liu
- Department of Nursing, Third Affiliated Hospital of Naval Medical University, Shanghai, 200438, China.
| | - Martin Christensen
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China; The Interdisciplinary Centre for Qualitative Research, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
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Niyigena A, Cubaka VK, Uwamahoro P, Mutsinzi RG, Uwizeye B, Mukamasabo B, Shyirambere C, Bigirimana BJ, Mubiligi J, Barnhart DA. Impact of facilitating continued accessibility to cancer care during COVID-19 lockdown on perceived wellbeing of cancer patients at a rural cancer center in Rwanda. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001534. [PMID: 36963043 PMCID: PMC10021873 DOI: 10.1371/journal.pgph.0001534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/01/2023] [Indexed: 03/03/2023]
Abstract
During the COVID-19 pandemic in Rwanda, Partners In Health Inshuti Mu Buzima collaborated with the Butaro Cancer Center of Excellence (BCCOE) to mitigate disruptions to cancer care by providing patients with free transportation to treatment sites and medication delivery at patients' local health facilities. We assessed the relationship between facilitated access to care and self-reported wellbeing outcomes. This cross-sectional telephone survey included cancer patients enrolled at BCCOE in March 2020. We used linear regression to compare six dimensions of quality of life (EORTC QLQ-C30), depression (PHQ-9), anxiety (GAD-7), and financial toxicity (COST) among patients who did and did not receive facilitated access to care. We also assessed access to cancer care and whether patient wellbeing and its association with facilitated access to care differed by socioeconomic status. Of 214 respondents, 34.6% received facilitated access to care. Facilitated patients were more likely to have breast cancer and be on chemotherapy. Facilitation was significantly associated with more frequent in-person clinical encounters, improved perceived quality of cancer care, and reduced transportation-related barriers. Facilitated patients had significantly better global health status (β = 9.14, 95% CI: 2.3, 16.0, p <0.01) and less financial toxicity (β = 2.62, 95% CI: 0.2,5.0, p = 0.03). However, over half of patients reported missing or delaying appointment. Patient wellbeing was low overall and differed by patient socioeconomic status, with poor patients consistently showing worse outcomes. Socioeconomic status did not modify the association between facilitated access to care and wellbeing indicators. Further, facilitation did not lead to equitable wellbeing outcomes between richer and poorer patients. Facilitated access to care during COVID-19 pandemic was associated with some improvements in access to cancer care and patient wellbeing. However, cancer patients still experienced substantial disruptions to care and reported low overall levels of wellbeing, with socioeconomic disparities persisting despite facilitated access to care. Implementing more robust, equity-minded facilitation and better patient outreach programs during health emergencies may promote better care and strengthen patient care overall and effect better patients' outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Dale A Barnhart
- Partners In Health, Kigali, Rwanda
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
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Zagouri F, Papatheodoridi A, Liontos M, Briasoulis A, Sklirou AD, Skafida E, Fiste O, Markellos C, Andrikopoulou A, Koutsoukos K, Kaparelou M, Gkogkou E, Trougakos IP, Dimopoulos MA, Terpos E. Assessment of Postvaccination Neutralizing Antibodies Response against SARS-CoV-2 in Cancer Patients under Treatment with Targeted Agents. Vaccines (Basel) 2022; 10:vaccines10091474. [PMID: 36146552 PMCID: PMC9505348 DOI: 10.3390/vaccines10091474] [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: 07/11/2022] [Revised: 08/27/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
The administration of a third dose of a vaccine against SARS-CoV-2 has increased protection against disease transmission and severity. However, the kinetics of neutralizing antibodies against the virus has been poorly studied in cancer patients under targeted therapies. Baseline characteristics and levels of neutralizing antibodies at specific timepoints after vaccination were compared between patients suffering from breast, ovarian or prostate cancer and healthy individuals. Breast cancer patients were treated with cyclin D kinase 4/6 inhibitors and hormonal therapy, ovarian cancer patients were treated with poly (ADP-ribose) polymerase inhibitors and prostate cancer patients were treated with an androgen receptor targeted agent. Levels of neutralizing antibodies were significantly lower in cancer patients compared to healthy individuals at all timepoints. Antibodies’ titers declined over time in both groups but remained above protective levels (>50%) at 6 months after the administration of the second dose. The administration of a third dose increased neutralizing antibodies’ levels in both groups. The titers of protective against SARS-CoV-2 antibodies wane over time and increase after a third dose in cancer patients under treatment.
