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Izadi-Najafabadi S, McTaggart-Cowan H, Halperin R, Lambert L, Mitton C, Peacock S. The impact of the COVID-19 pandemic on health-related quality of life of cancer patients in British Columbia. J Patient Rep Outcomes 2024; 8:100. [PMID: 39177926 PMCID: PMC11343924 DOI: 10.1186/s41687-024-00759-z] [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: 01/22/2024] [Accepted: 07/04/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic resulted in unprecedented changes to cancer care in many countries, impacting cancer patients' lives in numerous ways. This study examines the impact of changes in cancer care on patient's health-related quality of life (HRQL), which is a key outcome in cancer care. The study aims to estimate patients' self-reported HRQL before and during the pandemic and identify predictive factors for their physical and mental wellbeing. METHOD The study employed the large-scale Outpatient Cancer Care (OCC) Patient Experience Survey, including the Veterans RAND 12-Item Health Survey, to evaluate cancer patients' experiences and HRQL before (January to May 2020) and during the COVID-19 pandemic (May to July 2021). Paired t-tests were conducted to compare differences in Physical Component Scores (PCS) and Mental Component Scores (MCS) before and during the pandemic. Multivariable linear regressions were employed to investigate the factors (sociodemographic, clinical, and patient-reported experience) influencing PCS and MCS during the pandemic. RESULTS PCS decreased significantly during the pandemic, while MCS remained stable. Lower PCS contributors included older age, more telehealth visits, self-reported hospitalization, and a longer time since the last cancer diagnosis. Higher PCS was associated with urban residence, higher MCS during the pandemic, and perceived active Healthcare Provider (HCP) involvement. For MCS, lower scores related to female gender and more telehealth visits, while higher scores were associated with being white, higher education, high MCS before the pandemic, and perceived active HCP involvement. CONCLUSION The OCC Patient Experience Survey provides a unique patient level data set measuring HRQL pre- and post- the onset of the COVID-19 pandemic. The study highlights challenges faced by cancer patients during the pandemic, with a significant reduction in PCS. However, the stability in MCS suggests effective coping mechanisms. Sociodemographic, clinical, and telehealth-related variables play a complex role in shaping both PCS and MCS. Perceived HCP involvement emerges as a crucial factor correlating with higher PCS and MCS. Navigating the post-pandemic era necessitates interventions fortifying patient-provider relationships, optimizing healthcare support systems, such as telehealth services, and prioritizing mental-well-being given its impact on both PCS and MCS.
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Affiliation(s)
| | - Helen McTaggart-Cowan
- BC Cancer Research Centre, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | | | - Leah Lambert
- Department of Nursing and Allied Health Research and Knowledge Translation, BC Cancer, Vancouver, BC, Canada
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Craig Mitton
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Stuart Peacock
- BC Cancer Research Centre, Vancouver, BC, Canada.
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
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Debie Y, Palte Z, Salman H, Verbruggen L, Vanhoutte G, Chhajlani S, Raats S, Roelant E, Vandamme T, Peeters M, van Dam PA. Long-term effects of the COVID-19 pandemic for patients with cancer. Qual Life Res 2024:10.1007/s11136-024-03726-9. [PMID: 38961007 DOI: 10.1007/s11136-024-03726-9] [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: 06/20/2024] [Indexed: 07/05/2024]
Abstract
INTRODUCTION Long COVID is defined as the continuation of symptoms, unexplainable by alternative diagnosis, longer than four weeks after SARS-CoV-2 infection. These symptoms might hinder daily activities and overall well-being, ultimately impacting quality of life (QoL). Several studies have reported fatigue as the most common symptom, followed by dyspnoea, headache and myalgia. Although it is assumed that long COVID affects 10-20% of SARS-CoV-2 infected individuals, recently numbers up to 60% were described for patients with cancer. This study uncovers the impact of the COVID-19 pandemic on QoL of patients with cancer and how long COVID manifests in this cohort. METHODS A group of 96 patients with cancer was followed from March 2022 till March 2023. Online questionnaires assessing symptoms associated with long COVID, anxiety and depression (HADS), quality of life (EORTC-QLQ-C30) and cognitive functioning (CFQ) were sent every three months during this period. Furthermore, a semi-structured focus group was organised for qualitative data collection. RESULTS Overall, these patients reported a negative impact of the enforced COVID-19 restrictions on the emotional and psychological wellbeing. Forty nine patients with cancer (51.0%) were infected with SARS-CoV-2 over the course of the study, of which 39 (79.6%) reported long COVID symptoms. The most commonly reported symptoms were myalgia (46.2%), fatigue (38.5%) and disturbed sleep (35.9%) and it was observed that male sex is associated with poor long COVID outcomes. CONCLUSION While patients with cancer experience similar long COVID symptoms as healthy controls, the prevalence is remarkably higher possibly due to their compromised immune system and weakened physiological reserve.
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Affiliation(s)
- Yana Debie
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Drie Eikenstraat 655, Edegem, 2650, Belgium
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium
| | - Ziyad Palte
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium
| | - Haya Salman
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium
| | - Lise Verbruggen
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Drie Eikenstraat 655, Edegem, 2650, Belgium
| | - Greetje Vanhoutte
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Drie Eikenstraat 655, Edegem, 2650, Belgium
| | - Siddharth Chhajlani
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Drie Eikenstraat 655, Edegem, 2650, Belgium
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium
| | - Silke Raats
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Drie Eikenstraat 655, Edegem, 2650, Belgium
| | - Ella Roelant
- Clinical Trial Center (CTC), Antwerp University Hospital, Drie Eikenstraat 655, Edegem, 2650, Belgium
| | - Timon Vandamme
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Drie Eikenstraat 655, Edegem, 2650, Belgium
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium
| | - Marc Peeters
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Drie Eikenstraat 655, Edegem, 2650, Belgium
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium
| | - Peter A van Dam
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Drie Eikenstraat 655, Edegem, 2650, Belgium.
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Universiteitsplein 1, Wilrijk, 2610, Belgium.
