The COVID-19 pandemic: a new epoch and fresh challenges for cancer patients and caregivers-a descriptive cross-sectional study

Analysis of the status and content of consultations with a Cancer Consultation and Support Centre during the COVID-19 pandemic

PURPOSE

Cancer Consultation and Support Centres (CCSCs) in Japan have been established at designated cancer hospitals nationwide and these centres provide information and consultation support for cancer care. The purpose of this study is to analyse the status and content of consultations during the COVID-19 pandemic using consultation record data from the Cancer Consultation Support Centre (CCSC) database from January 2020 to March 2021.

METHODS

First, we examined the number and percentage of cases involving and not involving COVID-19 and compared the items of the entry forms between the groups. The comparison between the two groups suggests that the traditional consultation items used before the COVID-19 pandemic did not adequately cover the consultation content during the COVID-19 pandemic. Therefore, we categorised the content of consultation records related to COVID-19.

RESULTS

As a result, the content was consolidated into 16 categories, which were appropriately captured from five different aspects.

CONCLUSION

Using the resulting categories, we were able to create a complementary consultation entry form that could be operational during the COVID epidemic and consult consultants for the support they needed.

TRIAL REGISTRATION

Not applicable.

A Mixed-Method Examination of Emerging and Young Adult Cancer Caregivers' Experiences during the COVID-19 Pandemic

Advanced cancer caregivers in emerging and young adulthood (EYACs; ages 18-35) are an understudied yet vulnerable caregiving population. The COVID-19 pandemic created new challenges for advanced cancer caregivers but also created unique contexts from which caregivers sometimes benefited. To understand how the pandemic may have positively and negatively impacted their caregiving and bereavement experiences, we examined EYACs' experiences of caring for and losing a parent with advanced cancer during the pandemic in comparison to those of EYACs with a parent who died outside the context of the pandemic. Eligible EYACs completed an online survey and semi-structured interview. Quantitative analyses compared responses for pre-pandemic EYACS (n = 14) and pandemic EYACs (n = 26). A thematic analysis of the interview transcripts of pandemic EYACS (n = 14) was conducted. Pandemic EYACs experienced non-significant but higher communal coping, benefit finding, negative emotional experiences, and caregiver strain than pre-pandemic EYACs. Thematic analysis revealed that the pandemic negatively affected EYACs' caregiving efficacy, personal well-being, interpersonal dynamics, and bereavement; shifts to remote work and schooling were reported as benefits. The findings can inform the design of resources to support EYACs whose parents died during the pandemic and who are navigating the healthcare system today.

Somatic burden in Russia during the COVID-19 pandemic

Somatic burden has become one of the most common psychological reactions to the COVID-19 pandemic worldwide. This study examined the prevalence of somatic burden, latent profiles, and associated factors of somatic symptoms during the pandemic in a large sample of Russians. We used cross-sectional data from 10,205 Russians collected during October-December, 2021. Prevalence of somatic burden was assessed with the Somatic Symptom Scale-8. Latent profiles of somatic burden were identified using latent profile analysis. Multinomial logistic regression was used to examine demographic, socioeconomic, and psychological associated factors of somatic burden. Over one-third (37%) of the Russians reported being somatised. We selected the three-latent profile solution with high somatic burden profile (16%), medium somatic burden profile (37%), and low somatic burden profile (47%). The associated factors of greater somatic burden were female gender, lower education, history of COVID-19 disease, refusing vaccination against SARS-CoV-2 infection, poorer self-rated health, greater fear of COVID-19 pandemic, and living in regions with higher excess mortality. Overall, this study contributes to knowledge about the prevalence, latent profiles, and associated factors of somatic burden during the COVID-19 pandemic. It can be useful to researchers in psychosomatic medicine and practitioners in the health care system.

Palliative care delivery changes during COVID-19 and enduring implications in oncology nursing: a rapid review

PURPOSE OF REVIEW

A rapid review was conducted to synthesize evidence of palliative care delivery changes during the COVID-19 pandemic. Changes were synthesized according to the eight domains of high-quality palliative care and enduring implications for oncology nurses beyond the pandemic discussed.

RECENT FINDINGS

The most significant changes occurred in the structure and processes of palliative care (Domain 1), where increased utilization of telehealth was critical in circumventing barriers imposed by COVID-19 mitigation. The suboptimal availability of community-based psychosocial supports for patients and caregivers and inadequate health system-based psychosocial supports for healthcare providers were highlighted (Domains 3-5). The pandemic also ushered in an increased emphasis on the need for advance care planning (ACP), where integrating its delivery earlier in the outpatient setting and shifting policy to promote subsequent virtual documentation (Domain 8) were essential to ensure care preferences were clarified and accessible before health crises occurred.

SUMMARY

Continuing to embrace and sustain systems-level changes with respect to telehealth, psychosocial supports, and ACP are critical to bridging gaps in palliative care delivery underscored by the pandemic. Oncology nurses are well positioned to fill these gaps in care beyond the pandemic by providing evidence-based, palliative care throughout the cancer continuum.

Spirituality in Serious Illness and Health

IMPORTANCE

Despite growing evidence, the role of spirituality in serious illness and health has not been systematically assessed.

OBJECTIVE

To review evidence concerning spirituality in serious illness and health and to identify implications for patient care and health outcomes.

EVIDENCE REVIEW

Searches of PubMed, PsycINFO, and Web of Science identified articles with evidence addressing spirituality in serious illness or health, published January 2000 to April 2022. Independent reviewers screened, summarized, and graded articles that met eligibility criteria. Eligible serious illness studies included 100 or more participants; were prospective cohort studies, cross-sectional descriptive studies, meta-analyses, or randomized clinical trials; and included validated spirituality measures. Eligible health outcome studies prospectively examined associations with spirituality as cohort studies, case-control studies, or meta-analyses with samples of at least 1000 or were randomized trials with samples of at least 100 and used validated spirituality measures. Applying Cochrane criteria, studies were graded as having low, moderate, serious, or critical risk of bias, and studies with serious and critical risk of bias were excluded. Multidisciplinary Delphi panels consisting of clinicians, public health personnel, researchers, health systems leaders, and medical ethicists qualitatively synthesized and assessed the evidence and offered implications for health care. Evidence-synthesis statements and implications were derived from panelists' qualitative input; panelists rated the former on a 9-point scale (from "inconclusive" to "strongest evidence") and ranked the latter by order of priority.

FINDINGS

Of 8946 articles identified, 371 articles met inclusion criteria for serious illness; of these, 76.9% had low to moderate risk of bias. The Delphi panel review yielded 8 evidence statements supported by evidence categorized as strong and proposed 3 top-ranked implications of this evidence for serious illness: (1) incorporate spiritual care into care for patients with serious illness; (2) incorporate spiritual care education into training of interdisciplinary teams caring for persons with serious illness; and (3) include specialty practitioners of spiritual care in care of patients with serious illness. Of 6485 health outcomes articles, 215 met inclusion criteria; of these, 66.0% had low to moderate risk of bias. The Delphi panel review yielded 8 evidence statements supported by evidence categorized as strong and proposed 3 top-ranked implications of this evidence for health outcomes: (1) incorporate patient-centered and evidence-based approaches regarding associations of spiritual community with improved patient and population health outcomes; (2) increase awareness among health professionals of evidence for protective health associations of spiritual community; and (3) recognize spirituality as a social factor associated with health in research, community assessments, and program implementation.

CONCLUSIONS AND RELEVANCE

This systematic review, analysis, and process, based on highest-quality evidence available and expert consensus, provided suggested implications for addressing spirituality in serious illness and health outcomes as part of person-centered, value-sensitive care.