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Dumas A, Milcent K, Bougas N, Bejarano-Quisoboni D, El Fayech C, Charreire H, Oberlin O, Patte C, Allard J, Thebault E, Boumaraf A, Belhout A, Giao VB, Souchard V, Jackson A, Allodji R, Valteau-Couanet D, Dufour C, Vassal G, Haddy N, De Vathaire F, Fresneau B. Predictive factors of long-term follow-up attendance in very long-term childhood cancer survivors. Cancer 2023; 129:3476-3489. [PMID: 37432135 DOI: 10.1002/cncr.34944] [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: 01/17/2023] [Revised: 05/03/2023] [Accepted: 05/11/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Long-term follow-up (LTFU) clinics have been developed but only some childhood cancer survivors (CCS) attend long-term follow-up (LTFU). OBJECTIVE To identify factors that influence LTFU attendance. METHODS Five-year CCS treated for a solid tumor or lymphoma in Gustave Roussy before 2000, included in the FCCSS cohort (French Childhood Cancer Survivor Study), aged >18 years and alive at the date of the LTFU Clinic opening (January 2012) were invited to a LTFU visit. Factors associated with attendance at the LTFU clinic between 2012 and 2020 were estimated using logistic regression analyses. Analyses included different types of factors: clinical (tumor characteristics, cancer treatments, late effects), medical (medical expenses were used as a proxy of survivor's health status), social (deprivation index based on census-tract data relating to income, educational level, proportion of blue-collar workers, and unemployed people living in the area of residence), and spatial (distance to the LTFU clinic). RESULTS Among 2341 CCS contacted (55% males, mean age at study, 45 years; SD ± 10 years; mean age at diagnosis, 6 years; SD ± 5 years), 779 (33%) attended at least one LTFU visit. Initial cancer-related factors associated with LTFU visit attendance were: treatment with both radiotherapy and chemotherapy (odds ratio [OR], 4.02; 95% CI, 2.11-7.70), bone sarcoma (OR, 2.43; 95% CI, 1.56-3.78), central nervous system primitive tumor (OR, 1.65; 95% CI, 1.02-2.67), and autologous hematopoietic cell transplant (OR, 2.07; 95% CI, 1.34-3.20). Late effects (OR, 1.70; 95% CI, 1.31-2.20), highest medical expenses (OR, 1.65; 95% CI, 1.22-2.22), living in the most advantaged area (OR vs. the most deprived area = 1.60; 95% CI, 1.15-2.22), and shorter distance from LTFU care center (<12 miles) also increased attendance. CONCLUSIONS Patients who are apparently healthy as well as socially disadvantaged and living far away from the center are less likely to attend LTFU care. PLAIN LANGUAGE SUMMARY Among 2341 adult childhood cancer survivors contacted between 2012 and 2020, 33% attended at least one long-term follow-up visit. Clinical factors related to attendance were multimodal treatment of first cancer (combining chemotherapy and radiotherapy), stem cell transplant, type of diagnosis (bone tumor and central nervous system primitive tumor), late effects (at least one disease among second malignancy, heart disease, or stroke), and highest medical expenses. In addition, the study identified social and spatial inequalities related to attendance, with independent negative effects of distance and social deprivation on attendance, even though the medical costs related to the long-term follow-up examinations are covered by the French social security system.
