The impact of COVID-19 on cancer patients, their carers and oncology health professionals: A qualitative study

P Butow; P E Havard; Z Butt; Juraskova 1st; L Sharpe; H Dhillon; L Beatty; P Beale; M Cigolini; B Kelly; R J Chan; L Kirsten; M Best; J Shaw

doi:10.1016/j.pec.2022.01.020

The impact of COVID-19 on cancer patients, their carers and oncology health professionals: A qualitative study

Patient Educ Couns. 2022 Jul;105(7):2397-2403. doi: 10.1016/j.pec.2022.01.020. Epub 2022 Jan 31.

Authors

P Butow¹, P E Havard², Z Butt², Juraskova 1st², L Sharpe², H Dhillon², L Beatty³, P Beale⁴, M Cigolini⁵, B Kelly⁶, R J Chan⁷, L Kirsten⁸, M Best⁹, J Shaw²

Affiliations

¹ Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia. Electronic address: phyllis.butow@sydney.edu.au.
² Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia.
³ Flinders University, Órama Institute, College of Education, Psychology & Social Work, Adelaide, Australia.
⁴ Concord Clinical School, Faculty of Medicine and Health, University of Sydney, NSW 2006 Australia.
⁵ Department of Palliative Medicine, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia.
⁶ School of Medicine and Public Health, University of Newcastle, Callaghan NSW 2308, Australia.
⁷ Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia.
⁸ Nepean Cancer Care Centre, Penrith, NSW 2751, Australia.
⁹ Institute for Ethics and Society, University of Notre Dame, Broadway, NSW 2007, Australia.

Abstract

Objective: Cancer patients, carers and oncology health professionals have been impacted by the COVID-19 pandemic in many ways, but their experiences and psychosocial responses to the pandemic are still being explored. This study aimed to document the experience of Australians living with cancer, family carers, and Oncology health professionals (HPs) when COVID-19 first emerged.

Methods: In this qualitative study, participants (cancer patients currently receiving treatment, family carers and HPs) completed a semi-structured interview exploring their experiences of COVID-19 and the impact it had on cancer care. Participants also completed the Hospital Anxiety and Depression Scale (patients) and the Depression, Anxiety and Stress Scale (carers and HPs) to assess emotional morbidity. Thematic analysis was undertaken on qualitative data.

Results: 32 patients, 16 carers and 29 HPs participated. Qualitative analysis yielded three shared themes: fear and death anxiety, isolation, and uncertainty. For HPs, uncertainty incorporated the potential for moral distress and work-stress. Patients and carers scoring high on anxiety/depression measures were more likely to have advanced disease, expressed greater death anxiety, talked about taking more extreme precautionary measures, and felt more impacted by isolation.

Conclusion: Cancer and COVID-19 can have compounding psychological impacts on all those receiving or giving care.

Practice implications: Screening for distress in patients, and burnout in HPs, is recommended. Increased compassionate access and provision of creative alternatives to face-to-face support are warrented.

Keywords: COVID; COVID-19; Cancer; Cancer patients; Coronavirus; Family members of cancer, patients; Fear and death anxiety; Isolation; Moral distress; Oncology; Oncology health professionals; Pandemic; Psycho-oncology; Uncertainty; Work, stress.

MeSH terms

Anxiety / psychology
Australia / epidemiology
COVID-19* / epidemiology
Caregivers / psychology
Humans
Neoplasms* / therapy
Pandemics