Psychological reactions and interventions to help Cancer patients cope during the COVID-19 pandemic in China

Psychological Impact of COVID-19 on Oncology Patients: Perceptions of Oncology Health Care Providers

The COVID-19 pandemic profoundly impacted psychological well-being worldwide. Oncology health care professionals' (OHCPs') perceptions of psychological effects of COVID-19 among people in active cancer treatment were explored. Semi-structured interviews with a purposive sample of OHCPs actively providing care were conducted. Interviews were audio-recorded, transcribed, and coded using Atlas.ti v8 and thematic analysis. In total, 30 OHCPs participated. Most were registered nurses (70%), worked in outpatient setting (56.7%) and were in their current position 1-5 years (53.3%). Overarching themes are as follows: (a) cancer treatment disrupted due to patients' fear of exposure to COVID-19; (b) social distancing restrictions caused discontinued social support and supportive services that exacerbated psychological distress; (c) pandemic-related stressors led to overwhelmed coping skills; and (d) OHCPs played a vital role in providing emotional support and connecting patients with family/friends through technology. Behavioral health interventions should focus within the "new world of COVID-19" of reduced face-to-face support and increased online support for patients.

The psychological impact of COVID-19 pandemic on healthcare workers

Background

As unprecedented and prolonged crisis, healthcare workers (HCWs) are at high risk of developing psychological disorders. We investigated the psychological impact of COVID-19 pandemic on HCWs.

Methods

This cross-sectional study randomly recruited 439 HCWs in Hunan Cancer Hospital via a web-based sampling method from June 1st 2021 to March 31st 2022. Anxiety and depression levels were measured using Hospital Anxiety and Depression Scale (HADS). The Post Traumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) was used to assess the presence and severity of PTSD. Fear was measured by modified scale of SARS. Data were collected based on these questionnaires. Differences in fear, anxiety, depression and PTSD among HCWs with different clinical characteristics were analyzed using a multivariate analysis of variance. The Cronbach's alpha scores in our samples were calculated to evaluate the internal consistency of HADS, fear scale and PCL-5.

Results

The prevalence of anxiety, depression, and PTSD in HCWs was 15.7, 9.6, and 12.8%, respectively. Females and nurses were with higher fear level (P < 0.05) and higher PTSD levels (P < 0.05). Further analysis of female HCWs revealed that PTSD levels in the 35-59 years-old age group were higher than that in other groups; while married female HCWs were with increased fear than single HCWs. The internal consistency was good, with Cronbach's α = 0.88, 0.80 and 0.84 for HADS, fear scale, and PCL, respectively.

Conclusion

Gender, marital status, and age are related to different level of psychological disorders in HCWs. Clinical supportive care should be implemented for specific group of HCWs.

Experiences of Newly Diagnosed Oral Cancer Patients during the First Wave of the COVID-19 Pandemic: A Qualitative Study from Pakistan

The COVID-19 pandemic has resulted in the scaling back or postponement of non-emergency hospital services, including care of cancer patients. The present qualitative study explored the experiences of newly diagnosed oral cancer patients during the first wave of the COVID-19 pandemic in Pakistan. Patients who attended the Department of Maxillofacial Surgery, Khyber College of Dentistry in July 2020 were selected using a maximum variation purposive sampling method. Seventeen semi-structured interviews were conducted in Pashto, the local language of Khyber Pakhtunkhwa. All interviews were audiotaped, transcribed verbatim, and translated into English. Thematic content analysis yielded eight major themes: pain and generalised physical weakness, shock at diagnosis, psychological distress of the COVID-19 pandemic, faith and religion, double hit loss of employment, social isolation, social support from caregivers, and lack of support from health care professionals. In conclusion, the COVID-19 pandemic has a clear impact on the life experiences of newly diagnosed oral cancer patients. Distress due to delay in accessing health care and lack of support from health care providers are a matter of great concern. Appropriate interventions should be introduced to ensure psychological and social support strategies are in place for patients during interruptions of health care services.

A study to assess the psychosocial aspects of care for cancer patients with COVID-19 at Tata Memorial Hospital, Mumbai, India

COVID-19 has more impact on cancer patients due to their immune compromised status. In this study, we tried to understand the impact of cancer patients afflicted with COVID-19 in the physical, emotional, vocational, financial and social domains. The patient caregivers’ problems were also assessed. The investigator tailored the tool and content validity was done by the experts. Total samples were 50 and convenient sampling was used. Descriptive statistics were used and the Shapiro–Wilk’s test was used for normalcy of the variables. The major findings were that the majority belonged to male population with an average annual salary. The diagnosis was hematolymphoid as the main focus compared to breast, bone, gynaecological, gastrointestinal, genitourinary and others. Patients who were receiving chemotherapy were in the majority when compared to radiation, Palliation and surgery. In the physical domain, patients experienced fatigue as a major problem most probably due to the treatment of chemotherapy. The other major problems were loss of smell, breathlessness and loss of appetite. Skin pigmentations were not experienced. In the emotional domain, the major problem was the depression they experienced during COVID-19. In the social domain, financial problems was the most important aspect and access to medication acquirement and transport during the pandemic and job securities were the other problems. Care givers felt social distancing to be a major aspect while looking after patients. They were very uncertain about the prognosis of COVID-19. The Middle age group had more emotional problems.

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

PURPOSE

Cancer patients and their caregivers are overwhelmed with features of uncertainty, fear, shock, worry, anxiety, sadness, and grief. To add on to their misery, the COVID-19 pandemic has severely afflicted the cancer care delivery. The study was conducted to observe the challenges faced by cancer patients and their caregivers and to formulate strategies for oncological setups to overcome those challenges.

METHODS

After obtaining institutional ethical clearance, a descriptive cross-sectional study was conducted to observe the challenges faced by patients and their caregivers at the level of various domains (physical, logistic, psychological, socioeconomic, and spiritual) who visited the outpatient and inpatient department of cancer pain and palliative care unit. The results were expressed in absolute numbers.

RESULTS

Major challenges encountered were suffering from physical symptoms like pain, nausea, vomiting, dyspnea (90%), postponement of cancer treatment (80%), fear of contracting COVID infection due to hospital visit (93.5%), lack of accommodation (70%), and lack of spiritual clarity and hope (50%).

CONCLUSIONS

Major challenges faced by patients were in physical and psychological domains, and those by caregivers were in socioeconomic domains and handling physical symptoms of their patients. It is imperative to recognize and be cognizant of the challenges faced by cancer patients and their caregivers. Health care setups should formulate strategies to alleviate these challenges and provide holistic care to cancer patients. These strategies will hold in good stead for future pandemics also.