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Affiliation(s)
- Agnes Dumas
- Université de Paris, ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research), Paris, France
| | - Karen Milcent
- Pediatric Department, AP-HP, Antoine Béclère Hospital, Université Paris-Saclay, Clamart, France
| | - Nicolas Bougas
- Université de Paris, ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research), Paris, France
| | - Daniel Bejarano-Quisoboni
- INSERM Radiation Epidemiology Team, Villejuif, France
- Department of Clinical Research, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France
| | - Chiraz El Fayech
- Department of Children and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Hélène Charreire
- LabUrba, Université Paris Est Créteil (UPEC), Créteil, France
- Institut Universitaire de France (IUF), Paris, France
| | - Odile Oberlin
- Department of Children and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Catherine Patte
- Department of Children and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Julie Allard
- Department of Children and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Eric Thebault
- Department of Children and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Amel Boumaraf
- INSERM Radiation Epidemiology Team, Villejuif, France
- Department of Clinical Research, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France
| | - Amel Belhout
- INSERM Radiation Epidemiology Team, Villejuif, France
- Department of Clinical Research, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France
| | - Vu-Bezin Giao
- INSERM Radiation Epidemiology Team, Villejuif, France
- Department of Clinical Research, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France
| | - Vincent Souchard
- INSERM Radiation Epidemiology Team, Villejuif, France
- Department of Clinical Research, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France
| | - Angela Jackson
- INSERM Radiation Epidemiology Team, Villejuif, France
- Department of Clinical Research, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France
| | - Rodrigue Allodji
- INSERM Radiation Epidemiology Team, Villejuif, France
- Department of Clinical Research, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France
| | - Dominique Valteau-Couanet
- Department of Children and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Christelle Dufour
- Department of Children and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Gilles Vassal
- Department of Clinical Research, Gustave Roussy, Villejuif, France
| | - Nadia Haddy
- INSERM Radiation Epidemiology Team, Villejuif, France
- Department of Clinical Research, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France
| | - Florent De Vathaire
- INSERM Radiation Epidemiology Team, Villejuif, France
- Department of Clinical Research, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France
| | - Brice Fresneau
- INSERM Radiation Epidemiology Team, Villejuif, France
- Department of Clinical Research, Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Villejuif, France
- Department of Children and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
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Lefebvre C, Heitzmann P, Pelletier S, Lecomte T, Maakaroun A. [Experiences of patients with cancer during the first COVID-19 lockdown: What was the impact on the patients' healthcare pathway, mental condition, and access to supportive care in cancer?]. Bull Cancer 2023; 110:193-200. [PMID: 36621399 PMCID: PMC9701632 DOI: 10.1016/j.bulcan.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The COVID-19 pandemic disrupted the organisation of the healthcare system. Very little data is available regarding the impact of the COVID-19 pandemic on patients' perceptions of their healthcare pathway. The objective of this survey was to evaluate cancer patients' perceptions of the impact of the first COVID-19 lockdown on continuity of care, their mental condition, as well as their access to Supportive Care in Cancer (SCC). METHODS Between June 2nd and 30th, 2020, an anonymous questionnaire was sent out to the patients who visited 17 healthcare establishments in the Centre-Val de Loire region. RESULTS Our survey questioned 861 patients, amongst which 839 were selected. The population was predominantly female (58%). Breast cancer was the most represented (27%). Approximately three patients out of four considered that their care was maintained during the lockdown. In total, 348 patients (44%) reported an altered mental status. Approximately 1/4th of patients benefited from SCC. More than half of the patients felt that SCC was not relevant to their situation, although 40% of these patients expressed mental issues. CONCLUSION Our survey highlighted a negative impact on patients' mental condition and a low use of SCC in spite of existing needs. This demonstrates the necessity of evaluating the patients' needs and offering adequate SCC at various stages of the healthcare pathway, as well as the need for a clearly identifiable offer for the healthcare professionals and the patients.
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Affiliation(s)
- Carole Lefebvre
- Réseau OncoCentre, dispositif spécifique régional du cancer (DSRC), 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
| | - Patrick Heitzmann
- Réseau OncoCentre, dispositif spécifique régional du cancer (DSRC), 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - Sylvie Pelletier
- Réseau OncoCentre, dispositif spécifique régional du cancer (DSRC), 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - Thierry Lecomte
- Réseau OncoCentre, dispositif spécifique régional du cancer (DSRC), 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Université de Tours, faculté de médecine, 10, boulevard Tonnellé, 37032 Tours cedex 1, France
| | - Abadallah Maakaroun
- Réseau OncoCentre, dispositif spécifique régional du cancer (DSRC), 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Centre hospitalier Jacques Coeur, 145, avenue François-Mitterrand, 18020 Bourges cedex, France
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Mostafaei A, Sadeghi-Ghyassi F, Kabiri N, Hajebrahimi S. Experiences of patients and providers while using telemedicine in cancer care during COVID-19 pandemic: a systematic review and meta-synthesis of qualitative literature. Support Care Cancer 2022; 30:10483-10494. [PMID: 36322247 PMCID: PMC9628519 DOI: 10.1007/s00520-022-07415-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 06/17/2022] [Indexed: 11/06/2022]
Abstract
Purpose The objective of this meta-synthesis was to identify, appraise, and synthesize patients and provider’s experiences while using telemedicine in cancer care during the COVID-19 pandemic. Methods The databases Medline, Embase, Cinahl, PsycInfo, Web of Science, and other related databases were searched. Reviewers followed the Joanna Briggs Institute (JBI) meta-aggregation method to identify categories and synthesized findings and to assign a level of confidence to synthesized findings. The listed quotations and the original author interpretations were synthesized using MAXQDA software. Results Nineteen studies were included in the meta-synthesis. Three synthesized findings emerged from 243 primary findings: telemedicine assists but cannot be a substitute for face-to-face appointments in a health care crisis and in the provision of routine care to stable patients with cancer, infrastructural drivers and healthcare provider’s support and attention affect patients’ experiences and feelings about telemedicine, and patients who use telemedicine expect their health care providers to devote enough time and consider emotional needs, the lack of which can develop a negative response. The methodological quality of the studies ranged between 4 and 10, and the overall level of confidence of the synthesized findings was determined to be low and medium. Conclusion The findings from this meta-synthesis gave a new insight to promoting the safe and evidence-based use of telemedicine during the current pandemic and future emergencies. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-022-07415-6.