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3
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Sebastian M, Eberhardt WEE, von der Heyde E, Dörfel S, Wiegand J, Schiefer C, Losem C, Jänicke M, Fleitz A, Zacharias S, Kaiser-Osterhues A, Hipper A, Dietel C, Bleckmann A, Benkelmann R, Boesche M, Grah C, Müller A, Griesinger F, Thomas M. Patient-reported outcomes in advanced NSCLC before and during the COVID-19 pandemic: Real-world data from the German prospective CRISP Registry (AIO-TRK-0315). Int J Cancer 2024; 154:1967-1978. [PMID: 38329180 DOI: 10.1002/ijc.34868] [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: 07/07/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 02/09/2024]
Abstract
Patients with lung cancer under treatment have been associated with a high risk of COVID-19 infection and potentially worse outcome, but real-world data on patient-reported outcomes (PROs) are rare. We assess patients' characteristics and PROs before and during the COVID-19 pandemic in an advanced non-small cell lung cancer (NSCLC) cohort in Germany. Patients with locally advanced or metastatic NSCLC from the prospective, multicentre, observational CRISP Registry (NCT02622581) were categorised as pre-pandemic (March 2019 to Feb 2020, n = 1621) and pandemic (March 2020 to Feb 2021, n = 1317). From baseline to month 15, patients' health-related quality of life (HRQoL) was assessed by FACT-L, anxiety and depression by PHQ-4. Association of pandemic status with time to deterioration (TTD) in QoL scales adjusted for potential covariates was estimated using Cox modelling. PROs were documented for 1166 patients (72%) in the pre-pandemic, 979 (74%) in the pandemic group. Almost 60% of patients were male, median age was 66 years, comorbidities occurred in 85%. Regarding HRQoL, mean-change-from-baseline plots hardly differed between both samples. Approximately 15%-21% of patients reported anxiety, about 19%-27% signs of depression. For the pandemic group, TTD was slightly, but statistically significantly, worse for the physical well-being-FACT-G subscale (HR 1.15 [95%CI 1.02-1.30]) and the anxiety-GAD-2 subscale (HR 1.14 [95%CI 1.01-1.29]). These prospectively collected real-world data provide valuable insights into PROs before and during the COVID-19 pandemic in advanced NSCLC. For the patients, the pandemic seemed to be less of a burden than the disease itself, as there was a considerable proportion of patients with anxiety and depression in both groups.
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Grants
- The CRISP project is supported by grants from Amgen Ltd, AstraZeneca GmbH, Boehringer Ingelheim Pharma GmbH & Co. KG, Bristol-Myers Squibb GmbH & Co. KGaA, Celgene GmbH, Janssen-Cilag GmbH, Lilly Deutschland GmbH, MSD Sharp & Dohme GmbH, Novartis Pharma GmbH, Pfizer Pharma GmbH, Roche Pharma AG, and Takeda Pharma Vertriebs GmbH & Co. KG. None of the funders had any role in study design, data collection and analysis, interpretation of results, decision to publish, or preparation of the manuscript
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Affiliation(s)
- Martin Sebastian
- Department of Medicine II, Hematology/Oncology, University Hospital Frankfurt, Frankfurt, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt, Germany
- Frankfurt Cancer Institute, Goethe University Frankfurt, Frankfurt, Germany
| | - Wilfried E E Eberhardt
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany
- Division of Thoracic Oncology, West German Cancer Center, University Medicine Essen-Ruhrlandklinik, Essen, Germany
| | | | | | - Jörg Wiegand
- Gemeinschaftspraxis für Hämatologie & Onkologie, Moers, Germany
| | | | | | - Martina Jänicke
- Clinical Epidemiology and Health Economics, iOMEDICO, Freiburg i. Br, Germany
| | - Annette Fleitz
- Clinical Epidemiology and Health Economics, iOMEDICO, Freiburg i. Br, Germany
| | | | | | | | | | - Annalen Bleckmann
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany
| | - Robin Benkelmann
- Innere Medizin/Hämatoonkologie/Gastroenterologie/Palliativmedizin, I. Med. Klinik, Konstanz, Germany
| | - Michael Boesche
- Pneumologie, Klinik für Innere Medizin B, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Christian Grah
- Pneumologie-Lungenkrebszentrum, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Annette Müller
- Marienhof Koblenz, Katholisches Klinikum Koblenz Montabaur, Koblenz, Germany
| | - Frank Griesinger
- Department of Hematology and Oncology, University Department Internal Medicine-Oncology, Pius-Hospital, University Medicine Oldenburg, Oldenburg, Germany
| | - Michael Thomas
- Department of Thoracic Oncology, Thoraxklinik, University Hospital Heidelberg and Translational, Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
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Urbano Chamorro I, de la Torre-Montero JC. Cancer-related fatigue and activities of daily living: lessons learned from the COVID-19 pandemic. BMC Palliat Care 2024; 23:110. [PMID: 38678234 PMCID: PMC11055275 DOI: 10.1186/s12904-024-01437-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: 12/15/2023] [Accepted: 04/19/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Cancer-related fatigue is a prevalent condition in all stages of oncologic disease that is poorly diagnosed, with a negative impact on physical function to perform activities of daily living. Fatigue is also one of the main manifestations in post-COVID-19 syndrome, and few studies have explored the functionality of cancer patients after infection by the new coronavirus. This study was designed to assess cancer-related fatigue symptoms and their implications on physical function and quality of life during the pandemic. METHODOLOGY An observational study with a cross-sectional survey in cancer patients ≥ 18 years of age was conducted. The Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-F), the perception of asthenia and performance status were evaluated, and the differences between groups according to the history of COVID-19 were calculated. RESULTS A total of 60 cancer patients had an average age of 33.5 ± 10.11 years, 73.3% were female, and 98.3% had an Eastern Cooperative Oncology Group-Performance Status level < 2. Severe fatigue was found in 43.3% of patients, and the average FACIT-F score was 33.5 ± 10.11. The proportion of coronavirus infection was 13,3%, and the performance of this group was worse on the scale compared to the group without infection (25 ± 10,40 vs. 34,81 ± 9,50 [p = 0,009]). There was a significant correlation between visual analog scale values and FACIT-F scale scores (Pearson's r = -0.76). CONCLUSION SARS-CoV-2 infection could increase cancer-related fatigue symptoms, limiting activities of daily living and impairing quality of life.
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Affiliation(s)
- Iveth Urbano Chamorro
- Universidad Pontificia Comillas, Health Sciences Department, Madrid, Spain.
- Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Julio C de la Torre-Montero
- Universidad Pontificia Comillas, Health Sciences Department, Madrid, Spain
- Fundación San Juan de Dios, Madrid, Spain
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Tao L, Lv J, Zhong T, Zeng X, Han M, Fu L, Chen H. Effects of sleep disturbance, cancer-related fatigue, and psychological distress on breast cancer patients' quality of life: a prospective longitudinal observational study. Sci Rep 2024; 14:8632. [PMID: 38622186 PMCID: PMC11018625 DOI: 10.1038/s41598-024-59214-0] [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: 07/20/2023] [Accepted: 04/08/2024] [Indexed: 04/17/2024] Open
Abstract
More attention has gone to researching the cancer-related fatigue (CRF)-sleep disturbance (SD)-psychological distress (PD) symptom cluster in breast cancer patients during the chemotherapy period, but the change trend and heterogeneous development track in the whole treatment stage remain unclear, and it is also unclear whether the appearance of and changes in one symptom cause changes in other symptoms and quality of life (QoL). This study, using breast cancer patients' data collected through a validated questionnaire, examined the relationships between SD, CRF, PD, and QoL using latent growth modeling analyses. CRF developmental trajectories showed an upward trend over five surveys (slope = 0.649, P < 0.001); PD showed a significant weakening trend (slope = - 0.583, P < 0.001); SD showed an increasing trend (slope = 0.345, P < 0.001), and QoL showed a statistically significant weakening trend (slope = - 0.373, P < 0.001). The initial CRF (coefficient = - 0.233, P < 0.01), PD (coefficient = - 0.296, P < 0.01), and SD (coefficient = - 0.388, P < 0.001) levels had a statistically significant negative effect on initial QoL level. The linear development rate of PD was statistically significant and negatively affected that of QoL (coefficient = - 0.305, P < 0.05), whereas the quadratic development rate of SD negatively affected that of QoL (coefficient = - 0.391, P < 0.05). Medical staff should identify the change characteristics of different variables based on SD, CRF, PD, and QoL change trajectories, and advance the intervention time, as changes in variables affect other variables' subsequent changes.
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Affiliation(s)
- Lin Tao
- Cancer Day-Care Unit, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jieying Lv
- Cancer Day-Care Unit, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Ting Zhong
- Cancer Day-Care Unit, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaohong Zeng
- Cancer Day-Care Unit, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Manxia Han
- Division of Head & Neck Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Lan Fu
- Cancer Day-Care Unit, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Hong Chen
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Wuhou District, Chengdu, 610041, China.
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Özönder Ünal I, Ünal C, Duymaz T, Ordu C. The relationship between psychological flexibility, self-compassion, and posttraumatic growth in cancer patients in the COVID-19 pandemic. Support Care Cancer 2023; 31:428. [PMID: 37380871 DOI: 10.1007/s00520-023-07891-4] [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: 03/15/2023] [Accepted: 06/16/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE The COVID-19 pandemic may have an important long-term emotional impact on patients with cancer diagnosis, as they are in the high-risk group. We aimed to evaluate the relationship between self-compassion, psychological flexibility, and posttraumatic growth, and to examine whether psychological flexibility may serve as a mediator between self-compassion and posttraumatic growth. METHODS Two hundred fifty-three patients with cancer were included in the study. Sociodemographic and Clinical Features Data Form, Self-Compassion Scale (SCS), Freiburg Mindfulness Inventory (FMI), Acceptance and Action Questionnaire-II (AAQ-II), Cognitive Fusion Questionnaire (CFQ), and Posttraumatic Growth Inventory (PTGI) were applied to all patients. RESULTS The multivariate analysis with independent variable SCS, FMI, AAQ-II, and CFQ scores explains 49% of the variance in PTGI (F(4,248) = 60,585, p < 0.001). SC and FMI scores were found to have a positive and AAQ-II and CFQ scores a negative predictive effect on PTGI scores. The partial mediational effect of psychological flexibility on the relationship between self-compassion and posttraumatic growth was found to be statistically significant. CONCLUSION In traumatic life events such as pandemics, the importance of self-compassion for posttraumatic growth and the mediator role of psychological flexibility in this relationship should be considered in order to manage the treatment process in cancer patients. These patients are more affected by the pandemic due to the nature of their malignancy and the strict protective measures they must follow as members of a high-risk group. The significance of therapies focused on psychological flexibility should be emphasized in comprehensive biopsychosocial approaches for the management of cancer patients.
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Affiliation(s)
- Ipek Özönder Ünal
- Department of Psychiatry, Tuzla State Hospital, Içmeler Mahallesi, Piri Reis Caddesi, No: 74 Tuzla, Istanbul, Turkey.
| | - Caglar Ünal
- Department of Medical Oncology, Istanbul Lutfi Kirdar City Hospital, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, 34865 Kartal, Istanbul, Turkey
| | - Tomris Duymaz
- Department of Physiotherapy & Rehabilitation, Istanbul Bilgi University, İnönü Cad. No: 72 Kuştepe 34387 Şişli, Istanbul, Turkey
| | - Cetin Ordu
- Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, Cemil Aslan Güder Sk. No: 8, 34349 Beşiktaş, Istanbul, Turkey
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Nelson D, Cooke S, McLeod B, Nanyonjo A, Kane R, Gussy M. A Rapid Systematic Review on the Experiences of Cancer Survivors Residing in Rural Areas during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16863. [PMID: 36554740 PMCID: PMC9778689 DOI: 10.3390/ijerph192416863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/01/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic has caused considerable disruption to cancer care and may have exacerbated existing challenges already faced by cancer survivors from rural areas. This has created a need for a rapid evidence synthesis to inform the development of tailored interventions that address the specific needs of rural cancer survivors who continue to be affected by the pandemic. The review was conducted following guidance from the Cochrane Rapid Review Methods Group. Database searches were performed via the EBSCOHost interface (includes MEDLINE, CINAHL, PsycINFO) on 25 May 2022 and supplemented with searches on Google Scholar. Peer-reviewed articles published after March 2020 that reported primary data on the experiences of cancer survivors residing in rural and remote settings during the pandemic were included. Findings were tabulated and written up narratively. Fourteen studies were included. The COVID-19 pandemic had a mostly detrimental impact on the experiences of rural cancer survivors. People's individual coping mechanisms were challenging for a range of reasons. Specifically, the pandemic impacted on their ability to access testing, treatment, check-ups and supportive care, their ability to maintain and access social support with close friends and family, as well as negative consequences to their finances and emotional wellbeing with some reporting feelings of psychological distress including depression and anxiety. This review provides important insight into the experiences of rural cancer survivors that may help inform tailored support in line with the needs and challenges faced because of the pandemic.
