How did women with breast cancer experience the first wave of the COVID-19 pandemic? A qualitative study

Objective

The ongoing COVID-19 global pandemic is a stressful experience that is particularly likely to negatively affect cancer patients. The goal of this qualitative study was to explore how breast cancer patients experienced the first wave of the COVID-19 outbreak.

Methods

As part of a larger study, 23 women accepted to take part in an individual phone interview investigating the psychosocial consequences of the COVID-19 pandemic.

Results

The hybrid inductive-deductive thematic analysis revealed the following themes: (1) increased general psychological distress; (2) concerns about the impact of treatment-related immunosuppression (i.e., increased risk of catching the SARS-CoV-2 and of developing more severe complications); (3) higher risk of catching the SARS-CoV-2 in the hospital; (4) possible impact of changes in cancer care trajectory on prognosis; (5) distress related to going to treatment alone; (6) social isolation and decreased family relationships; (7) increased responsibility at home; (8) variety of coping strategies used (i.e., adherence to public health measures, seeking professional help, avoidance); (9) difficulty receiving professional mental health services and social support; (10) anxiety related to return to work; and (11) uncertainty about the future.

Conclusions

The COVID-19 outbreak is a major medical, psychological, social, and occupational stressor for women undergoing treatment for breast cancer. We offer recommendations to reduce the impact of subsequent waves of COVID-19 and other epidemics in this population.

Use of phalangeal bone mineral density and multi-site speed of sound conduction to monitor therapy with alendronate in postmenopausal women

In women with postmenopausal osteoporosis (PMO), response to therapy with bisphosphonates is conventionally monitored using central-site (hip and spine) bone mineral density (BMD), but more convenient alternatives are desirable. During a randomized parallel-group study of the efficacy of once-weekly (80 mg vs 160 mg) oral alendronate in the treatment of PMO, 81 women (mean age 70.2 years +/- 4.6 SD) had BMD measurements of total hip (TH) and lumbar spine (LS) (L1-L4, Hologic); and of the middle phalanx of the middle digit of the non-dominant hand (accuDXA) at baseline and after 6 and 12 months of therapy with alendronate. At the same timepoints, subjects also had measurements of speed of sound (SOS) through bone at four sites (distal 1/3 radius, proximal phalanx of the third finger, midshaft of the tibia and fifth metatarsal) using the Sunlight Omnisense Ultrasound Bone Sonometer. Data from both patient groups were pooled for this analysis. Mean TH BMD at baseline was 0.705 g/cm2 +/- 0.093 (SD) and increased by 1.7% +/- 2.3% and 2.5% +/- 2.3% at 6 and 12 months respectively (p = 0.09 and p<0.0001). Mean LS BMD at baseline was 0.718 +/- 0.076 g/cm2 and increased by 3.9% +/- 3.6% and 6.1% +/- 3.5% at 6 and 12 months respectively (both p<0.0001). There was no statistically significant change from baseline in mean BMD by accuDXA at either 6 or 12 months. The only statistically significant changes in SOS were at the radius (decrease in SOS at 12 months, p= 0.04) and tibia (increase at 6 months, p<0.01, but no change between baseline and 12 months). Baseline correlation coefficients between accuDXA and LS and TH DXA were 0.22 (p = 0.05) and 0.27 (p = 0.02) respectively. Correlation coefficients between SOS and LS DXA ranged from 0.05 to 0.22; and between SOS and TH DXA ranged from -0.08 to 0.10 (all p = NS). These data suggest that the response to alendronate therapy over this time period cannot be measured by accuDXA or Sunlight SOS at the sites studied.

[Caregivers of persons infected with HIV]

This study describes the extent of caregivers' knowledge about Quebec men infected with HIV/AIDS, highlights some of the caregivers' own health behaviors, assesses their perceptions of their own quality of life, and verifies links between these three variables. The findings are part of a master's thesis, written in 1995 at the Université de Montréal. The respondents' overall perceptions of their quality of life was fair. However, they were not as satisfied with their work outside the home and their recreation. Respondents also felt that their quality of life was least affected in the area of their relationships as part of a couple. In general the variables-knowledge about AIDS and health behaviors-best explain the perceptions of the quality of life of these caregivers. The study concludes that health care providers of this population should learn more about: AIDS among natural caregivers; their own health behaviors; and their perceptions of their own quality of life. By doing so, they can take an active role in their own well-being while performing their duties.