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Affiliation(s)
- Ali Mostafaei
- grid.412888.f0000 0001 2174 8913Research Center for Evidence‑Based Medicine: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Sadeghi-Ghyassi
- grid.412888.f0000 0001 2174 8913Research Center for Evidence‑Based Medicine: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran ,grid.412888.f0000 0001 2174 8913Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Kabiri
- grid.412888.f0000 0001 2174 8913Research Center for Evidence‑Based Medicine: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran ,grid.412888.f0000 0001 2174 8913Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Hajebrahimi
- grid.412888.f0000 0001 2174 8913Research Center for Evidence‑Based Medicine: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Huret L, Stoeklé HC, Benmaziane A, Beuzeboc P, Hervé C. Cancer and COVID-19: ethical issues concerning the use of telemedicine during the pandemic. BMC Health Serv Res 2022; 22:703. [PMID: 35614442 PMCID: PMC9132171 DOI: 10.1186/s12913-022-08097-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 05/18/2022] [Indexed: 12/02/2022] Open
Abstract
The lockdown imposed in France during the first wave of the COVID-19 pandemic wreaked havoc with access to healthcare. From March 2020 onwards, the oncologists of Foch Hospital, like many others at hospitals throughout the world, were obliged to adapt to the new conditions, including, in particular, the impossibility of seeing patients in classic consultations for the diagnosis and treatment of cancer. Patients with cancer are particularly susceptible to this new virus, due to their immune status, and this made it difficult to carry out standard hospital visits for these patients. Some patients refused to come to the hospital, whereas the doctors decided, for others, that consultation conditions at the hospital were not sufficiently safe, with sanitary measures that had yet to be precisely defined. Telemedicine was one of the adaptations adopted during this period. This mode of consultation was little used before the pandemic, for various reasons, and reimbursement was not automatic. This new approach proved to have limitations as well as advantages, as demonstrated by our empirical ethics research study, a retrospective qualitative survey of the doctors of the oncology and supportive care departments of Foch Hospital, performed during July 2021. The interview grid was based on the studies on telemedicine, oncology, COVID-19 and empirical ethics available at the time. Based on the experience gained in this domain during the first wave of the epidemic, which hit France between March and June 2020, we identified three eligibility criteria for consultations in telemedicine: the consultation concerned should not be the first consultation, the patient should be a known patient that the doctor trusts not to minimize the description of symptoms, and the results of the patient’s evaluations and examinations must be good. It may be appropriate to continue the use of teleconsultation in the future, provided that these criteria are respected.
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Affiliation(s)
- Lucas Huret
- ESME Sudria, Ivry-Sur-Seine, France.,Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France
| | - Henri-Corto Stoeklé
- Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France
| | | | - Philippe Beuzeboc
- Department of Oncology and Supportive Care, Foch Hospital, Suresnes, France
| | - Christian Hervé
- Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France. .,Medical School, Paris Cité University, Paris, France. .,Medical School, Versailles-Saint-Quentin-en-Yvelines University (UVSQ), Montigny le Bretonneux, France. .,Veterinary Academy of France, Paris, France. .,International Academy of Medical Ethics and Public Health, Paris Cité University, Paris, France.