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Affiliation(s)
- David Nelson
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
- Macmillan Cancer Support, London SE1 7UQ, UK
| | - Samuel Cooke
- School of Health and Social Care, College of Social Science, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
| | - Ben McLeod
- Lincoln Medical School, College of Science, University of Nottingham and University of Lincoln, Lincoln LN6 7TS, UK
| | - Agnes Nanyonjo
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
| | - Ros Kane
- School of Health and Social Care, College of Social Science, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
| | - Mark Gussy
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
- La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo, VIC 3086, Australia
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Kenis I, Theys S, Daem M, Decoene E, Demolder V, Duprez V, Pape E, Quaghebeur M, Verhaeghe S, Foulon V, Van Hecke A. Experiences of patients with cancer and their relatives confronted with COVID-19 related delay or change in care: A qualitative study. J Adv Nurs 2022; 78:4150-4164. [PMID: 36052660 PMCID: PMC9538827 DOI: 10.1111/jan.15431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/08/2022] [Accepted: 08/20/2022] [Indexed: 12/12/2022]
Abstract
AIMS To provide in-depth insight into how patients and their relatives experienced change or delay in cancer treatment and care due to COVID-19. DESIGN A qualitative study including semi-structured interviews with patients with cancer and their relatives. METHODS Between July and October 2020, 42 patients who were confronted with a change or delay in cancer treatment or care, and 11 relatives were interviewed. Data collection and analysis were performed according to the most important methods of grounded theory, including iterative data collection and analysis, theoretical sampling, constant comparative analysis and theoretical sensitivity. RESULTS This study shows that patients with cancer and relatives experienced paradoxical feelings when confronted with change or delay in treatment or care due to COVID-19. Patients and relatives felt relieved (e.g. less risk of infection), but were also concerned and anxious (e.g. fear for progression, fear for more side effects). Due to these ambivalent feelings, it was difficult for patients and relatives to cope with the change or delay in treatment or care, both when this was decided by the physician and by themselves. In combination with the general impact of COVID-19 on their daily lives, the change or delay led to additional distress. The interviews showed that exploring the meaning of change or delay of care for patients and their relatives and discussing what would help them might prevent or relieve distress. CONCLUSION The findings of our study show that COVID-19 and the associated delay or changes in cancer treatment and care had a major impact on the well-being of patients and their relatives. Person-oriented care is even more important during (emergency) situations in which care might be changed or delayed.
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Affiliation(s)
- Ilyse Kenis
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological SciencesKU LeuvenLeuvenBelgium
- Department of Public Health and Primary Care, Faculty of Medicine and Health SciencesUniversity Centre for Nursing and Midwifery, Ghent UniversityGhentBelgium
| | - Sofie Theys
- Department of Public Health and Primary Care, Faculty of Medicine and Health SciencesUniversity Centre for Nursing and Midwifery, Ghent UniversityGhentBelgium
| | - Michiel Daem
- Cancer Center, Ghent University HospitalGhentBelgium
| | - Elsie Decoene
- Cancer Center, Ghent University HospitalGhentBelgium
| | | | - Veerle Duprez
- Department of Public Health and Primary Care, Faculty of Medicine and Health SciencesUniversity Centre for Nursing and Midwifery, Ghent UniversityGhentBelgium
| | - Eva Pape
- Department of Public Health and Primary Care, Faculty of Medicine and Health SciencesUniversity Centre for Nursing and Midwifery, Ghent UniversityGhentBelgium
- Cancer Center, Ghent University HospitalGhentBelgium
| | | | - Sofie Verhaeghe
- Department of Public Health and Primary Care, Faculty of Medicine and Health SciencesUniversity Centre for Nursing and Midwifery, Ghent UniversityGhentBelgium
- Department of Health CareVIVES University CollegeRoeselareBelgium
| | - Veerle Foulon
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological SciencesKU LeuvenLeuvenBelgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, Faculty of Medicine and Health SciencesUniversity Centre for Nursing and Midwifery, Ghent UniversityGhentBelgium
- Nursing DepartmentGhent University HospitalGhentBelgium
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Nguyen HTH, Duong KL, Nguyen ST, Trinh Q, Hoang HTL, Phung TQ, Lin HW, Nguyen HTL. Quality of Life and Its Associated Factors Among Cancer Patients Receiving Chemotherapy at Oncology Hospitals in Vietnam After the Third Wave of the COVID-19 Pandemic. Cancer Manag Res 2022; 14:2429-2444. [PMID: 35979066 PMCID: PMC9377346 DOI: 10.2147/cmar.s370034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/30/2022] [Indexed: 12/19/2022] Open
Abstract
Purpose This study aimed to evaluate the health-related quality of life (HRQOL) of cancer patients receiving chemotherapy and identify associated factors affecting the HRQOL after the third wave of the COVID-19 pandemic in Vietnam. Patients and Methods Patients with solid cancers receiving chemotherapy at two oncology hospitals in Vietnam during April and May 2021 were included. The European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire version 3 was used to measure the HRQOL. Three questions were asked to explore patients’ concern levels about contracting COVID-19, delaying chemotherapy, or not controlling cancer well. One question was used to explore whether patients were concerned about cancer progression or COVID-19 infection more, or equally, or had no concern about both. Multiple regression models were conducted to examine factors associated with the global health status (GHS) score. Results Of 270 included patients, mean (Standard deviation [SD]) GHS was 56.7 (20.8). Among the functional statuses, social functioning (SF) had the lowest score of 63.6 (29.2). The symptoms with the highest means were insomnia and fatigue, obtaining the score of 38.5 (31.7) and 37.3 (29.2), respectively. The mean of financial difficulties was 54.1 (32.2). In univariate analysis, high concerns about contracting COVID-19, delaying chemotherapy, not controlling cancer well, or more concern about either cancer or COVID-19 over the other were associated with worse GHS, physical functioning, emotional functioning, and SF. In multivariate analysis, those concerns and no income were significantly related to lower GHS scores besides the non-modifiable factors, such as female gender and some cancer types. Conclusion Patients at the high concern levels, or with more concern about either cancer or COVID-19 over the other had poorer HRQOL. Interventions to address the concerns are required to improve their HRQOL, particularly for women, those without income, or with some specific cancers.
