Experiences of healthcare providers of older adults with cancer during the COVID-19 pandemic

Abstract

Objectives: Care for older adults with cancer became more challenging during the COVID-19 pandemic. We sought to examine healthcare providers' clinical barriers, patient questions, and overall experiences related to care delivery for these patients during the pandemic. Materials and methods: Members of the Advocacy Committee of the Cancer and Aging Research Group along with the Association of Community Cancer Centers developed a 20-question survey for healthcare providers of older adults with cancer. Eligible participants were recruited by email sent through professional organizations' listservs, email blasts, and social media. This manuscript reports the qualitative data from the survey's three open-ended questions. Free text, open-ended survey items were analyzed by two independent coders for identification of common themes using NVivo software. Theme agreement was reached through consensus and count comparisons of participant responses were made. Results: Healthcare system organizational challenges and meeting basic needs and support were commonly reported themes among respondents (n = 274). Barriers to care delivery included organizational challenges, patients' access to resources and support, concerns for patients' mental and physical health, and telehealth challenges. Respondents reported older adults were asking about their health and cancer care as well as access to basic needs and supports. Providers described worrying about patients' mental health, fear of personal safety, frustration in multi-level institutions, as well as experiencing positive leadership and communication. Conclusion: Providers are faced with balancing their concerns for personal and patient safety. These findings demand resources and support allocation for older adults with cancer and healthcare providers during the COVID-19 pandemic.

Impact of the COVID-19 Pandemic on Older Adults: Rapid Review

“…Moreover, 15 (11.1%) studies included persons with specific conditions such as Alzheimer disease [ 33 - 35 ], Parkinson disease [ 36 ], frontotemporal lobar degeneration [ 37 ], severe cognitive impairments [ 38 ], ovarian cancer [ 39 ], gynecological cancer [ 40 ], patients with cancer actively treated with systemic therapy [ 41 ], pre-existing depression [ 42 ], chronic conditions [ 43 ], long-term respiratory conditions [ 44 ], migraine [ 45 ], epilepsy [ 46 ], and visual impairments [ 47 ]. A total of 29 (21.5%) studies were conducted in North America [ 40 , 42 , 43 , 48 - 73 ], 14 (10.3%) in China [ 46 , 74 - 86 ], 61 (45.1%) in Europe [ 33 - 38 , 41 , 44 , 87 - 139 ], 3 (2.2%) in Japan [ 140 - 142 ], 4 (3.0%) in Israel [ 143 - 146 ], 4 (3.0%) in Brazil [ 147 - 150 ], 4 (3.0%) in Australia [ 151 - 154 ], 2 (1.5%) in India [ 155 , 156 ], 1 (0.7%) in Malaysia [ 157 ], 2 (1.5%) in Kuwait [ 45 , 158 ], 1 (0.7%) in Saudi Arabia [ 159 ], 3 (2.2%) in Argentina [ 160 - 162 ], 1 (0.7%) in Cameroon [ 163 ], 1 (0.7%) in Russia [ 164 ], 1 (0.7%) in Ghana [ 47 ], 1 (0.7% in Cyprus [ 165 ], and 3 (2.2%) in multiple countries [ 39 , 166 , 167 ].…”

“…Older adults reported unmet personal, domestic, or social needs [ 128 ]; difficulty finding help with functional needs such as bathing [ 62 ]; insufficient personal care [ 139 ]; decreased care rendered by caregivers [ 47 ]; and reductions in social support services hours [ 99 ]. Multiple barriers to care delivery were noted during this time [ 166 ]. For instance, one study reported that older adults were more likely to miss or cancel medical appointments [ 129 ], whereas another reported the opposite [ 60 ].…”

“…The selected records and their corresponding levels of evidence are shown in Table S1 [36], frontotemporal lobar degeneration [37], severe cognitive impairments [38], ovarian cancer [39], gynecological cancer [40], patients with cancer actively treated with systemic therapy [41], pre-existing depression [42], chronic conditions [43], long-term respiratory conditions [44], migraine [45], epilepsy [46], and visual impairments [47]. [160][161][162], 1 (0.7%) in Cameroon [163], 1 (0.7%) in Russia [164], 1 (0.7%) in Ghana [47], 1 (0.7% in Cyprus [165], and 3 (2.2%) in multiple countries [39,166,167].…”

Prolonged Stress, Anxiety, and Depression in Frontline Medical Staff Working with COVID-19 Patients

“…(Greenberg, 2020) The main concerns of COVID-19 primary care providers are their patients' safety and treatment hindrances and their colleagues' mental health together with worries as regards their loved ones being infected. (Krok-Schoen et al, 2020) The COVID-19 contagion, mortality, and morbidity rates amplify the related psychological fear, leading to adverse mental health consequences. (Wong et al, 2020) Healthcare professionals ensure first-rate patient care and prevent infection outbreaks in hospitals throughout the COVID-19 pandemic.…”

Impact of the COVID-19 Pandemic on Older Adults: Rapid Review (Preprint)

“…Older adults reported unmet personal, domestic, or social needs [128]; difficulty finding help with functional needs such as bathing [62]; insufficient personal care [139]; decreased care rendered by caregivers [47]; and reductions in social support services hours [99]. Multiple barriers to care delivery were noted during this time [166]. For instance, one study reported that older adults were more likely to miss or cancel medical appointments [129], whereas another reported the opposite [60].…”