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5
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Janah A, Demoor-Goldschmidt C, De Vathaire F, Bougas N, Clavel J, Poulalhon C, Lacour B, Souchard V, Jackson A, Casagranda L, Berger C, Allodji R, Haddy N, El Fayech C, Fresneau B, Dumas A. Risk perceptions and health care use in the era of the COVID-19 pandemic in adults treated for childhood cancer. Support Care Cancer 2022; 30:6263-6271. [PMID: 35460426 PMCID: PMC9033518 DOI: 10.1007/s00520-022-07035-0] [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: 02/03/2022] [Accepted: 04/03/2022] [Indexed: 12/11/2022]
Abstract
Purpose During the COVID-19 pandemic, childhood cancer survivors (CCS) may have felt more at risk of having severe consequences of COVID-19 and therefore may have been more likely to defer their health care use. We aimed to assess the risk perceptions of CCS related to COVID-19 (perceived infection risk, perceived risk of experiencing a severe illness in the event of infection), and their forgoing of health care during the year 2020. Methods In December 2020, we interviewed through an online self-report questionnaire 580 5-year CCS participating in the French Childhood Cancer Survivor Study (FCCSS) cohort. Combining clinical and patient-reported outcomes, we studied predictors of perceived risks related to COVID-19 and forgoing health care. Results Overall, 60% of respondents stated that COVID-19 could have severe consequences for their health if infected. Survivors with a cardiovascular disease and those who felt more at risk of being infected were more likely to think that COVID-19 could have severe health consequences for them. Moreover, 30% of respondents seeking care declared they had forgone at least one medical appointment in 2020. Forgoing medical appointments was more common among CCS who reported a deterioration in their financial situation in 2020 and those who felt more at risk of being infected. Conclusions This study shows that a considerable proportion of survivors had forgone medical appointments because of the pandemic; forgoing care was more frequent among the most socioeconomically disadvantaged survivors. Implications for cancer survivors. This study presents data hitherto absent in the literature and suggests the need to develop telehealth to ensure appropriate long-term follow-up of CCS.
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Affiliation(s)
- Asmaa Janah
- ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research, University of Paris, F-75010, Paris, France
| | - Charlotte Demoor-Goldschmidt
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
- Pediatric Oncology Department, CHU Angers, F-49100, Angers, France
- Radiotherapy Department, François Baclesse Center, 14000, Caen, France
| | - Florent De Vathaire
- University of Paris-Saclay, F-94800, Villejuif, France.
- Gustave Roussy, F-94800, Villejuif, France.
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France.
| | - Nicolas Bougas
- ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research, University of Paris, F-75010, Paris, France
| | - Jacqueline Clavel
- Centre of Research in Epidemiology and Statistics, INSERM, Villejuif, France
- National Registry of Childhood Cancer, Paul Brousse Hospital (AP-HP), Villejuif, France
- Regional University Hospital Center of Nancy (CHRU Nancy), Vandœuvre-lès-Nancy, France
| | - Claire Poulalhon
- Centre of Research in Epidemiology and Statistics, INSERM, Villejuif, France
- National Registry of Childhood Cancer, Paul Brousse Hospital (AP-HP), Villejuif, France
- Regional University Hospital Center of Nancy (CHRU Nancy), Vandœuvre-lès-Nancy, France
| | - Brigitte Lacour
- Centre of Research in Epidemiology and Statistics, INSERM, Villejuif, France
- National Registry of Childhood Cancer, Paul Brousse Hospital (AP-HP), Villejuif, France
- Regional University Hospital Center of Nancy (CHRU Nancy), Vandœuvre-lès-Nancy, France
| | - Vincent Souchard
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
| | - Angela Jackson
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
| | - Leonie Casagranda
- Pediatric Oncology Department, CHU Saint-Etienne, Saint-Etienne, France
- University of Jean Monnet, INSERM, University of Lyon, U 1059, Sainbiose, France
| | - Claire Berger
- Pediatric Oncology Department, CHU Saint-Etienne, Saint-Etienne, France
- University of Jean Monnet, INSERM, University of Lyon, U 1059, Sainbiose, France
| | - Rodrigue Allodji
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
| | - Nadia Haddy
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
| | - Chiraz El Fayech
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
| | - Brice Fresneau
- University of Paris-Saclay, F-94800, Villejuif, France
- Gustave Roussy, F-94800, Villejuif, France
- INSERM U 1018, CESP, Radiation Epidemiology Team, F-94800, Villejuif, France
| | - Agnès Dumas
- ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research, University of Paris, F-75010, Paris, France
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Despinasse M, Schohn A, Bimboes A, Trensz P, Sirlin F, Chiappa P, Frasie V. COVID-19 et modification des aides à domicile : étude prospective auprès de 100 patients suivis en CLCC. Bull Cancer 2022; 109:396-408. [PMID: 35219501 PMCID: PMC8841147 DOI: 10.1016/j.bulcan.2022.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 11/29/2022]
Abstract
Contexte Lors de l’épidémie de la COVID-19, les mesures de confinement ont été associées à des recommandations professionnelles pour la prise en charge des patients. Nous avons constaté auprès des patients suivis en service de soins de support que certains actes à domicile n’étaient plus effectués. L’objectif de notre étude est de déterminer l’impact du confinement sur les aides à domicile des patients atteints de cancer. Matériels et méthodes Cette étude observationnelle descriptive monocentrique et prospective a été réalisée en Hôpital de jour de soins de support du 20 avril au 15 mai 2020 auprès de 100 patients. Ils étaient interrogés sur les aides à domicile et leurs fréquences avant et après le confinement. Notre étude a reçu l’avis favorable du Comité d’éthique des hôpitaux universitaires de Strasbourg. Résultats Environ deux tiers des patients ont subi une modification de leurs aides à domicile. Un arrêt du passage d’un professionnel à domicile a concerné 40 % d’entre eux et une diminution de la fréquence, 10 % d’entre eux. Certaines populations ont été significativement plus touchées : les patients de statut OMS 3 et 4, les femmes, les patients vivant seuls et ceux atteints d’un handicap moteur. Un arrêt de la réalisation d’un acte habituellement réalisé par un professionnel à domicile a concerné 49 % des patients avec un report de ces tâches sur les patients ou leurs aidants. Conclusion Notre étude montre un impact fort du confinement sur les aides à domicile en dépit des recommandations émises sur la continuité des soins. Notre étude souligne l’importance de veiller à l’accès aux soins des plus vulnérables.