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Affiliation(s)
- Flora Zagouri
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece
| | - Alkistis Papatheodoridi
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece
| | - Michalis Liontos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece
| | - Alexandros Briasoulis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece
| | - Aimilia D. Sklirou
- Section of Cell Biology and Biophysics, Department of Biology, School of Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15701 Athens, Greece
| | - Efthymia Skafida
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece
| | - Oraianthi Fiste
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece
| | - Christos Markellos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece
| | - Angeliki Andrikopoulou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece
| | - Konstantinos Koutsoukos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece
| | - Maria Kaparelou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece
| | - Eirini Gkogkou
- Section of Cell Biology and Biophysics, Department of Biology, School of Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15701 Athens, Greece
| | - Ioannis P. Trougakos
- Section of Cell Biology and Biophysics, Department of Biology, School of Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15701 Athens, Greece
| | - Meletios-Athanasios Dimopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece
| | - Evangelos Terpos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, 11528 Athens, Greece
- Correspondence:
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Murphy A, Kirby A, Lawlor A, Drummond FJ, Heavin C. Mitigating the Impact of the COVID-19 Pandemic on Adult Cancer Patients through Telehealth Adoption: A Systematic Review. SENSORS 2022; 22:s22093598. [PMID: 35591287 PMCID: PMC9105995 DOI: 10.3390/s22093598] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/27/2022] [Accepted: 05/02/2022] [Indexed: 11/16/2022]
Abstract
During the first wave of the COVID-19 pandemic, the delivery of life-saving and life-prolonging health services for oncology care and supporting services was delayed and, in some cases, completely halted, as national health services globally shifted their attention and resources towards the pandemic response. Prior to March 2020, telehealth was starting to change access to health services. However, the onset of the global pandemic may mark a tipping point for telehealth adoption in healthcare delivery. We conducted a systematic review of literature published between January 2020 and March 2021 examining the impact of the COVID-19 pandemic on adult cancer patients. The review's inclusion criteria focused on the economic, social, health, and psychological implications of COVID-19 on cancer patients and the availability of telehealth services emerged as a key theme. The studies reviewed revealed that the introduction of new telehealth services or the expansion of existing telehealth occurred to support and enable the continuity of oncology and related services during this extraordinary period. Our analysis points to several strengths and weaknesses associated with telehealth adoption and use amongst this cohort. Evidence indicates that while telehealth is not a panacea, it can offer a "bolstering" solution during a time of disruption to patients' access to essential cancer diagnostic, treatment, and aftercare services. The innovative use of telehealth has created opportunities to reimagine the delivery of healthcare services beyond COVID-19.
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Affiliation(s)
- Aileen Murphy
- Department of Economics, Cork University Business School, University College Cork, T12 CY82 Cork, Ireland; (A.M.); (A.K.); (A.L.)
| | - Ann Kirby
- Department of Economics, Cork University Business School, University College Cork, T12 CY82 Cork, Ireland; (A.M.); (A.K.); (A.L.)
| | - Amy Lawlor
- Department of Economics, Cork University Business School, University College Cork, T12 CY82 Cork, Ireland; (A.M.); (A.K.); (A.L.)
| | | | - Ciara Heavin
- Department of Business Information Systems, Cork University Business School, University College Cork, T12 CY82 Cork, Ireland
- Correspondence:
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Empowerment of Primary Healthcare Providers on the Prevention and Management of Dental or Oral Health Issues among Postchemotherapy Patients in Pandemic. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:9087776. [PMID: 35310187 PMCID: PMC8930226 DOI: 10.1155/2022/9087776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/08/2022] [Indexed: 02/01/2023]
Abstract
Objectives. The study aim was to evaluate the empowerment of primary healthcare providers on the prevention and management of dental or oral health issues among postchemotherapy (PC) patients, in selected rural regions, India, during a pandemic. Methods. Initially, 240 PHPs were recruited by convenient and snow ball sampling with 90.3% response rate. A descriptive, cross-sectional study was adopted using a self-administered questionnaire with 5 sections: demographics, identification of dental/oral health issues, knowledge, attitude, and practice on prevention and management of dental/oral health problems in PC patients. Statistical Packages for Social Sciences (SPSS) version 23.0 was used for statistical analysis. Results. The overall knowledge was better among nurses (64.56%), followed by pharmacists (54.5%). 81.65% of PHPs were willing to learn more and expressed the need for collaboration with dentists. In the past 3 months, 18.81% of them had PC patients with dental/oral health issues, but only 3.5% of nurses and 0.8% of pharmacists treated them. The logistic regression model revealed higher scores in mucositis/mucosal pain (OR = 1.41), altered taste sensation (OR = 1.34), sensitive gums (OR = 1.71), and dental caries (OR = 1.32) domains (
). Those who had readiness to learn (OR = 5.37), nurses and pharmacists, and having less years of experience (OR = 1.31) and higher degree (OR = 1.4) had a positive attitude (
). Conclusion. PHPs had limited empowerment in terms of knowledge and practice but showed a positive attitude toward the prevention and management of dental/oral health issues of PC patients. For better practice, continuing education and collaboration with dental professionals is essential.
