Psychosocial impact of COVID-19 on cancer patients, survivors, and carers in Australia: a real-time assessment of cancer support services

Abstract

Purpose This study aimed to explore the psychosocial impacts of the coronavirus disease (COVID-19) pandemic on cancer patients, survivors, and carers in Australia. Methods Using real-time insights from two Cancer Council NSW services—131120 Information and Support Line and Online Community (CCOC) forums—we assessed service demand trends, distress levels (using the distress thermometer), and content from 131120 calls and online posts between 01 December 2019 and 31 May 2020. Emergent themes were identified through an inductive conventional content analysis with 131120 call notes, followed by a deductive directed content analysis on CCOC posts. Results In total, 688 COVID-19-related 131120 calls (n = 496) and online posts (n = 192) were analysed. Service demand peaked in March 2020 and self-reported distress peaked in May 2020 at an average of 8/10 [Mean = 7.5; SD = 0.9]. Five themes emerged from the qualitative analysis: psychological distress and fear of virus susceptibility, practical issues, cancer service disruptions, information needs, and carer Issues. Conclusions The psychosocial impacts of COVID-19 on people affected by cancer are multifaceted and likely to have long-lasting consequences. Our findings drove the development of six recommendations across three domains of support, information, and access. Cancer patients, survivors, and carers already face stressful challenges dealing with a cancer diagnosis or survivorship. The added complexity of restrictions and uncertainty associated with the pandemic may compound this. It is important that healthcare providers are equipped to provide patient-centred care during and after this crisis. Our recommendations provide points of consideration to ensure care is tailored and patient oriented.

Mental Health in Persons With Chronic Myeloid Leukemia During the SARS-CoV-2 Pandemic: The Need for Increased Access to Health Care Services

“…These data suggest that persons with CML are psychologically vulnerable during the SARS-CoV-2 pandemic. Delay in monitoring response to TKI therapy, TKI therapy interruption, or dose reduction in persons with CML was associated with worse mental health in our study, consistent with the recent findings that treatment interruption, delay in cancer care, or reduced therapy intensity was associated with mental health problems and worse HRQoL in persons with cancer or lymphoma (12,13,(16)(17)(18)(40)(41)(42)(43). Fear of being infected with SARS-CoV-2 in the hospital or during travel as the common reason causing them not to follow the regular monitoring or cannot get TKI drugs in the hospital also reflected that they exaggerated the implementation of containment measures for avoidance of SARS-CoV-2 infection due to their psychological fragility.…”

“…The IES-R (range, 0-88) was used to assess subjective distress (excessive panic and anxiety) caused by traumatic events including traumarelated distressing memories and persistent negative emotions resulting from the pandemic, which is composed of three subscales to measure the avoidance, intrusion, and hyper-arousal. The total IES-R score was categorized as follows: subclinical (0-8), mild (9-25), moderate (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43), and severe (44-88) (37). Respondents who had the scores greater than the cutoff threshold of 10 in PHQ-9, 10 in GAD-7, and 26 in IES-R indicate moderate to severe depression, anxiety, and distress, respectively, and IES-R score ≥ 26 is associated with post-traumatic stress disorder (PTSD) symptoms (35,38,39).…”

COVID-19 and Cancer Therapy: Interrelationships and Management of Cancer Cases in the Era of COVID-19

“…In order to ensure that such patients do not show any complications consistent with COVID-19 before being admitted to oncology or radiotherapy wards, it would be prudent for caregivers to make regular calls to those scheduled for admission, just to know their status [83,84]. e greatest threat for cancer patients in this pandemic is the difficulty or inability to obtain requisite healthcare services in terms of getting to the hospital and receiving regular follow-ups [83].…”

Prevalence and correlates of psychological distress, unmet supportive care needs, and fear of cancer recurrence among haematological cancer patients during the COVID-19 pandemic

“…Having recent cancer treatment, pre-existing health conditions, having lower levels of formal education qualifications, female gender, and younger age have been found to correlate with distress [8,9,11]. Qualitative findings suggest that the challenges created by the pandemic, such as fears of contracting COVID-19, reduced access to support from healthcare providers and family, and financial hardship, may also exacerbate distress in cancer patient [8,[10][11][12]. However, these results have been mixed and apply primarily to patients with solid cancers.…”

“…Emerging research suggests that the disruptions associated with the COVID-19 pandemic have contributed to heightened levels of psychological distress and fear of recurrence (FCR) among people with cancer [8][9][10]. Early studies suggest that concerns about the perceived impact of COVID-19 on cancer management and treatment delays contribute to increased distress and FCR in cancer patients [8,11].…”