The Level of COVID-19 Anxiety among Oncology Patients in Poland

The impact of the Covid-19 pandemic on outpatient visits for patients with cancer in Iran: an interrupted time series analysis

BACKGROUND

The Covid-19 pandemic has posed unprecedented challenges to healthcare systems worldwide, affecting routine medical services, including for cancer patients. This study investigates the impact of the Covid-19 pandemic on outpatient visits for patients with cancer in Iran.

METHODS

We conducted an interrupted time series analysis (ITSA) on data collected from electronic medical records. The ITSA methodology was employed to analyze monthly outpatient visits for patients with cancer data from March 2017 to January 2023 in Lorestan University of Medical Sciences.

RESULTS

Following the announcement of Covid-19 in Iran, outpatient visits for patients with cancer decreased immediately and sharply, with a mean of 247.08 visits per month, which has a 95% confidence interval of [-297; -197]. Subsequent waves in June 2020, September 2020, April 2021, July 2021, and January 2022 further affected outpatient visits. However, the initiation of Covid-19 vaccination, particularly for cancer patients, marked a positive turning point, leading to an increase of 156.39 outpatient visits between January and February 2022.

CONCLUSION

Our study provides critical insights into the dynamic relationship between the Covid-19 pandemic, patient behavior, and cancer care utilization. The observed decrease in outpatient visits underscores the multifaceted challenges faced by cancer patients during the pandemic, while the positive influence of vaccination signals a pathway towards recovery. The importance of vaccination is highlighted as a key factor in improving outpatient visit rates. As healthcare systems adapt to ongoing challenges, understanding the complex interplay between public health crises and patient behavior is crucial for shaping resilient and patient-centric healthcare systems.

The mediating role of COVID-19 anxiety on the relationship between quality of life and spiritual well-being, and hopelessness: A study on cancer patients

OBJECTIVES

The coronavirus pandemic has caused concern in the community, especially in patients. Spirituality, hopelessness, and quality of life have an impact on the management of the process in cancer patients during these crisis periods. To investigate COVID-19 anxiety's mediating role in hopelessness' relationships with the quality of life and spiritual well-being among cancer patients.

METHODS

This study used a cross-sectional design to collect data from cancer patients using self-administered questionnaires. The study recruited 176 cancer patients receiving treatment at a university hospital. The participants completed measures of spiritual well-being, COVID-19 anxiety, hopelessness, and quality of life. Following preliminary analyses, a mediation model was analyzed using the PROCESS macro for SPSS, with the bootstrap method applied (model 4).

RESULTS

The results showed that spiritual well-being was negatively associated with COVID-19 anxiety and hopelessness, and positively associated with the quality of life. COVID-19 anxiety was associated positively with hopelessness, and negatively with the quality of life. Moreover, COVID-19 anxiety mediated the relationship between hopelessness, spiritual well-being, and quality of life.

SIGNIFICANCE OF RESULTS

This study provides evidence for COVID-19 anxiety's mediating role in the relationship between spiritual well-being and quality of life and hopelessness among cancer patients. The findings suggest that interventions aimed at reducing COVID-19 anxiety may be effective in reducing hopelessness among cancer patients, by promoting higher levels of spiritual well-being and improving quality of life.

Correlation of Spiritual Health and Stress Related to the COVID-19 Pandemic in Cancer Patients

Background

Both coronavirus disease-2019 (COVID-19) and cancer place a heavy burden on the society and mental health of patients. Spiritual health may play a prominent role in coping with stressful conditions. Considering the existing controversy regarding the correlation between spiritual health and stress related to the COVID-19 pandemic in cancer patients, this study aimed to assess the correlation between spiritual health and COVID-19 stress in cancer patients.

Methods

This cross-sectional study was conducted on cancer patients presenting to Rasoul and Firouzgar Hospitals, affiliated with Iran University of Medical Sciences, in 2022. After obtaining written informed consent, eligible patients filled out the spiritual health questionnaire and COVID Stress Scale (CSS). Data were analyzed by the Pearson and Spearman correlation coefficients and one-way ANOVA.

Results

The mean (SD) levels of COVID-19 stress and spiritual health were equal to 106.5 (44.5) and 26.2 (10.9), respectively, which are regarded as moderate levels. An inverse correlation of -0.48 was found between spiritual health and COVID-19 stress (P < 0.001). Spiritual health decreased by an increase in the stage of cancer (P < 0.001). The mean COVID-19 total stress score and its domain scores [except for the post-traumatic stress syndrome (PTSD) domain] were significantly higher in patients with poor spiritual health compared with those with good spiritual health. However, the difference in this regard was not significant between patients with poor and moderate spiritual health (P > 0.05).