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Challinor J, Sierra MFO, Burns K, Young A. Oncology nursing in the Global South during COVID-19. Ecancermedicalscience 2022; 15:1329. [PMID: 35211198 PMCID: PMC8816499 DOI: 10.3332/ecancer.2021.1329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Indexed: 11/06/2022] Open
Abstract
In mid-2020, a call was made to oncology nurses in the Global South to share their experiences managing patient care during the coronavirus disease 2019 (COVID-19) pandemic. Eighteen submissions were received from 16 countries across Latin America, Africa, Europe and Asia. Three were research-based and 15 were personal narratives on the psychosocial impact of COVID-19 on the nurses, colleagues, patients and families. Three narratives were from oncology nurses working with cancer-related non-governmental organisations locally or, in one case, internationally. A simultaneous literature search for publications (including grey literature) was performed to identify themes of COVID-19’s impact in these 16 countries and specifically on oncology nurses and patients/families. Four themes were identified: a) interruptions to care; b) support/resource shortages; c) psychosocial impact on nurses and patients and d) staffing and nursing role impacts. The three research-based studies describe oncology nursing in-depth efforts to explore the impact of COVID-19. Findings in the 15 narratives are briefly presented according to the four themes identified in the literature. Due to the severe shortage of physician adult and paediatric oncology specialists, oncology nurses in the Global South often shoulder much of the care for patients with cancer and even more so during COVID-19 with attendant oncology nursing shortages due to reassignment to COVID-19 units. It is important to hear from these critical members of the oncology nursing workforce who often lack the time, resources or training to publish in peer-reviewed journals in English, particularly in the middle of a pandemic. Giving voice to these nurses documents the reality of their work and ability to continue to provide care despite the chaos and rapidly changing guidelines and government action. Lessons learned by these nurses to improve mental health and psychosocial support of the nurses as well as their patients/families will be essential for the next global pandemic.
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Affiliation(s)
- Julia Challinor
- University of California San Francisco, 2 Koret Way, San Francisco, CA 94143, USA.,https://orcid.org/0000-0002-5008-8501
| | | | - Kathryn Burns
- Qualitative Research, Budapest, Hungary.,https://orcid.org/0000-0002-2695-1088
| | - Annie Young
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.,https://orcid.org/0000-0001-6611-6653
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Walsh C, Leavey G, McLaughlin M. Systematic review of psychosocial needs assessment tools for caregivers of paediatric patients with dermatological conditions. BMJ Open 2022; 12:e055777. [PMID: 35046005 PMCID: PMC8772405 DOI: 10.1136/bmjopen-2021-055777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To identify validated dermatology-specific and disease-specific psychosocial needs assessment tools for caregivers of paediatric patients with dermatological conditions. A secondary objective was to assess the adequacy of their measurement properties. DESIGN Systematic review. DATA SOURCES EMBASE, PsycINFO, MEDLINE (in Ovid SP), Cochrane, Cumulative Index to Nursing and Allied Health EBSCO, U Search and Web of Science were searched (2000-5 October 2021). Grey literature, bibliographies, online databases of QoL tools and several trial registers were searched (2000-5 Oct 2021). ELIGIBILITY CRITERIA Eligible studies involved adult caregivers caring for a child (no age limit) with any form of any skin condition. Predetermined exclusion criteria, as per protocol, were applied to the search results. DATA ABSTRACTION AND SYNTHESIS Title, abstract, full-text screening and data abstraction (standardised forms) were done independently in duplicate. Both's predefined methodological criteria assessed risk of bias. Narrative synthesis was used to present the findings. RESULTS 187 full-text articles were examined from a total of 8979 records. Most tools were generic QoL tools, relevant to spouse/partner or based on their child's perception of the disease or assessed patients' quality of life. Following quality appraisal, 26 articles were identified, and 11 tools (1 dermatology-specific and 10 disease-specific) were included. Information outcome domains were provided for each tool (study specific, questionnaire specific, adequacy of measurement properties and risk of bias). No literature was found pertaining to the use of these tools within healthcare settings and/or as e-tools. DISCUSSION With limited evidence supporting the quality of their methodological and measurement properties, this review will inform future dermatological Core Outcome Set development and improve evidence-based clinical decisions. Increasing demand on limited healthcare resources justifies the codevelopment of an accessible solution-focused psychosocial needs assessment e-tool to promote caregiver health outcomes. PROSPERO REGISTRATION NUMBER PROSPERO (CRD42019159956).
