Patient Perceptions of Changes in Breast Cancer Care and Well-Being During COVID-19: A Mixed Methods Study

Abstract

Background Widespread healthcare restructuring due to the COVID-19 pandemic led to modifications in the timing and delivery of care for breast cancer patients. Our study explores patient concerns relating to COVID-19, breast cancer, and changes to breast cancer care. Patients and Methods Breast cancer patients who presented for surgical consultation at an academic, multidisciplinary clinic completed the electronically distributed validated COVID-19 Impact and Healthcare Related Quality of Life questionnaire between August 2020 and February 2021. This questionnaire uses Likert score responses to assess COVID-specific concerns within domains, including distress and financial hardship. Scale scores were determined by averaging items within each domain, and scores > 2 indicated greater disruption. Semistructured interviews were conducted with patients who indicated interest in participating in the questionnaire. Results Of 381 patients recruited, 133 patients completed the questionnaire and 20 patients completed interviews. Sixty-three percent of survey participants reported attending a telemedicine appointment for their cancer care, and the majority (67%) were satisfied with their experience. Half of the participants (50%) reported fear about how the COVID-19 pandemic will impact their cancer care or recovery, and 66% reported anxiety about contracting COVID-19. Twenty-two percent of participants reported decreased income due to COVID-19. Patient interviews revealed tangible changes to care and provided in-depth information on the advantages and disadvantages of telehealth. Conclusions Breast cancer patients report anxiety about COVID-19 infection and potential care modifications. Our study identifies impacts on patients’ care and quality of life. Further investigation will inform interventions to improve psychosocial outcomes for patients and the telehealth experience. Supplementary Information The online version contains supplementary material available at 10.1245/s10434-021-11209-1.

Cancer Patients’ Health Related Quality of Life (HRQoL) and Its Predictor Factors during the COVID-19 Pandemic: A Cross-sectional Survey Study in China

“…In our study, the proportion of patients who reported experiencing sadness or depression was 30.7%, which was consistent with previous ndings. However, according to survey studies and literature review, the incidence of anxiety or depress among cancer patients in other western countries during COVID-19 pandemic was about 33.5% to 47% [14,21,22]. Although Chinese cancer patients might experience less psychological distress compared with patients from western countries, they still need more professional psychosocial support which has not been fully addressed.…”

“…To better evaluate and address cancer survivors' needs during this special period, health-related quality of life (HRQoL) had been applied to comprehensively assess the level of symptoms, wellbeing and perceived bene ts or concerns in many countries [11,12]. In 2020, MD Anderson Cancer Center (MDACC) developed a 'COVID-19: Impact of The Pandemic and HRQoL in Cancer Survivors (COVID-19 IHRQOL)' questionnaire to speci cally investigate the level of cancer related HRQoL during the pandemic(ClinicalTrials.gov NCT04447222), which had been translated into many other languages after publication [13][14][15]. Due to socioeconomic disparities in different countries, the levels of HRQoL among cancer patients during COVID-19 pandemic were found to be associated with different factors such as treatment delay, lower level of physical activities and so on [16,17].…”

Dyadic Profiles of Couples Coping With Body Image Concerns After Breast Cancer: Preliminary Results of a Cluster Analysis

“…Subsequently, data collection was interrupted due to COVID-19 pandemic. In addition, considering the effects of the pandemic on cancer patients and caregivers’ psychosocial wellbeing ( Dhada et al, 2021 ; Ludwigson et al, 2022 ), couples recruited after the first lockdown were considered intrinsically different and therefore were not included in the present contribution.…”

Decision Conflicts in Clinical Care during COVID-19: A Patient Perspective

“…In addition, the pandemic affects availability and accessibility of healthcare very intensively, inducing moral distress for healthcare providers [ 3 ] and decisional problems for patients. For example, during the COVID-19 pandemic patients and caregivers experienced delays [ 4 ] and treatment modifications in various clinical settings [ 5 , 6 ] that negatively affected their psychological wellbeing and caused decisional conflicts. Shared decision making (SDM) rapidly became challenging during the pandemic, and affected various participants in healthcare processes to a different extent.…”