COVID-19-Related Fear and Health-Related Safety Behavior in Oncological Patients

Abstract

Objective This study aimed to assess cancer patients’ psychological burden during the COVID-19 pandemic by investigating distress (distress-thermometer), health status (EQ-5D-3L), general anxiety (GAD-7), COVID-19-related fear and associated behavioral changes and comparing these to matched healthy controls, using propensity score matching (PSM). Methods During the first days of the COVID-19 pandemic in Germany, March 16 to 30, 2020, 150 actually treated cancer patients and 150 matched healthy controls participated in this study. Participants completed an anonymous online survey assessing health status, distress, general anxiety, COVID-19-related fear and behavioral changes (i.e., adherent safety behavior and dysfunctional safety behavior). Results Cancer patients showed no elevated level of distress, U = 10,657.5, p = 0.428, general anxiety U = 10,015.5, p = 0.099, or COVID-19-related fear compared to healthy controls, U = 10,948, p = 0.680. Both groups showed elevated COVID-19-related fear. Cancer patients reported more adherent safety behavior, such as washing hands more often or avoiding public places, U = 8,285, p < 0.001, d = 0.468. They also reported more dysfunctional safety behavior such as buying larger quantities of basic food, compared to healthy controls U = 9,599, p = 0.029, d = 0.256. Adherent safety behavior could be significantly explained by cancer diagnosis, increased COVID-19-related fear and subjective level of information about COVID-19, R 2 = 0.215, F (3) = 27.026, p < 0.001. Conclusion This suggests that cancer patients are more likely to utilize adherent safety behavior. Cancer patients reported comparable levels of distress and anxiety compared to healthy controls. Still, the COVID-19 pandemic is associated with elevated COVID-19-related fear. Therefore, specific interventions are needed to prevent anxiety and improve mental health during the COVID-19 pandemic.

Non-pharmaceutical interventions during the COVID-19 pandemic: A review

“…However, a similar research done in Japan hints to a negative impact of reduced physical activity on glycemic control [190] . A cohort of patients affected by cancer in Germany showed levels of stress and anxiety similar to a control [189] . Drastic reduction of physical activity, with potentially detrimental effects, has been reported for adults with hypertension [193] .…”

“…Several surveys aimed at provide a better understanding of this unfortunate phenomenon. They considered patients affected by diabetes, cancer, ALS, hypertension, mental or substance abuse disorders [188] , [189] , [190] , [191] , [192] , [193] , [194] . Admittedly, the research focused on short term effects and on the shift towards telemedicine (i.e., remote care).…”

Veränderung der psychischen Belastung in der COVID-19-Pandemie in Deutschland: Ängste, individuelles Verhalten und die Relevanz von Information sowie Vertrauen in Behörden

“…Cronbachs α = 0,801 und Cronbachs α = 0,738 (vgl. auch [ 13 , 16 , 36 ]). Die Items zu den Skalen sind im Online-Zusatzmaterial (Tab.…”

Different Correlates of COVID-19-Related Adherent and Dysfunctional Safety Behavior

“…Hence, while fear is spreading across the population ( 2 ), motives to wash hands seem to differ from motives to panic buy and hoard. Higher vulnerabilities to the virus caused by, e.g., cancer or chronic somatic diseases, but also mental illnesses, can increase fear and anxiety, which eventually leads to some safety behavior ( 4 – 6 ). The current strongly increasing numbers of new infections during the “second wave” on one hand, and political demonstrations against COVID-19 protection-regulations on the other hand, indicate the strong necessity to understand underlying motives for distinct safety behaviors.…”