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Affiliation(s)
- Carleen Walsh
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
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Singh N, Mishra N, Jayraj AS, Ghatage P. Management of Gynecologic Cancer During COVID-19 Pandemic: South Asian Perspective. Cancer Control 2022; 29:10732748221119349. [PMID: 36036360 PMCID: PMC9420651 DOI: 10.1177/10732748221119349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Management of gynecological cancers has suffered during the pandemic, partly due to lockdown and partly due to directing resources to manage COVID-19 patients. Modification of gynecological cancer management during this pandemic is recommended. Cervical cancer patients who present with stage IA1 disease can have a delay of up to 8 weeks for surgical treatment, considering the slow tumor growth rate. Women with stages IA2, IB1, IB2, IIA1 must undergo radical hysterectomy and lymphadenectomy within 6 to 8 weeks. In areas where surgical treatment is not available, patients should be referred for radiation therapy/areas with adequate surgical expertise. The surgical option is attractive for early cancers during the COVID era, as it involves a single visit compared to the multiple visits required for chemoradiation. The value of lymph node staging needs to be reconsidered. Neoadjuvant chemotherapy should be given preference over primary cytoreductive surgery for advanced ovarian cancers. Surgeries, which demand extended surgical time such as Hyperthermic Intraperitoneal Chemotherapy and pelvic exenterations, should be avoided during this pandemic. For patients scheduled for interval surgery after two or three neoadjuvant cycles, six cycles of chemotherapy should be considered before surgery is performed. For early-stage, low-grade endometrial cancer, consideration should be given to medical management until surgery is possible. The above recommendations have been made keeping in mind the geography, patient load, and availability of resources available to health care providers from southeast Asia. They might not be applicable globally and every practitioner should take call regarding patient's management as per availability of resources and loco-regional circumstances. The implementation of recommended international guidelines for the management of gynecologic cancers should take precedence. Each modification to the standard approach should be approved by a multidisciplinary team depending on the condition of the patients and the locoregional circumstances.
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Affiliation(s)
- Nilanchali Singh
- Department of Obstetrics and Gynaecology, 28730AIIMS, New Delhi, India.,Department of Gynaecologic Oncology, Tom Baker Cancer Centre, 2125University of Calgary, Calgary, AB, Canada
| | - Neha Mishra
- Department of Obstetrics and Gynaecology, 28730AIIMS, New Delhi, India.,Department of Obstetrics and Gynaecology, 517234GIMS, Uttar Pradesh, India
| | | | - Prafull Ghatage
- Department of Gynaecologic Oncology, Tom Baker Cancer Centre, 2125University of Calgary, Calgary, AB, Canada
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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.
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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
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13
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Rohilla KK, Kalyani CV, Gupta S, Gupta A, Gupta M. Quality of Life of People with Cancer in the Era of the COVID-19 Pandemic in India: A Systematic Review. Clin Pract Epidemiol Ment Health 2021; 17:280-286. [PMID: 35444705 PMCID: PMC8985464 DOI: 10.2174/1745017902117010280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 08/24/2021] [Accepted: 09/11/2021] [Indexed: 12/24/2022]
Abstract
Background:
The recent pandemic of COVID-19 caused havoc on the health system globally and raised a lot of questions and issues. Treatment for cancer is an emergency that cannot be taken back, particularly in an era of global pandemics. Cancer treatment mainly includes chemotherapy, surgery, radiotherapy, and palliative care, and because of the pandemic, all of these treatments are affected. The COVID-19 pandemic also had a potential effect on the quality of life and mental health of patients as well as health workers.
Objective:
This systematic review was intended to discuss the quality of life of people with cancer in the era of the COVID-19 pandemic in India in the light of the best available facts.
