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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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De Santis KK, Helmer S, Barnes B, Kraywinkel K, Imhoff M, Müller-Eberstein R, Kirstein M, Quatmann A, Simke J, Stiens L, Christianson L, Zeeb H. Impact of the COVID-19 pandemic on oncological care in Germany: rapid review. J Cancer Res Clin Oncol 2023; 149:14329-14340. [PMID: 37507594 PMCID: PMC10590309 DOI: 10.1007/s00432-023-05063-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVES The COVID-19 pandemic affected medical care for chronic diseases. This study aimed to systematically assess the pandemic impact on oncological care in Germany using a rapid review. METHODS MEDLINE, Embase, study and preprint registries and study bibliographies were searched for studies published between 2020 and 2 November 2022. Inclusion was based on the PCC framework: population (cancer), concept (oncological care) and context (COVID-19 pandemic in Germany). Studies were selected after title/abstract and full-text screening by two authors. Extracted data were synthesized using descriptive statistics or narratively. Risk of bias was assessed and summarized using descriptive statistics. RESULTS Overall, 77 records (59 peer-reviewed studies and 18 reports) with administrative, cancer registry and survey data were included. Disruptions in oncological care were reported and varied according to pandemic-related factors (e.g., pandemic stage) and other (non-pandemic) factors (e.g., care details). During higher restriction periods fewer consultations and non-urgent surgeries, and delayed diagnosis and screening were consistently reported. Heterogeneous results were reported for treatment types other than surgery (e.g., psychosocial care) and aftercare, while ongoing care remained mostly unchanged. The risk of bias was on average moderate. CONCLUSIONS Disruptions in oncological care were reported during the COVID-19 pandemic in Germany. Such disruptions probably depended on factors that were insufficiently controlled for in statistical analyses and evidence quality was on average only moderate. Research focus on patient outcomes (e.g., longer term consequences of disruptions) and pandemic management by healthcare systems is potentially relevant for future pandemics or health emergencies.
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Affiliation(s)
- Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany.
| | - Stefanie Helmer
- Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Benjamin Barnes
- German Center for Cancer Registry Data, Robert Koch Institute (RKI), Berlin, Germany
| | - Klaus Kraywinkel
- German Center for Cancer Registry Data, Robert Koch Institute (RKI), Berlin, Germany
| | - Maren Imhoff
- German Center for Cancer Registry Data, Robert Koch Institute (RKI), Berlin, Germany
| | | | - Mathia Kirstein
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany
| | - Anna Quatmann
- Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Julia Simke
- Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Lisa Stiens
- Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Lara Christianson
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany
- Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
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Baydoun M, McLennan AI, Carlson LE. People With Cancer Experience Worse Psychosocial and Financial Consequences of COVID-19 Compared With Other Chronic Disease Populations: Findings From the International COVID-19 Awareness and Response Evaluation Survey Study. JCO Glob Oncol 2023; 9:e2300085. [PMID: 38060976 PMCID: PMC10723856 DOI: 10.1200/go.23.00085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/05/2023] [Accepted: 10/10/2023] [Indexed: 12/17/2023] Open
Abstract
PURPOSE The COVID-19 pandemic is likely to have profound psychosocial impacts across the globe. In this analysis of the International COVID-19 Awareness and Response Evaluation (iCARE) survey study, we comparatively investigated the psychosocial effects of COVID-19 on individuals with cancer and people with other chronic illness. METHODS iCARE study respondents were divided into two groups on the basis of self-reported health status: (1) active/current cancer (with or without any other chronic condition: heart disease, lung disease, hypertension, diabetes, severe obesity, immunity disease, and depressive or anxiety disorder); and (2) other chronic condition, but not cancer. Linear regressions were conducted to evaluate the associations between health status and outcomes. RESULTS Worldwide, 18,154 iCARE study respondents (mean age, 50.8 years) from 175 countries were included in the analysis. Among them, 3.8% (n = 677) identified as having active/current cancer and 96.2% (n = 17,477) identified as having other chronic condition. Multivariate analyses showed significant associations between having cancer and declined mental (β = .364; P < .0001) and physical (β = .317; P < .0001) health since the start of the COVID-19 pandemic, relative to those with other chronic illness. Moreover, individuals with cancer demonstrated a higher likelihood of reporting maladaptive coping mechanisms such as increased alcohol use (β = .457; P < .0001) and financial hardships such as not paying rent/mortgage (β = .476; P < .0001), compared with people with other chronic illness. CONCLUSION Individuals with cancer worldwide tended to have worse psychosocial and financial challenges during the COVID-19 pandemic, compared with other chronic disease populations. Clinicians need to be aware of the importance of attending to the specific mental health needs of individuals with cancer during and after COVID-19-related restrictions.
