COVID-19’s Impact on Cancer Care: Increased Emotional Stress in Patients and High Risk of Provider Burnout

Abstract

Background COVID-19’s precise impact on cancer patients and their oncologic care providers remains poorly understood. This study aims at comparatively analyzing COVID-19’s effect on cancer care from both patient and provider perspectives. Methods A multi-institutional survey was developed to assess COVID-19-specific concerns regarding treatment, safety, and emotional stress through 5-point Likert-type prompts and open-ended questions before and during the pandemic. Wilcoxon signed-rank and rank-sum tests were used to analyze before/during answers for providers and patients independently. Open-ended responses were assessed using inductive thematic analysis. Results The survey was completed by 104 (69.3%) patients and 50 (50%) providers. Patients demonstrated a significant change in only 1 of 15 Likert prompts. Most significant were increased concern regarding susceptibility to infection [ z = 2.536, p = 0.011] and concerns regarding their cancer outcome [ z = 4.572, p < 0.001]. Non-physician providers demonstrated significant change in 8 of 13 Likert prompts, whereas physicians had all 13 Likert prompts change in the COVID-19 setting. Physicians believed care to be more poorly planned [ z = −3.857, p ≤ 0.001], availability of protective personal equipment to be more limited [ z = −4.082, p < 0.001], and were significantly concerned infecting family members [ z = 4.965, p < 0.001]. Conclusions While patients had more difficulty coping with their cancer, they did not perceive significant differences in their actual treatment. This suggests the need for a renewed focus on patients coping with cancer. Among providers, physicians more than any other provider group had a strong negative perception of COVID-19’s impact on healthcare, suggesting the need for novel approaches to target physician burnout.

Patients’ Experiences with Cancer Care: Impact of the COVID-19 Pandemic

“…Only about one-quarter of survey respondents reported coping very well during the pandemic with worse coping across several sociodemographic groups. Several other studies assessed the psychosocial impact of the COVID-19 pandemic on cancer patients, such as fear and social isolation, but not overall coping ( 4 , 8 , 10 , 42 ). For example, Lou and colleagues’ ( 4 ) cross-sectional survey found significantly higher levels of concern about contracting COVID-19, serious illness, and not being able to get needed healthcare (for COVID-19 or other serious illness) among respondents with cancer.…”

“…A cancer diagnosis can lead to anxiety, fear, and feelings of uncertainty about treatment options and prognosis (1,2). The COVID-19 pandemic has heightened the psychosocial impact of cancer as patients face additional concerns about the risk of COVID-19 infection and serious disease (3)(4)(5)(6)(7)(8)(9)(10). Adding to distress and uncertainty, patients also have experienced disruptions and delays in cancer care as healthcare systems established safety protocols, postponed or canceled nonurgent care, and prioritized COVID-19 efforts (11,12).…”

Managing uncertainty and responding to difficult emotions: Cancer patients’ perspectives on clinician response during the COVID-19 pandemic

“…If not properly managed, this distress leads to treatment burden, such as poorer functioning and well-being associated with treatment and self-care activities [1] ; poorer symptom management; and poorer health-related quality of life 2 , 3 , 4 . The COVID-19 pandemic adds additional psychological burden as cancer patients worry about risk of COVID-19 infection and serious disease 5 , 6 , 7 , 8 , social isolation, loss of social support 9 , 10 , 11 , along with delays, disruptions, and postponement of needed procedures and treatment 10 , 12 , 13 , 14 .…”

Outcomes of psychological support skills training for cancer care staff: Skill acquisition, work engagement, mental wellbeing and burnout

“…1,2 This problem has worsened since the COVID-19 pandemic, with more than half of UK staff surveyed meeting criteria for a mental disorder. 3,4 Burnout can be defined as a syndrome encompassing exhaustion, low self-efficacy, and negative attitudes towards work. 5 Burnout often results from a high stress working environment with few resources that mediate the impact.…”