Conclusion

This study confirmed the prominent role of spiritual health in the reduction of COVID-19 stress. Promotion of spiritual health in cancer patients should be considered as an inseparable part of patient care to prevent disease aggravation and decrease the stress level of cancer patients, particularly during the COVID-19 pandemic.

A study of COVID anxiety, spiritual well-being and resilience levels in patients with cancer undergoing chemotherapy during the COVID-19 pandemic: a cross-sectional study in the south of Iran

BACKGROUND

Patients with cancer are at higher risk of contracting COVID-19 with poor prognosis. Therefore, the present study was conducted to investigate anxiety, spiritual well-being, and resilience levels in patients with cancer undergoing chemotherapy during the COVID-19 pandemic in the south of Fars Province, Iran.

METHODS

This is a descriptive study with a cross-sectional design conducted on the patients undergoing chemotherapy at Dr. Ali Shariati Hospital in Fasa from November 2021 to February 2022. Cancer patients undergoing chemotherapy were included in the study by census method. Out of 210 patients, 155 participated in the study. Data were collected electronically using the standard instruments of Ellison's Spiritual Well-being Scale, COVID-19 anxiety questionnaire, and Connor-Davidson resilience scale. The collected data were analyzed in SPSS 22 using descriptive statistics, Pearson correlation tests, T-test, ANOVA and multivariate linear regression at a level of significance of P < 0.05.

RESULTS

The participants' resilience mean score was 46.35 ± 26.51 and their spiritual well-being mean score was 69.58 ± 9.32. In addition, their COVID anxiety mean, score was found to be 16.85 ± 10.51. The results showed a significant direct correlation between the patients' spiritual well-being and resilience (r = 0.47, P < 0.001) and a significant inverse correlation between the patients' spiritual well-being and COVID-19-related anxiety (r = - 0.275, P < 0.001). In addition, there was a significant inverse correlation between the variables of resilience and COVID-19-related anxiety (r = - 0.637, P < 0.001). Based on multivariate linear regression, the most common predictors in resilience were age and history of infection with COVID-19, and in spiritual health and anxiety, was a history of infection with COVID-19.

CONCLUSION

Enhancement of spiritual well-being and resilience in patients should be an integral part of care as these qualities are valuable resources in fighting cancer and lowering patients' anxiety, especially during the COVID-19 pandemic.

Availability of Medical Services and Teleconsultation during COVID-19 Pandemic in the Opinion of Patients of Hematology Clinics-A Cross-Sectional Pilot Study (Silesia, Poland)

A new virus, SARS-CoV-2, emerged in December 2019, triggering the COVID-19 pandemic in 2020 due to the rapid spread and severity of cases worldwide. In Poland, the first case of COVID-19 was reported on 4 March 2020. The aim of the prevention efforts was primarily to stop the spread of the infection to prevent overburdening the health care system. Many illnesses were treated by telemedicine, primarily using teleconsultation. Telemedicine has reduced personal contact between doctors and patients and reduced the risk of exposure to disease for patients and medical personnel. The survey aimed to gather patients' opinions on the quality and availability of specialized medical services during the pandemic. Based on the data collected regarding patients' opinions on services provided via telephone systems, a picture was created of patients' opinions on teleconsultation, and attention was drawn to emerging problems. The study included a 200-person group of patients, realizing their appointments at a multispecialty outpatient clinic in Bytom, aged over 18 years, with various levels of education. The study was conducted among patients of Specialized Hospital No. 1 in Bytom. A proprietary survey questionnaire was developed for the study, which was conducted on paper and used face-to-face interaction with patients. Results: 17.5% of women and 17.5% of men rated the availability of services during the pandemic as good. In contrast, among those aged 60 and over, 14.5% of respondents rated the availability of services during the pandemic as poor. In contrast, among those in the labor force, as many as 20% of respondents rated the accessibility of services provided during the pandemic as being well. The same answer was marked by those on a pension (15%). Overwhelmingly, women in the age group of 60 and over showed a reluctance toward teleconsultation. Conclusions: Patients' attitudes toward the use of teleconsultation services during the COVID-19 pandemic varied, primarily due to attitudes toward the new situation, the age of the patient, or the need to adapt to specific solutions not always understood by the public. Telemedicine cannot completely replace inpatient services, especially among the elderly. It is necessary to refine remote visits to convince the public of this type of service. Remote visits should be refined and adapted to the needs of patients in such a way as to remove any barriers and problems arising from this type of service. This system should also be introduced as a target, providing an alternative method of inpatient services even after the pandemic ends.

Psychological Well-Being of Cancer Patients before and during the Pandemic: The Impact of COVID-19 Peritraumatic Distress

BACKGROUND

This study aimed to evaluate the psychological impact of the COVID-19 pandemic on cancer patients.