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Affiliation(s)
- Mohamad Baydoun
- Faculty of Nursing, University of Regina, Regina, SK, Canada
| | | | - Linda E. Carlson
- Department of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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4
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Gomes F, Taylor S, Scanlon L, Coombermoore J, Eastwood C, Stanworth M, Williamson A, Barnes C, Yorke J. The experience of patients with lung cancer during the COVID-19 pandemic and its importance for post-pandemic outpatient cancer care planning: A cross sectional study exploring the roles of age and frailty. J Geriatr Oncol 2023; 14:101449. [PMID: 36870223 PMCID: PMC9933321 DOI: 10.1016/j.jgo.2023.101449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/12/2022] [Accepted: 02/08/2023] [Indexed: 02/18/2023]
Abstract
INTRODUCTION The COVID-19 pandemic impacted the care and experiences of people with cancer, but it presented an opportunity to improve the delivery of outpatient care post-pandemic. MATERIALS AND METHODS We performed an observational cross-sectional study with people with lung cancer throughout the COVID-19 pandemic. A survey investigated patients' experiences and preferences regarding the delivery of cancer care to plan for post-pandemic care, as well as the pandemic's impact on their functional status (physical and psycho-social), exploring the role of age and frailty. RESULTS Amongst 282 eligible participants, 88%, 86%, and 59% of patients reported feeling appropriately supported during the pandemic by their cancer centre, friends/family, and primary care services, respectively. Remote oncology consultations were delivered to 90% of patients during the pandemic, of which 3% did not meet patients' expectations. Regarding post-pandemic outpatient care preferences, face-to-face appointments were preferred by 93% for the first appointment, by 64% when discussing imaging results, and by 60% for reviews during anti-cancer treatments. Older patients aged 70 years and above were more likely to favour face-to-face appointments (p = 0.007), regardless of their frailty status. Patient preferences changed over time, with the more recent participants preferring remote appointments during anti-cancer treatments (p = 0.0278). Regarding the pandemic's impact, abnormal levels of anxiety and depression were found in 16% and 17% of patients, respectively. Younger patients experienced higher abnormal levels of anxiety and depression (p = 0.036, p = 0.021). Amongst the older sub-group, those with frailty had higher levels of anxiety and depression (p < 0.001). Amongst all participants, 54% reported a considerable negative impact from the pandemic on different aspects of their daily life, particularly emotional and psychological health and sleep patterns, which were more marked in younger patients and the older sub-group with frailty. Older patients without frailty reported the least impact on their functional status. DISCUSSION There is a need for more personalised outpatient consultation options during cancer care. Whilst there is a preference for face-to-face consultations for older patients, following the pandemic there is a growing acceptance of remote consultations particularly during anti-cancer treatment. Older patients with lung cancer without frailty were less affected by the pandemic than those with frailty and younger patients, requiring less support from healthcare services.
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Affiliation(s)
- Fabio Gomes
- Medical Oncology Department, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK; Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK; Clinical Outcomes Unit, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK.
| | - Sally Taylor
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK; School of Nursing and Midwifery, The University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Lauren Scanlon
- Clinical Outcomes Unit, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - Jake Coombermoore
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - Charlotte Eastwood
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - Melissa Stanworth
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - Andrew Williamson
- Medical Oncology Department, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - Claire Barnes
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - Janelle Yorke
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK; School of Nursing and Midwifery, The University of Manchester, Oxford Road, Manchester M13 9PL, UK
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Puts M, Alqurini N, Strohschein F, Koneru R, Szumacher E, Mariano C, Monette J, Hsu T, Brennenstuhl S, McLean B, Wills A, Berger A, Amir E, Romanovsky L, Li A, Mehta R, Krzyzanowska M, Elser C, Jang R, Prica A, Wan-Chow-Wah D, Pitters E, Emmenegger U, Menjak IB, Bergman S, Lemonde M, Breunis H, Béland F, Alibhai SM. Impact of Geriatric Assessment and Management on Quality of Life, Unplanned Hospitalizations, Toxicity, and Survival for Older Adults With Cancer: The Randomized 5C Trial. J Clin Oncol 2023; 41:847-858. [PMID: 36473126 PMCID: PMC9902020 DOI: 10.1200/jco.22.01007] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE American Society of Clinical Oncology recommends that older adults with cancer being considered for chemotherapy receive geriatric assessment (GA) and management (GAM), but few randomized controlled trials have examined its impact on quality of life (QOL). PATIENTS AND METHODS The 5C study was a two-group parallel 1:1 single-blind multicenter randomized controlled trial of GAM for 6 months versus usual oncologic care. Eligible patients were age 70+ years, diagnosed with a solid tumor, lymphoma, or myeloma, referred for first-/second-line chemotherapy or immunotherapy or targeted therapy, and had an Eastern Cooperative Oncology Group performance status of 0-2. The primary outcome QOL was measured with the global health scale of the European Organisation for the Research and Treatment of Cancer QOL questionnaire and analyzed with a pattern mixture model using an intent-to-treat approach (at 6 and 12 months). Secondary outcomes included functional status, grade 3-5 treatment toxicity; health care use; satisfaction; cancer treatment plan modification; and overall survival. RESULTS From March 2018 to March 2020, 350 participants were enrolled. Mean age was 76 years and 40.3% were female. Fifty-four percent started treatment with palliative intent. Eighty-one (23.1%) patients died. GAM did not improve QOL (global QOL of 4.4 points [95% CI, 0.9 to 8.0] favoring the control arm). There was also no difference in survival, change in treatment plan, unplanned hospitalization/emergency department visits, and treatment toxicity between groups. CONCLUSION GAM did not improve QOL. Most intervention group participants received GA on or after treatment initiation per patient request. Considering recent completed trials, GA may have benefit if completed before treatment selection. The COVID-19 pandemic may have affected our QOL outcome and intervention delivery for some participants.