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Affiliation(s)
- Hanh T H Nguyen
- School of Pharmacy and Graduate Institute, China Medical University, Taichung, Taiwan.,Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Khanh Linh Duong
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Son T Nguyen
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Quy Trinh
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Hao T L Hoang
- Pharmacy Department, Hanoi Oncology Hospital, Hanoi, Vietnam
| | - Toan Q Phung
- Pharmacy Department, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - Hsiang-Wen Lin
- School of Pharmacy and Graduate Institute, China Medical University, Taichung, Taiwan.,Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
| | - Huong T L Nguyen
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam
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10
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Madkhali NA, Ameri A, Al-Naamani ZY, Madkhali MA, Alshammari B, ALMeqbali MA. Has the COVID-19 pandemic affected the psychological state of arab cancer patients? CURRENT PSYCHOLOGY 2022:1-12. [PMID: 35880051 PMCID: PMC9301615 DOI: 10.1007/s12144-022-03414-2] [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: 03/17/2022] [Revised: 06/22/2022] [Accepted: 06/25/2022] [Indexed: 11/24/2022]
Abstract
The Covid-19 pandemic has increased the vulnerability of cancer patients to psychological symptoms, in addition to treatment modality issues. The present study has aimed to determine the psychological state of Arab cancer patients during the COVID-19 pandemic and to explore the contributing factors. A cross-sectional, descriptive, correlational design with the Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), Functional Assessment of Cancer Therapy-Fatigue subscale (FACT-F), and the Functional Assessment of Cancer Therapy-General (FACT-G) were used to collect the data. Out of 291 participants, 60.5% were female; 22.7% were 51-60 years; 31.6% were diagnosed with breast cancer; 44.3% with stage 2 cancer; 23% had contracted COVID-19; and 43.3% had received their first dose of the vaccine. The main study findings are: 74.9% had anxiety, 64.3% experienced depression, 68% suffered from insomnia, and 69.8% had fatigue. Quality of life (QoL) was low among cancer patients who had marked anxiety, depression, insomnia, or fatigue, and these findings were statistically significant (p < 0.05). Predictive factors showed males were 5.09 times more likely to report depression; gynecological cancer patients were 40.4 times more likely to experience insomnia, and patients who had COVID-19 were 5.13 times more likely to report fatigue. The study findings reveal that the COVID-19 pandemic affected the psychological state of cancer patients and had a significant effect on their quality of life. Hence, there is a need to develop a holistic cancer health care approach, which is often limited in Arab countries, to help patients manage these symptoms effectively and to decrease the prevalence of mental health morbidity.
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Affiliation(s)
| | | | | | | | - Bushra Alshammari
- Department of Medical Surgical Nursing, Collage of Nursing, University of Hail, Hail, Saudi Arabia
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11
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Carvalho AS, Brito Fernandes Ó, de Lange M, Lingsma H, Klazinga N, Kringos D. Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a scoping review. BMC Health Serv Res 2022; 22:786. [PMID: 35715795 PMCID: PMC9204363 DOI: 10.1186/s12913-022-08166-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/06/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cancer comprises a high burden on health systems. Performance indicators monitoring cancer outcomes are routinely used in OECD countries. However, the development of process and cancer-pathway based information is essential to guide health care delivery, allowing for better monitoring of changes in the quality of care provided. Assessing the changes in the quality of cancer care during the COVID-19 pandemic requires a structured approach considering the high volume of publications. This study aims to summarize performance indicators used in the literature to evaluate the impact of the COVID-19 pandemic on cancer care (January-June 2020) in OECD countries and to assess changes in the quality of care as reported via selected indicators. METHODS Search conducted in MEDLINE and Embase databases. Performance indicators and their trends were collated according to the cancer care pathway. RESULTS This study included 135 articles, from which 1013 indicators were retrieved. Indicators assessing the diagnostic process showed a decreasing trend: from 33 indicators reporting on screening, 30 (91%) signalled a decrease during the pandemic (n = 30 indicators, 91%). A reduction was also observed in the number of diagnostic procedures (n = 64, 58%) and diagnoses (n = 130, 89%). The proportion of diagnoses in the emergency setting and waiting times showed increasing trends (n = 8, 89% and n = 14, 56%, respectively). A decreasing trend in the proportion of earliest stage cancers was reported by 63% of indicators (n = 9), and 70% (n = 43) of indicators showed an increasing trend in the proportion of advanced-stage cancers. Indicators reflecting the treatment process signalled a reduction in the number of procedures: 79%(n = 82) of indicators concerning surgeries, 72%(n = 41) of indicators assessing radiotherapy, and 93%(n = 40) of indicators related to systemic therapies. Modifications in cancer treatment were frequently reported: 64%(n = 195) of indicators revealed changes in treatment. CONCLUSIONS This study provides a summary of performance indicators used in the literature to assess the cancer care pathway from January 2020 to June 2020 in OECD countries, and the changes in the quality of care signalled by these indicators. The trends reported inform on potential bottlenecks of the cancer care pathway. Monitoring this information closely could contribute to identifying moments for intervention during crises.
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Affiliation(s)
- Ana Sofia Carvalho
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands.
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Óscar Brito Fernandes
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Mats de Lange
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
| | - Hester Lingsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Niek Klazinga
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Dionne Kringos
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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12
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Quality of Life in Patients with Pancreatic Cancer before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063731. [PMID: 35329416 PMCID: PMC8948872 DOI: 10.3390/ijerph19063731] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/13/2022] [Accepted: 03/18/2022] [Indexed: 01/05/2023]
Abstract
Background: Coronavirus disease 19 (COVID-19) substantially affects cancer patients due to adverse outcomes and disruptions in cancer care. Recent studies have indicated the additional stress and anxiety burden arising from the pandemic and impairing quality of life in this vulnerable group of patients. However, patients with cancer represent a heterogenous group. Therefore, we conducted a study on patients with pancreatic cancer, requiring demanding surgical interventions and chemotherapy regimens due to its aggressive tumor biology, to explore the pandemic’s impact on quality of life within this homogenous cohort. Methods: In a descriptive observational study, the quality of life of patients who had undergone pancreatic surgery for tumor resection at our institution between 2014 and the beginning of the pandemic in March 2020 was assessed. For HRQoL measurement, we used the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), comparing their situation before the pandemic and since its beginning. An additional self-developed questionnaire was applied to assess the life circumstances during the pandemic. Results: Our cohort included 26 patients. Scores from the survey in HRQoL revealed no significant changes over time between before and during the pandemic. A medium deterioration in HRQoL was apparent in social functioning, as well as a small deterioration in role functioning and emotional functioning. Worries concerning a potential impact of COVID-19 on personal health were expressed. Psychological limitations in QoL were mainly attributed to the pandemic, whereas physical limitations in QoL were rather associated with the underlying disease of pancreatic cancer. Conclusion: The COVID-19 pandemic is causing considerable social and emotional distress among pancreatic cancer patients. These patients will benefit from psychological support during the pandemic and beyond. Long-time survivors of pancreatic cancer, such as those included in our cohort, appear to have improved resilience facing the psychosocial challenges of the pandemic. For pancreatic cancer, surgical care is considered the cornerstone of treatment. Prolonged delays in healthcare cause serious damage to mental and physical health. To date, the longer-term clinical consequences are not known and can only be estimated. The potential tragic outcome for the vulnerable group of pancreatic cancer patients highlights the urgency of timely healthcare decisions to be addressed in the future.