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Lucchi-Angellier E, Mino JC, Burnod A, Cottu P, Bozec L, Escalup L, Massing L, Papon M, Rizand P, Fumoleau P, Bouleuc C. [Adapting to the SARS-CoV2 pandemic: Experience of the Curie Institute]. Bull Cancer 2021; 108:787-797. [PMID: 34334191 PMCID: PMC8233851 DOI: 10.1016/j.bulcan.2021.06.001] [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: 02/16/2021] [Revised: 05/05/2021] [Accepted: 06/21/2021] [Indexed: 12/02/2022]
Abstract
L’Institut Curie prend en charge exclusivement des personnes atteintes de cancer, considérées dès le début de la pandémie SARS-CoV2 comme particulièrement « vulnérables ». Cette pandémie, qui a surpris le monde médical, est venue exiger brusquement de l’Ensemble Hospitalier une réorganisation rapide et multimodale, tout en ayant un impact sur chacun à des degrés divers. Nous examinerons ici comment cet hôpital a fait face, dans le souci d’une nouvelle balance bénéfices-risques, en temps de plus grande incertitude médicale et de rareté de certaines ressources, pour ces malades « vulnérables » mais aussi leurs proches et les personnels. Nous dégagerons par thématique les aspects positifs et les difficultés rencontrées, et ensuite ce qui pourrait être utile à d’autres hôpitaux alors que la pandémie se poursuit.
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Affiliation(s)
- Elisabeth Lucchi-Angellier
- Institut Curie Site Saint Cloud, département de Soins de Support, 35, rue Dailly, 92210 Saint-Cloud, France; Institut Curie, Comité d'éthique, 73, rue Claude-Bernard, 75005 Paris, France.
| | | | - Alexis Burnod
- Institut Curie Site Paris, dpartement de soins de support, 26, rue d'Ulm, 75005 Paris, France
| | - Paul Cottu
- Institut Curie, Comité d'éthique, 73, rue Claude-Bernard, 75005 Paris, France; Institut Curie Site Paris, département d'oncologie médicale, 26, rue d'Ulm, 75005 Paris, France
| | - Laurence Bozec
- Institut Curie, Comité d'éthique, 73, rue Claude-Bernard, 75005 Paris, France; Institut Curie Site Saint-Cloud, département d'oncologie médicale, 35, rue Dailly, 92210 Saint Cloud, France
| | - Laurence Escalup
- Institut Curie, département de pharmacie, 26, rue d'Ulm, 75005 Paris, France
| | - Louise Massing
- Institut Curie, cellule qualité de vie au travail, 26, rue d'Ulm, 75005 Paris, France
| | - Marc Papon
- Institut Curie, psychologue pour le personnel, 26, rue d'Ulm, 75005 Paris, France
| | - Philippe Rizand
- Institut Curie, direction des systèmes d'information, 26, rue d'Ulm, 75005 Paris, France
| | - Pierre Fumoleau
- Institut Curie, direction générale, 73, rue Claude-Bernard, 75005 Paris, France
| | - Carole Bouleuc
- Institut Curie, Comité d'éthique, 73, rue Claude-Bernard, 75005 Paris, France; Institut Curie, département de soins de support, 26, rue d'Ulm, 75005 Paris, France
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