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Affiliation(s)
- Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada,Martine Puts, RN, PhD, FAAN, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St, Suite 130, Toronto, ON, Canada M5T 1P8; e-mail:
| | - Naser Alqurini
- Division of Geriatrics, Department of Medicine, Amiri Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Fay Strohschein
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Rama Koneru
- Department of Medical Oncology, R.S. McLaughlin Durham Regional Cancer Centre, Lakeridge Health, Oshawa, Ontario, Canada
| | - Ewa Szumacher
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Caroline Mariano
- Department of Medical Oncology, BC Cancer Center, Vancouver, British Columbia, Canada
| | - Johanne Monette
- Division of Geriatric Medicine, Department of Medicine, McGill University, Montreal, Québec, Canada
| | - Tina Hsu
- Division of Medical Oncology, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Sarah Brennenstuhl
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Bianca McLean
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada,Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Aria Wills
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Arielle Berger
- Department of Geriatric Medicine, University Health Network, Toronto, Ontario, Canada
| | - Eitan Amir
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada,Department of Medical Oncology, Mount Sinai Hospital, Sinai Health System, Toronto, Ontario, Canada
| | - Lindy Romanovsky
- Department of Geriatric Medicine, University Health Network, Toronto, Ontario, Canada
| | - Anson Li
- Department of Geriatric Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada
| | - Rajin Mehta
- Division of Geriatric Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Monika Krzyzanowska
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Christine Elser
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada,Department of Medical Oncology, Mount Sinai Hospital, Sinai Health System, Toronto, Ontario, Canada
| | - Raymond Jang
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Anca Prica
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Doreen Wan-Chow-Wah
- Division of Geriatric Medicine, Department of Medicine, McGill University, Montreal, Québec, Canada
| | - Eric Pitters
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Urban Emmenegger
- Division of Medical Oncology & Hematology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Ines B. Menjak
- Division of Medical Oncology & Hematology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Simon Bergman
- Department of Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Manon Lemonde
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Henriette Breunis
- Department of Medicine, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Francois Béland
- Public Health School, University of Montreal, Montreal, Quebec, Canada
| | - Shabbir M.H. Alibhai
- Department of Medicine and Institute of Health Policy, Management, and Evaluation, University Health Network and University of Toronto, Toronto, Ontario, Canada
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Grajek M, Krupa-Kotara K, Rozmiarek M, Sobczyk K, Działach E, Górski M, Kobza J. The Level of COVID-19 Anxiety among Oncology Patients in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811418. [PMID: 36141692 PMCID: PMC9517625 DOI: 10.3390/ijerph191811418] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 05/13/2023]
Abstract
Cancer patients tend to have a high psychological burden. Half of cancer patients suffer from severe affective disorders and anxiety disorders, while one-third struggle with mild forms of these. The COVID-19 pandemic is damaging the mental health of the population due to social restrictions. A growing number of studies note the role of COVID-19 anxiety in the health and quality of life of cancer patients. The purpose of this study is to estimate the level of COVID-19 anxiety among oncology patients and to test the utility of the FCV-19S scale in a population study of cancer patients. The study included 600 respondents (300 oncology patients and 300 control subjects not undergoing oncological treatment). The FCV-19S scale and the GAD-7 scale were used in the study. The results were interpreted according to the following verbal scale: 76-100%, high anxiety; 56-75%, moderate anxiety; 26-55%, low COVID-19 anxiety; <25%, no COVID-19 anxiety. In the analysis of the GAD-7 questionnaire results, the mean score obtained was 8.21 (min. 0; max. 21; SD 5.32). For 81% of respondents in the group of oncology patients, the total score indicated the presence of anxiety symptoms with varying degrees of severity; in the control group, this proportion was 55% of respondents. The FCV-19S scale score as a percentage was 57.4% for oncology patients, indicating a moderate level of fear of the SARS-CoV-2 virus, and 30.3% for the control group, indicating a low level of fear of the SARS-CoV-2 virus. One-fifth of oncology patients were afraid of losing their lives due to the SARS-CoV-2 virus; in the control group, this proportion was 13% of respondents. Oncology patients were characterized by a higher prevalence of sleep disturbance than control group respondents, which was associated with greater anxiety. The study, therefore, shows that oncology patients have moderate levels of anxiety associated with the COVID-19 pandemic, and non-oncology patients show lower levels of anxiety.