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13
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The Psychosocial Impact of COVID-19 on Older Adults with Cancer: A Rapid Review. Curr Oncol 2022; 29:589-601. [PMID: 35200553 PMCID: PMC8870801 DOI: 10.3390/curroncol29020053] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/18/2022] [Accepted: 01/22/2022] [Indexed: 12/26/2022] Open
Abstract
Background: Older adults with cancer are amongst the most vulnerable population to be negatively impacted by COVID-19 due to their likelihood of comorbidities and compromised immune status. Considering the longevity of the pandemic, understanding the subjective perceptions and psychosocial concerns of this population may help ameliorate the psychological aftermath. In this review, we systematically analyze the literature surrounding the psychosocial impact and coping strategies among older adults with cancer within the context of COVID-19. Methods: We conducted a rapid review of literature following PRISMA guidelines between January 2020 to August 2021 using (1) MEDLINE, (2) Embase, (3) CINAHL, and (4) PsychINFO and keyword searches for “cancer” and “COVID-19” focused on adults 65 years or older. Results: Of the 6597 articles screened, 10 met the inclusion criteria. Based on the included articles, the psychosocial impact of COVID-19 was reported under four domains, (1) impact of COVID-19 on quality of life (QoL), (2) concerns related to COVID-19, (3) coping with the impact of COVID-19, and (4) recommendations for future care. Results pertaining to perceived quality of life were inconsistent across the included articles. The most common concerns related to: contracting COVID-19, survivorship transitions, and feelings of isolation. Coping strategies reported by older adults included: spiritual care, lived experience, acceptance, and positive reinterpretation. Conclusions: We found many psychosocial impacts of the pandemic on older adults with cancer. The findings from this review can inform interventions related to shared decision-making and tailored patient care in the future.
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14
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Lamblin G, Chene G, Leaune E, Philip CA, Moret S, Nohuz E, Golfier F, Cortet M. The psychological impact of therapeutic changes during the COVID-19-lockdown for gynaecological and breast cancer patients . J Gynecol Obstet Hum Reprod 2022; 51:102311. [PMID: 35007776 PMCID: PMC8739811 DOI: 10.1016/j.jogoh.2022.102311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/22/2021] [Accepted: 01/05/2022] [Indexed: 12/05/2022]
Abstract
Objective The exceptional health situation related to the Coronavirus 2019 (COVID-19) pandemic has required an in-depth and immediate reorganisation of gynaecological cancer care. The main objective was to assess the psychological impact of such treatment modifications during the lockdown period for gynaecological and breast cancer patients. Patients and methods A multicentre prospective study was conducted in three university gynaecological cancer wards (Hospices Civils de Lyon, France) during the French first lockdown (16th March to 11th May 2020). All patients with non-metastatic breast cancer or gynaecological cancer were included. Data was collected regarding treatment modifications (delay, cancellation, change of therapeutic plan). The psychological impact of treatment modifications during and after the lockdown was assessed by validated questionnaires (SF-12, EORTC-QLQ-C30, HADS). Results A total of 205 consecutive patients were included, aged 60.5 ± 1.0 years. Seven patients (3.4%) presented a SARS-CoV-2 infection, and two patients died. Treatment was maintained for 122 (59.5%) patients, postponed for 72 (35.1%) and cancelled for 11 (5.4%). During the lockdown, 35/118 (29.7%) patients suffered from confirmed anxiety and the mean fatigue-EORTC score was 48.00 ± 2.51; it was 38.64 ± 2.33 (p = 0.02) after the lockdown. After the lockdown and compared to the lockdown period, the mental SF-12 score and overall health status EORTC score were significantly higher (45.03 ± 1.06 vs 41.71 ± 1.15, p = 0.02 and 64.58 ± 1.66 vs 57.44 ± 2.02, p = 0.0007, respectively). The number of confirmed-anxiety cases was significantly higher amongst patients for whom treatment was delayed or cancelled (40.5% vs 23.7%, p = 0.04). Conclusion This study quantified the treatment modifications of gynaecological cancer patients during the COVID-19 lockdown and revealed a poorer psychological state and quality of life during this period, even for patients whose treatment plan was not actually modified. Anxiety was more significant in patients with a delayed or cancelled treatment.
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Affiliation(s)
- G Lamblin
- Department of Obstetrics and Gynaecology Surgery, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Bron, France; University of Lyon, Université Claude Bernard Lyon 1, Lyon, France.
| | - G Chene
- Department of Obstetrics and Gynaecology Surgery, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Bron, France; University of Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - E Leaune
- Centre de Prévention du Suicide, Centre Hospitalier le Vinatier, 69500 Bron, France
| | - C A Philip
- Department of Obstetrics and Gynaecology Surgery, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - S Moret
- Department of Obstetrics and Gynaecology Surgery, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Bron, France
| | - E Nohuz
- Department of Obstetrics and Gynaecology Surgery, Femme Mère Enfant University Hospital, Hospices Civils de Lyon, Bron, France; University of Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - F Golfier
- Department of Obstetrics and Gynaecology Surgery, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, 165 chemin du Grand Revoyet, 69310 Pierre Bénite, France
| | - M Cortet
- Department of Obstetrics and Gynaecology Surgery, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France; LabTAU, Unité INSERM U 1032, Université Claude Bernard Lyon 1, Lyon, France
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15
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Dawson LP, Dinh DT, Stub D, Ahern S, Bloom JE, Duffy SJ, Lefkovits J, Brennan A, Reid CM, Oqueli E. Health-related quality of life following percutaneous coronary intervention during the COVID-19 pandemic. Qual Life Res 2022; 31:2375-2385. [PMID: 34978043 PMCID: PMC8720546 DOI: 10.1007/s11136-021-03056-0] [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] [Accepted: 11/25/2021] [Indexed: 12/02/2022]
Abstract
Purpose During the COVID-19 pandemic, widespread public health measures were implemented to control community transmission. The association between these measures and health-related quality of life (HRQOL) among patients following percutaneous coronary intervention has not been studied. Methods We included consecutive patients undergoing percutaneous coronary intervention (PCI) in the state-wide Victorian Cardiac Outcomes Registry between 1/3/2020 and 30/9/2020 (COVID-19 period; n = 5024), with a historical control group from the identical period one year prior (control period; n = 5041). HRQOL assessment was performed via telephone follow-up 30 days following PCI using the 3-level EQ-5D questionnaire and Australian-specific index values. Results Baseline characteristics were similar between groups, but during the COVID-19 period indication for PCI was more common for acute coronary syndromes. No patients undergoing PCI were infected with COVID-19 at the time of their procedure. EQ-5D visual analogue score (VAS), index score, and individual components were higher at 30 days following PCI during the COVID-19 period (all P < 0.01). In multivariable analysis, the COVID-19 period was independently associated with higher VAS and index scores. No differences were observed between regions or stage of restrictions in categorical analysis. Similarly, in subgroup analysis, no significant interactions were observed. Conclusion Measures of HRQOL following PCI were higher during the COVID-19 pandemic compared to the previous year. These data suggest that challenging community circumstances may not always be associated with poor patient quality of life. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-03056-0.