Methods:
An extensive literature search was done on PubMed, Medline, Embase, Clinical Key and Google Scholar databases till 3rd Feb 2021. Out of 1455 research articles, 06 research articles were included in this systematic review.
Results:
The results showed that cancer treatment delivery was as per standard safety protocol and the best treatment decisions were made by scheduling and setting priority. Till data, no direct research was conducted on the Indian continent to assess the quality of life of cancer patients in the COVID-19 era. The effect on the quality of life of cancer patients is very large and needs to be explored more by further research. Issues to be discussed with health care administrators and policy makers further. The tele-oncology method of cancer care delivery to patients is another rational option which is applicable as well.
Conclusion:
This systematic review demonstrated up-to-date evidence regarding the quality of life of cancer patients in the COVID-19 era in India. No research has been done to assess the quality of life of cancer patients. Still, the area is unrevealed, but evidence from other global studies indicates an altered quality of life for cancer patients. To maintain quality of life, cancer physicians should make evidence-based decisions and incorporate multidisciplinary management into decision making.
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14
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Immunological Response to COVID-19 Vaccination in Ovarian Cancer Patients Receiving PARP Inhibitors. Vaccines (Basel) 2021; 9:vaccines9101148. [PMID: 34696256 PMCID: PMC8541338 DOI: 10.3390/vaccines9101148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 02/07/2023] Open
Abstract
Objective: Vaccination for SARS-CoV-2 provides significant protection against the infection in the general population. However, limited data exist for cancer patients under systemic therapy. Methods: In this cohort, we prospectively enrolled cancer patients treated with PARPi as well as healthy volunteers in order to study the kinetics of anti-SARS-CoV-2 antibodies (NAbs) after COVID-19 vaccination. Baseline demographics, co-morbidities, and NAb levels were compared between the two groups. Results: The results of the cohort of 36 patients receiving PARP inhibitors are presented here. Despite no new safety issues being noticed, their levels of SARS-CoV-2 neutralizing antibodies were significantly lower in comparison to matched healthy volunteers up to day 30 after the second dose. Conclusions: These results suggest that maintaining precautions against COVID-19 is essential for cancer patients and should be taken into consideration for the patients under treatment, while further exploration is needed to reduce the uncertainty of SARS-CoV-2 immunity among cancer patients under treatment.
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Dhada S, Stewart D, Cheema E, Hadi MA, Paudyal V. Cancer Services During the COVID-19 Pandemic: Systematic Review of Patient's and Caregiver's Experiences. Cancer Manag Res 2021; 13:5875-5887. [PMID: 34349561 PMCID: PMC8328387 DOI: 10.2147/cmar.s318115] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/10/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Cancer patients have faced intersecting crises during the COVID-19 pandemic. This review aimed to examine patients' and caregivers' experiences of accessing cancer services during the pandemic and its perceived impact on their psychological wellbeing. PATIENTS AND METHODS A protocol-led (CRD42020214906) systematic review was conducted by searching six databases including EMBASE, MEDLINE and CINAHL for articles published in English-language between 1/2020 and 12/2020. Data were extracted using a pilot-tested, structured data extraction form. Thematic synthesis of data was undertaken and reported as per the PRISMA guideline. RESULTS A total of 1110 articles were screened, of which 19 studies met the inclusion criteria. Studies originated from 10 different countries including the US, UK, India and China. Extracted data were categorised into seven themes. Postponement and delays in cancer screening and treatment, drug shortages and inadequate nursing care were commonly experienced by patients. Hospital closures, resource constraints, national lockdowns and patient reluctance to use health services due to infection worries contributed to the delay. Financial and social distress, isolation, and spiritual distress were also commonly reported. Caregivers in addition felt anxious about infecting cancer patients with COVID-19. CONCLUSION Patients and caregivers experienced delays in cancer screening, treatment and care during the COVID-19 pandemic and negatively affected their psychological wellbeing. Their views and preferences should be accounted to minimise the impact of the current and any future pandemics and ensure resilient cancer services. PROTOCOL REGISTRATION Published protocol registered with Centre for Review and Dissemination CRD42020214906 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214906).
