Objective Continuing to utilize healthcare as needed during an epidemic outbreak is significant, in general, and especially for cancer patients. Therefore, this study aimed to explore factors associated with health services utilization among breast cancer patients during the coronavirus disease (COVID-19) outbreak. Method A cross-sectional online survey was conducted among 151 women with breast cancer. Participants completed measures of perceived health status, perceived susceptibility to COVID-19, anxiety, coping resources, health services utilization (contact with healthcare professionals and cancellation of an appointment to the oncology/hematology clinic), and socio-demographic questionnaires. A multiple hierarchical regression was calculated; contact with healthcare professionals was the dependent variable. In addition, a logistic regression was calculated; cancellation of an appointment to the oncology/hematology clinic because of the COVID-19 was the dependent variable. Results Breast cancer patients’ contact with healthcare professionals was lower than their contact prior to the pandemic. A higher extent of contact with healthcare professionals was related to patients’ perception of health as bad/reasonable, lower perceived susceptibility, a lower sense of mastery, and higher social support. In addition, the odds of cancelling an appointment to the oncology/hematology clinic were higher in the presence of additional chronic illnesses and a higher sense of mastery. Significance of results The results could provide public health agencies with a more complete picture of the impact of the COVID-19 epidemic among breast cancer patients. This is significant because, in the event that COVID-19 re-emerges, the findings of the current study could help guide public health officials and possibly prevent the future avoidance of health services’ use among this high-risk population.

The study explored the experience of fatigue, its effects and ways of coping with fatigue and the role of family and social support among breast cancer patients. In-depth, semi-structured interviews were conducted with 13 breast cancer patients stages I-III, aged 34-67, who were up to one year after the termination of chemotherapy. Two main themes emerged: "Being imprisoned in the body of an 80-year-old," focuses the fatigue experienced by younger and older women, during and post treatment, including the different patterns of fatigue and the various means of coping with fatigue; The "Family's bear-hug" exemplifies the role of the environment in coping with the experience of fatigue and the complexities entailed in receiving support from family and friends. The study provides a comprehensive picture of fatigue in its various contexts during and post-treatment and its impact on family relations and quality of life among younger and older breast cancer patients.

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Aim: This study aims to assess how optimism, social support, and perceived susceptibility are associated with depressive symptoms and health-related quality of life among elderly patients during the COVID-19 pandemic in Israel. Methods: In a cross-sectional study, 256 participants age 60 through 95 completed the following self-administered questionnaires: Perceived Susceptibility, Life Orientation Test (LOT-R), Multidimensional Scale of Perceived Social Support (MSPSS), Symptoms of Depression (CES-D) and health-related quality of life (SF-12v2 Health Survey). Data were collected from June to July 2020, 3 months after the COVID-19 state of emergency was declared in Israel. Participants were interviewed by family medicine residents via telephone. Statistical analyses included Pearson correlations, t-tests between groups, regression analyses, and Hayes’ PROCESS to analyze a moderated mediation model. Results: Of the elderly participants, 37.5% were classified as having depression. Optimism, social support and health-related quality of life were positively associated. Higher optimism and social support were related to lower perceived susceptibility and lower depression. Results of a multivariate regression explained 29% of the variance in depression and 19% of the variance in health-related quality of life. The relationships assessed by 4 Process models were significant, such that higher optimism and social support were related to lower perceived susceptibility, which in turn was related to higher depression and lower health-related quality of life. Conclusions: Optimism and social support may be effective in coping with challenges and buffering depression. Perceived susceptibility may mediate the association of optimism and social support with higher depression and lower health-related quality of life. The conclusions of this study underscore the need to treat depression among older adults during this period. Hence, healthcare providers should also support elderly patients living at home. In giving this type of help, healthcare providers should strive to increase social support and optimism among older adults.

Background The COVID-19 pandemic has had a profound impact worldwide. This study sought to assess the pandemic's psychological impact on the Israeli public. Methods Using mixed methods we assessed Israeli adults during the COVID-19 outbreak. In the quantitative study, participants (N=1407) completed an online battery of measures assessing psychological variables and perceived threat related to COVID-19. Statistical analyses included tests for between-group differences and Pearson correlations. The qualitative study entailed in-depth, semistructured interviews conducted by telephone (N=38). Results The quantitative findings indicate that about 48% of the public had negative emotional reactions and 20% perceived they were liable to contract the virus. Moreover, a positive correlation was found between these feelings and the degree of perceived threat. Three major themes emerged from the qualitative study: 1) a sense of shock and chaos; 2) gradual adjustment to the new reality; and 3) fears and concerns for self and family members. The study's results revealed the following sources of participants’ emotional responses and sense of threat: health concerns regarding themselves and their loved ones; employment concerns; problems with children and spouses caused by being together at home; and difficulties entailed in working at home. Conclusions The study reveals many of the psychological variables and perceived threats related to COVID-19 in Israel. While social distancing may make people feel safer, it can also increase their feelings of isolation, stress and frustration and cause difficulties in many life situations. The findings point to the necessity of addressing the public's perceived susceptibility and emotional reactions about COVID-19.