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Affiliation(s)
- Luke P Dawson
- Department of Cardiology, Royal Melbourne Hospital, Melbourne, VIC, Australia.,Department of Cardiology, The Alfred Hospital, Melbourne, VIC, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Diem T Dinh
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Dion Stub
- Department of Cardiology, The Alfred Hospital, Melbourne, VIC, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Susannah Ahern
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jason E Bloom
- Department of Cardiology, The Alfred Hospital, Melbourne, VIC, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Stephen J Duffy
- Department of Cardiology, The Alfred Hospital, Melbourne, VIC, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Jeffrey Lefkovits
- Department of Cardiology, Royal Melbourne Hospital, Melbourne, VIC, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Angela Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Centre of Clinical Research and Education, School of Public Health, Curtin University, Perth, WA, Australia
| | - Ernesto Oqueli
- Department of Cardiology, Ballarat Health Services, 1 Drummond St North, Ballarat, VIC, 3350, Australia. .,School of Medicine, Faculty of Health, Deakin University, Geelong, VIC, Australia.
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16
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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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17
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Ludwigson A, Huynh V, Myers S, Hampanda K, Christian N, Ahrendt G, Romandetti K, Tevis S. Patient Perceptions of Changes in Breast Cancer Care and Well-Being During COVID-19: A Mixed Methods Study. Ann Surg Oncol 2021; 29:1649-1657. [PMID: 34928479 PMCID: PMC8685309 DOI: 10.1245/s10434-021-11209-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/01/2021] [Indexed: 12/20/2022]
Abstract
Background Widespread healthcare restructuring due to the COVID-19 pandemic led to modifications in the timing and delivery of care for breast cancer patients. Our study explores patient concerns relating to COVID-19, breast cancer, and changes to breast cancer care. Patients and Methods Breast cancer patients who presented for surgical consultation at an academic, multidisciplinary clinic completed the electronically distributed validated COVID-19 Impact and Healthcare Related Quality of Life questionnaire between August 2020 and February 2021. This questionnaire uses Likert score responses to assess COVID-specific concerns within domains, including distress and financial hardship. Scale scores were determined by averaging items within each domain, and scores > 2 indicated greater disruption. Semistructured interviews were conducted with patients who indicated interest in participating in the questionnaire. Results Of 381 patients recruited, 133 patients completed the questionnaire and 20 patients completed interviews. Sixty-three percent of survey participants reported attending a telemedicine appointment for their cancer care, and the majority (67%) were satisfied with their experience. Half of the participants (50%) reported fear about how the COVID-19 pandemic will impact their cancer care or recovery, and 66% reported anxiety about contracting COVID-19. Twenty-two percent of participants reported decreased income due to COVID-19. Patient interviews revealed tangible changes to care and provided in-depth information on the advantages and disadvantages of telehealth. Conclusions Breast cancer patients report anxiety about COVID-19 infection and potential care modifications. Our study identifies impacts on patients’ care and quality of life. Further investigation will inform interventions to improve psychosocial outcomes for patients and the telehealth experience. Supplementary Information The online version contains supplementary material available at 10.1245/s10434-021-11209-1.
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Affiliation(s)
| | - Victoria Huynh
- Department of Surgery, University of Colorado, Aurora, CO, USA
| | - Sara Myers
- Department of Surgery, University of Pittsburg, Pittsburg, PA, USA
| | - Karen Hampanda
- Department of Obstetrics and Gynecology, University of Colorado, Aurora, CO, USA
| | | | | | | | - Sarah Tevis
- Department of Surgery, University of Colorado, Aurora, CO, USA.
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18
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Buttiron Webber T, Giuliano S, Patrone C, Briata IM, Franconeri M, Marceca F, Magnani M, Paciolla F, Provinciali N, Defferrari C, Clavarezza M, D’Amico M, Gozza A, Boitano M, Alessio-Mazzola M, Cevasco I, DeCensi A. Home Se-Cure: A Home Care Service for Cancer Patients during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010913. [PMID: 34682650 PMCID: PMC8535406 DOI: 10.3390/ijerph182010913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 12/15/2022]
Abstract
Cancer patients are exposed to a greater risk of COVID-19 infection, resulting in treatment delays and unnecessary hospitalizations. International authorities have suggested reducing visits to hospitals and guarantee continuity of care. We developed a home care project called Home Se-Cure (HSC) to guarantee the continuity of oral, intramuscular, and subcutaneous cancer therapy during COVID-19. The Home Se-Cure project included cancer patients living near Galliera Hospital. Patients received home visits by registered nurses (RNs), whoperformed blood tests and delivered cancer therapies. Patients were instructed to take drugs after blood test results and therapy confirmation by oncologists. Sixty-six patients decided to participate and 38 declined the service. A customer satisfaction questionnaire was administered to a subgroup of patients participating in the project. The most prevalent disease in the HSC group was prostate cancer. The mean age of the patients in HSC was 78.4 years and 68.9 in the decliner group. The majority of the HSC participants appreciated the project because they could stay at home (71%) and reduce the risk of COVID-19 contagion (67.7%). Compared to decliners, the time the study group saved was 2033 hours. HSC guaranteed the continuity of care during the COVID-19 pandemic by reducing the number of patients in the hospital and avoiding crowds in the waiting room.