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Affiliation(s)
- Symran Dhada
- College of Medical and Dental Sciences, School of Pharmacy, University of Birmingham, Birmingham, UK
| | - Derek Stewart
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Ejaz Cheema
- College of Medical and Dental Sciences, School of Pharmacy, University of Birmingham, Birmingham, UK
| | - Muhammad Abdul Hadi
- College of Medical and Dental Sciences, School of Pharmacy, University of Birmingham, Birmingham, UK
| | - Vibhu Paudyal
- College of Medical and Dental Sciences, School of Pharmacy, University of Birmingham, Birmingham, UK
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Powis M, Milley-Daigle C, Hack S, Alibhai S, Singh S, Krzyzanowska MK. Impact of the early phase of the COVID pandemic on cancer treatment delivery and the quality of cancer care: a scoping review and conceptual model. Int J Qual Health Care 2021; 33:6290320. [PMID: 34059892 PMCID: PMC8244741 DOI: 10.1093/intqhc/mzab088] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/27/2021] [Accepted: 05/31/2021] [Indexed: 12/13/2022] Open
Abstract
Background The disruption of health services due coronavirus disease (COVID) is expected
to dramatically alter cancer care; however, the implications for care
quality and outcomes remain poorly understood. We undertook a scoping review
to evaluate what is known in the literature about how cancer treatment has
been modified as a result of the COVID pandemic in patients receiving
treatment for solid tumours, and what domains of quality of care are most
impacted. Methods Citations were retrieved from MEDLINE and EMBASE (1 Jan 2019 to 28 Oct 2020),
utilizing search terms grouped by key concept (oncology, treatment,
treatment modifications and COVID). Articles were excluded if they dealt
exclusively with management of COVID-positive patients, modifications to
cancer screening, diagnosis or supportive care, or were not in English.
Articles reporting on guidelines, consensus statements, recommendations,
literature reviews, simulations or predictive models, or opinions in the
absence of accompanying information on experience with treatment
modifications in practice were excluded. Treatment modifications derived
from the literature were stratified by modality (surgery, systemic therapy
and radiotherapy) and thematically grouped. To understand what areas of
quality were most impacted, modifications were mapped against the Institute
of Medicine’s quality domains. Where reported, barriers and
facilitators were abstracted and thematically grouped to understand drivers
of treatment modifications. Findings were synthesized into a logic model to
conceptualize the inter-relationships between different modifications, as
well as their downstream impacts on outcomes. Results In the 87 retained articles, reductions in outpatients visits (26.4%),
and delays/deferrals were commonly reported across all treatment modalities
(surgery: 50%; systemic therapy: 55.8%; radiotherapy:
56.7%); as were reductions in surgical capacity (57.1%),
alternate systemic regimens with longer treatment intervals or use of oral
agents (19.2%), and the use of hypofractionated radiotherapy regimens
(40.0%). Delivery of effective, timely and equitable care were the
quality domains found to be most impacted. The most commonly reported
facilitator of maintaining cancer care delivery levels was the shift to
virtual models of care (62.1%), while patient-initiated deferrals and
cancellations (34.8%), often due to fear of contracting COVID
(60.9%), was a commonly reported barrier. Conclusions As it will take a considerable amount of time for the cancer system to resume
capacity and adjust models of care in response to the pandemic, these
treatment delays and modifications will likely be prolonged, and will
negatively impact quality of care and patient outcomes.
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Affiliation(s)
- Melanie Powis
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre, University Health Network, 700 University Ave, Toronto, ON M5G 1X6, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON M5T 3M6, Canada
| | - Carissa Milley-Daigle
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre, University Health Network, 700 University Ave, Toronto, ON M5G 1X6, Canada
| | - Saidah Hack
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre, University Health Network, 700 University Ave, Toronto, ON M5G 1X6, Canada
| | - Shabbir Alibhai
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON M5T 3M6, Canada.,Department of Medicine, University Health Network, 200 Elizabeth St, Toronto, ON M5G 2C4, Canada
| | - Simron Singh
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON M5T 3M6, Canada.,Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada
| | - Monika K Krzyzanowska
- Cancer Quality Lab (CQuaL), Princess Margaret Cancer Centre, University Health Network, 700 University Ave, Toronto, ON M5G 1X6, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON M5T 3M6, Canada.,Department of Medicine, University Health Network, 200 Elizabeth St, Toronto, ON M5G 2C4, Canada
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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.
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Nagarkar R, Patil R, Gadade K, Paleja N, Bhamre R, Ramesh Y. Psychological burden on cancer patients and their caregivers during COVID-19 pandemic in India. TAIWANESE JOURNAL OF PSYCHIATRY 2021. [DOI: 10.4103/tpsy.tpsy_35_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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