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Affiliation(s)
- Mateusz Grajek
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 40055 Katowice, Poland
- Correspondence: (M.G.); (K.K.-K.)
| | - Karolina Krupa-Kotara
- Department of Epidemiology, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 40055 Katowice, Poland
- Correspondence: (M.G.); (K.K.-K.)
| | - Mateusz Rozmiarek
- Department of Sports Tourism, Faculty of Physical Culture Sciences, Poznan University of Physical Education, 61871 Poznan, Poland
| | - Karolina Sobczyk
- Department of Health Economics and Health Management, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 40055 Katowice, Poland
| | - Eliza Działach
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 40055 Katowice, Poland
| | - Michał Górski
- Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 40055 Katowice, Poland
| | - Joanna Kobza
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 40055 Katowice, Poland
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7
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Supriati L, Sudiana IK, Nihayati HE, Ahsan, Rodli M, Kapti RE. Perspective of Uncertainty and Emotional Responses in Breast Cancer Patients During the COVID-19 Pandemic. SAGE Open Nurs 2022; 8:23779608221124294. [PMID: 36090540 PMCID: PMC9459494 DOI: 10.1177/23779608221124294] [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: 03/17/2022] [Accepted: 07/30/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction Breast cancer is a chronic disease that has implications for many aspects of the patient's life. Contracting the COVID-19 virus places cancer patients at a higher risk of infection. This condition triggers uncertainty which causes emotional responses. Objective The aim of this study was to measure the relationship between the uncertainty perspective of breast cancer patients and emotional responses during the COVID-19 pandemic. Methods This study used an observational study with a cross-sectional design. Data was collected from May to December 2021. The total sample of this study was 110 breast cancer patients undergoing chemotherapy at the Army Hospital of Dr. Soepraeon Malang, Indonesia. We used purposive sampling. The questionnaire used was a modified questionnaire from the Mishel Uncertainty in Illness Scale, a modified questionnaire from the Concerns about Recurrence Questionnaire, a modified questionnaire from the Zung Self Rating Anxiety Scale, and a modified questionnaire from the Depression, Anxiety, and Stress Scale. Data was analyzed using SPSS with a Spearman correlation test. Results The mean uncertainty of the respondents was 75.98 or in the moderate category, emotional response was moderate fear with a mean score of 18.40, the average anxiety score was 41.05 or normal, and the mean depression score was 15.96 or low depression. In addition, there was a significant relationship between uncertainty and the emotional response among breast cancer patients in the era of the COVID-19 pandemic (p < .05). Conclusion This study showed that there was a relationship between uncertainty and emotional response among breast cancer patients. It is important for nurses to provide good information about the disease among patients by using therapeutic communication and paying attention to the negative emotional responses of breast cancer patients.