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Affiliation(s)
- Tania Buttiron Webber
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
| | - Silvia Giuliano
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
| | - Carlotta Patrone
- Office Innovation, Development and Lean Application, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy;
| | - Irene Maria Briata
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
| | - Maria Franconeri
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
| | - Francesca Marceca
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
| | - Monica Magnani
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
| | - Fortuna Paciolla
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
| | - Nicoletta Provinciali
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
| | - Carlotta Defferrari
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
| | - Matteo Clavarezza
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
| | - Mauro D’Amico
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
| | - Alberto Gozza
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
| | - Monica Boitano
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
| | - Mattia Alessio-Mazzola
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy;
| | - Isabella Cevasco
- Healthcare Professions Structure, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy;
| | - Andrea DeCensi
- Medical Oncology, Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy; (T.B.W.); (S.G.); (I.M.B.); (M.F.); (F.M.); (M.M.); (F.P.); (N.P.); (C.D.); (M.C.); (M.D.); (A.G.); (M.B.)
- European Institute of Oncology (IEO), IRCCS, 20141 Milan, Italy
- Correspondence: ; Tel.: +39-01-0563-4535
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Patient-Reported Outcomes following Genetic Testing for Familial Hypercholesterolemia, Breast and Ovarian Cancer Syndrome, and Lynch Syndrome: A Systematic Review. J Pers Med 2021; 11:jpm11090850. [PMID: 34575627 PMCID: PMC8467628 DOI: 10.3390/jpm11090850] [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: 07/20/2021] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Patient-reported outcomes (PROs) and PRO measures (PROMs) are real-world evidence that can help capture patient experiences and perspectives regarding a clinical intervention such as genetic testing. Objective: To identify and capture methods and qualitative PRO themes among studies reporting PROs following genetic testing for FH, breast and ovarian cancer syndrome, and Lynch syndrome. Methods: A systematic review was conducted via PubMed/MEDLINE, EMBASE, and Yale University’s TRIP Medical Databases on articles published by April 2021. Results: We identified 24 studies published between 1996 and 2021 representing 4279 participants that reported PROs following genetic testing for FH, breast and ovarian cancer syndrome, and Lynch syndrome. Studies collected and reported PROs from validated PROM instruments (n = 12; 50%), validated surveys (n = 7; 26%), and interviews (n = 10; 42%). PRO themes ranged across all collection methods (e.g., psychological, knowledge, coping and satisfaction, concern about stigma/discrimination, etc.). Conclusions: Important gaps identified include (1) most studies (n = 18; 75%) reported PROs following genetic testing for breast and ovarian cancer, and (2) populations reporting PROs overall were largely of White/Caucasian/Northern European/Anglo-Saxon descent. We offer recommendations and describe real-world implications for the field moving forward.
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Yasin AI, Topcu A, Shbair AT, Isleyen ZS, Ozturk A, Besiroglu M, Türk HM. Anxiety levels of breast cancer patients in Turkey during the COVID-19 pandemic. Future Oncol 2021; 17:3373-3381. [PMID: 34291649 PMCID: PMC8297541 DOI: 10.2217/fon-2020-1265] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Aim: To assess the anxiety levels of breast cancer patients during the COVID-19 pandemic. Materials & methods: A total of 298 patients completed the State-Trait Anxiety Inventory (STAI-S and STAI-T) and the Visual Analogue Scale for Anxiety (VAS) and VAS for Anxiety in COVID-19 (VAS-CoV). Results: 144 patients were in the high anxiety category for STAI-S, and 202 patients were in the high anxiety category for STAI-T. STAI-T score was significantly high in the metastatic group (p = 0.017). VAS-CoV score in the hormonotherapy group was significantly higher than in the no-treatment group (p = 0.023). There was a positive correlation between VAS-CoV and VAS levels (r = 0.708, p < 0.001), VAS-CoV and STAI-S and STAI-T scores (r = 0.402, p < 0.001; r = 0.185, p = 0.001, respectively), and a negative correlation between education years and STAI-T scores (r = -0.172, p = 0.003). Conclusion: The COVID-19 pandemic is related to high anxiety levels in breast cancer patients. COVID-19 pandemic is related to rapidly rising anxiety levels worldwide. Because of the high mortality of COVID-19 in cancer patients, changing treatment routines and disruptions of the healthcare system, cancer patients are the most affected population in this situation. Anxiety among females and breast cancer patients tend to be high, although anxiety levels in cancer patients during the pandemic period varies according to the cancer type, treatment status and sociodemographic factors. This study assessed the effect of the COVID-19 pandemic on breast cancer patients' anxiety levels according to treatment status and stage of the disease. A total of 298 breast cancer patients completed the universally validated anxiety questionnaires. Results demonstrated high trait anxiety in breast cancer patients, particularly in the metastatic group. The current findings highlighted the importance of intensive assessment and close monitoring of breast cancer patients' psychological situations. It is crucial to provide psychological support to breast cancer patients to contribute to both treatment and follow-up processes during the pandemic.
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Affiliation(s)
- Ayse Irem Yasin
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Atakan Topcu
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Abdallah Tm Shbair
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | | | - Ahmet Ozturk
- Department of Psychiatry, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Mehmet Besiroglu
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Hacı Mehmet Türk
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
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21
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Quality of Life and Psychosocial Impacts of the Different Restrictive Measures during One Year into the COVID-19 Pandemic on Patients with Cancer in Italy: An Ecological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137161. [PMID: 34281098 PMCID: PMC8297179 DOI: 10.3390/ijerph18137161] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 01/22/2023]
Abstract
Background: The aim of the study was to assess the perceived quality of life and the psychosocial impact of the various restrictive measures due to COVID-19 pandemic on cancer patients in Italy, as well as their perception of the relationship with doctors and caregivers. Methods: This study compares three population-based observational studies of patients with cancer carried out in three consecutive time periods characterized by different restrictive measures using a self-administered online questionnaire. Results: Among the basic needs, psychological and medical support appeared to be prevalent; so did the need for safe transportation to reach the treatment facilities. Internet was the main source of information on the coronavirus. Although 74.6% of the total number of patients did not give up hospital therapies, 34.8% complained about variations in the continuity of treatment, with different percentages in the three samples. The majority of the sample (73.8%) was worried of being infected, but 21.9% did not share their anxieties and worries with others. The multivariate regression analysis showed that a pessimistic perception of quality of life was influenced by living in extra-urban areas and alone (OR = 1.4; OR = 2.1); while a perception of a reduced physical function result affected by the state of anxiety and stress (OR = 1.9) and the difficulties in continuity of medical assistance (OR = 2.2). The scoring of the SF-12 in the Physical Component Summary and Mental Component Summary scores showed a fluctuating trend throughout the three periods investigated. Conclusions: It is important for health professionals, caregivers and social workers to identify the new needs in order to enhance home care interventions, personalize and optimize care, ensure continuity of care and guarantee a high quality of life even in a health emergency situation.
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