METHODS

Ninety cancer patients undergoing chemotherapy with antiblastics were recruited from a tertiary medical center and completed a battery of standardized questionnaires to assess anxiety, depression, peritraumatic stress, and quality of life before and during the pandemic.

RESULTS

Quality of life worsened significantly during the pandemic compared with the pre-pandemic period. Anxiety and depression levels also increased significantly during the pandemic. COVID-19 peritraumatic distress significantly predicted lower quality-of-life scores during the pandemic.

CONCLUSIONS

COVID-19 distress affected the overall quality of life of patients who already had lower levels of quality of life before the pandemic and who had advanced cancers. Cancer patients must receive adequate support from psychiatrists and psychologists to mitigate the psychological distress related to the pandemic.

Proper Dietary and Supplementation Patterns as a COVID-19 Protective Factor (Cross-Sectional Study-Silesia, Poland)

BACKGROUND

The COVID-19 pandemic has become a challenge for the world today, so it is very important to create healthy eating habits in society to support immunity and raise awareness of the benefits of supplementation.

OBJECTIVE

The purpose of this study is to evaluate diet and dietary supplementation, since previous studies indicate the protective nature of these in building immunity during the pandemic and post-pandemic period (COVID-19). The hypothesis of the study is whether the dietary regimen presented by the COVID-19 respondents can be considered protective in building immunity against SARS-CoV-2.

MATERIAL AND METHODS

The study included 304 subjects, with an average age of 39.04 ± 23.59. The main criteria for inclusion in the study were that the respondent was ≥18 years old and participated voluntarily. The study was conducted using an original questionnaire.

RESULTS

In the study group, no change was noticed in the previous diet during the COVID-19 pandemic, while the level of physical activity among the respondents decreased. Too low a percentage of people regularly consumed, among other foods. legume seeds-only 10.5% of respondents consumed them several times a week-and citrus fruits-the largest number of respondents, as many as 39.8%, only consumed them several times a month. The largest percentage of respondents with mild/scanty COVID-19 disease regularly took vitamin C-containing preparations (n = 61; 59.80%). Statistical analysis showed that there was a correlation between the incidence of mild/scanty COVID-19 and the regularity of taking vitamin C-containing preparations (T = 11.374; r = 0.611; p = 0.04603). A statistical significance level was also obtained for the regularity of supplementation of multivitamin preparations, which were taken by 68% (34) of respondents affected by mild/scanty COVID-19 (T = 13.456; r = 0.711; p = 0.02191).

CONCLUSIONS

The study's hypothesis was supported. Respondents characterized by a normal dietary pattern and taking supplements commonly recognized as immune "boosters" were more likely to mildly survive COVID-19. Moreover, it was shown that the pandemic in most of the respondents did not significantly affect their dietary strategy. It is reasonable to conclude that the dietary patterns adopted may be a common way to prevent SARS-CoV-2 infections and their possible complications.

Polish Adaptation of the Modified Tampa Scale of Kinesiophobia for Fatigue (TSK-F) and the Revision of the Tampa Scale in Terms of Pain for Cancer Patients

The aim of this study was to create a Polish adaptation of the Tampa Scale of Kinesiophobia considering fatigue, and to verify the usefulness of the scale in the context of pain in cancer patients. The study was conducted at the Breast Cancer Unit, operating at the Greater Poland Cancer Centre, and at the Poznan Centre for Specialist Medical Services in Poznan. After considering the exclusion criteria, 100 people qualified for the interviews for the final study: 50 breast cancer patients and 50 healthy respondents (without cancer). Statistical analysis of the CFA score showed that the chi-square test was not significant (χ² = 10.243, p = 0.332), indicating an acceptable fit of items across scales. The reliability of the internal consistency of the scales was tested by examining the Cronbach's alpha scores for each question/statement. The mean values for this indicator were 0.74 for the pain-related scale and 0.84 for the fatigue-related scale. Construct validity was confirmed for the scales; AVE for the pain-related scale was 0.64 and for the fatigue-related scale was 0.68. The results suggest the validity of examining kinesiophobia in the context of pain- and fatigue-related mobility anxiety among breast cancer patients in Poland, and that the Tampa Scale of Kinesiophobia can be adapted for different dimensions of the condition. Both versions of the scale demonstrated adequately prepared parametric constructs, and all correlations showed a statistically significant relationship (p < 0.05). The use of the Tampa Scale of Kinesiophobia in oncology patient studies in Poland may ultimately improve rehabilitation programs and enable the development of strategies to assist patients in supporting treatment to reduce movement anxiety.