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Affiliation(s)
- Lilik Supriati
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia,Nursing Department, Faculty of Health Science, Brawijaya University, Malang, Indonesia,Lilik Supriati, Faculty of Nursing,
Universitas Airlangga, Surabaya, 60115, Indonesia.
| | - I Ketut Sudiana
- Medicine Faculty, Universitas Airlangga, Surabaya, Indonesia
| | - Hanik Endang Nihayati
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia,Anaesthesiology and Intensive Care Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Ahsan
- Nursing Department, Faculty of Health Science, Brawijaya University, Malang, Indonesia
| | - Muhammad Rodli
- Anaesthesiology and Intensive Care Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Rinik Eko Kapti
- Nursing Department, Faculty of Health Science, Brawijaya University, Malang, Indonesia
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8
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Haier J, Beller J, Adorjan K, Bleich S, De Greck M, Griesinger F, Hein A, Hurlemann R, Mees ST, Philipsen A, Rohde G, Schilling G, Trautmann K, Combs SE, Geyer S, Schäfers J. Decision Conflicts in Clinical Care during COVID-19: A Patient Perspective. Healthcare (Basel) 2022; 10:healthcare10061019. [PMID: 35742070 PMCID: PMC9222354 DOI: 10.3390/healthcare10061019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 12/16/2022] Open
Abstract
(1) Background: Uncertainty is typical for a pandemic or similar healthcare crisis. This affects patients with resulting decisional conflicts and disturbed shared decision making during their treatment occurring to a very different extent. Sociodemographic factors and the individual perception of pandemic-related problems likely determine this decisional dilemma for patients and can characterize vulnerable groups with special susceptibility for decisional problems and related consequences. (2) Methods: Cross-sectional data from the OnCoVID questionnaire study were used involving 540 patients from 11 participating institutions covering all major regions in Germany. Participants were actively involved in clinical treatment in oncology or psychiatry during the COVID-19 pandemic. Questionnaires covered five decision dimensions (conflicts and uncertainty, resources, risk perception, perception of consequences for clinical processes, perception of consequences for patients) and very basic demographic data (age, gender, stage of treatment and educational background). Decision uncertainties and distress were operationalized using equidistant five-point scales. Data analysis was performed using descriptive and various multivariate approaches. (3) Results: A total of 11.5% of all patients described intensive uncertainty in their clinical decisions that was significantly correlated with anxiety, depression, loneliness and stress. Younger and female patients and those of higher educational status and treatment stage had the highest values for these stressors (p < 0.001). Only 15.3% of the patients (14.9% oncology, 16.2% psychiatry; p = 0.021) considered the additional risk of COVID-19 infections as very important for their disease-related decisions. Regression analysis identified determinants for patients at risk of a decisional dilemma, including information availability, educational level, age group and requirement of treatment decision making. (4) Conclusions: In patients, the COVID-19 pandemic induced specific decisional uncertainty and distress accompanied by intensified stress and psychological disturbances. Determinants of specific vulnerability were related to female sex, younger age, education level, disease stages and perception of pandemic-related treatment modifications, whereas availability of sufficient pandemic-related information prevented these problems. The most important decisional criteria for patients under these conditions were expected side effects/complications and treatment responses.
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Affiliation(s)
- Jörg Haier
- Comprehensive Cancer Center Hannover, Hannover Medical School, 30625 Hannover, Germany; (J.B.); (J.S.)
- Correspondence:
| | - Johannes Beller
- Comprehensive Cancer Center Hannover, Hannover Medical School, 30625 Hannover, Germany; (J.B.); (J.S.)
- Medical Sociology Unit, Hannover Medical School, 30625 Hannover, Germany;
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, 81377 Munich, Germany;
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany;
| | - Moritz De Greck
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, 60528 Frankfurt, Germany;
| | - Frank Griesinger
- Department of Hematology and Oncology, Pius-Hospital Oldenburg, Carl von Ossietzky University, 26129 Oldenburg, Germany;
| | - Alexander Hein
- Department of Gynecology and Obstetrics, Erlangen University Hospital, 91054 Erlangen, Germany;
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany
| | - René Hurlemann
- Department of Psychiatry, Carl von Ossietzky University, 26129 Oldenburg, Germany;
| | - Sören Torge Mees
- Department of General, Visceral and Thoracic Surgery, Friedrichstadt General Hospital, 01067 Dresden, Germany;
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, 53105 Bonn, Germany;
| | - Gernot Rohde
- Department of Respiratory Medicine and Allergology, University Hospital, Goethe University, 60590 Frankfurt am Main, Germany;
| | - Georgia Schilling
- Department of Hematology, Oncology, Palliative Care and Rheumatology, Asklepios Hospital Altona, Asklepios Tumorzentrum, 22763 Hamburg, Germany;
| | - Karolin Trautmann
- Department of Hematology and Oncology, University Hospital Carl Gustav Carus, 01307 Dresden, Germany;
| | - Stephanie E. Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany;
| | - Siegfried Geyer
- Medical Sociology Unit, Hannover Medical School, 30625 Hannover, Germany;
| | - Jürgen Schäfers
- Comprehensive Cancer Center Hannover, Hannover Medical School, 30625 Hannover, Germany; (J.B.); (J.S.)
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