Psychological distress among cancer survivors during implementation of a nationwide Movement Control Order over the COVID-19 pandemic

Abstract

Purpose: This study aimed to investigate the psychological distress and its associated factors among cancer survivors in Malaysia during the COVID-19 pandemic.Methods: An anonymous Internet-based study was conducted between 23 April and 26 June 2020. During the study period, the country underwent Phase 3 and Phase 4 of the Movement Control Order (MCO), Conditional Movement Control Order (CMCO), and Recovery Movement Control Order (RMCO). Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS), which is a 14-item self-assessment scale for measuring distress (total HADS score (HADS-T)) with two subscales, namely anxiety (HADS-A) and depression (HADS-D). Results: From a total of 631 responses received, the proportion of participants with abnormal anxiety and depression was 29.0% and 20.9%, respectively. Distress was reported in 23.0% of the respondents. A total of 16.45% had combined abnormal anxiety and depression. The highest HADS-A (6.10; 95% CI 5.64‒6.56), HADS-D (5.61; 95% CI 5.14‒6.08), and HADS-T (11.71; 95% CI 10.84‒12.58) scores were reported among respondents during Phase 4 of the MCO. Partial least squares-based structural equation modelling (PLS-SEM) revealed that self-perceived health status, perceived susceptibility, and severity of COVID-19 have the greatest effect, leading to higher HADS-A, HADS-D, and HADS-T scores. Conclusion: Heightened psychological distress was evident in cancer survivors particularly during the enforcement of the MCO over COVID-19. Providing support to address cancer survivors’ psychological and emotional needs during the COVID-19 pandemic is essential.Implication for cancer survivors: Cancer survivors or their carers should be made aware of the high psychological risk during infectious disease outbreaks and seek timely support.

Impact of COVID-19 on quality of life in people with epilepsy, and a multinational comparison of clinical and psychological impacts

“…[20] As a comparison, we found different pattern in cancer studies during the pandemic, in which the rates of depression and anxiety were lower in Malaysia but not in China, whereas for European countries the rates were high but not in USA. [21][22][23][24] Stress or anxiety was commonly associated with seizure worsening, [4][5][6]9,11] but not depression. In our study, though depression was associated with seizure worsening in univariate analysis, the association was not significant in multivariate analysis.…”

“…The responses are summed to obtain the total score for each subscale. The total score for each subscale were then categorized into normal (0-7), and abnormal -borderline (8)(9)(10) and definite (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). HADS was validated in epilepsy cohort, age 18 years and above, with high internal consistency reported for HAD-Anxiety (Cronbach's α = 0.88) and HAD-Depression (Cronbach's α = 0.82).…”

Cancer survivors’ perceived vulnerability to COVID-19 and impacts on cognitive, affective, and behavioral responses to the pandemic

“…Although these results are potentially informative, the study was conducted early in the pandemic in a region where the government took highly effective, centralized actions to reduce transmissions rates, 13 and institutions and individuals quickly complied with these policies. 14 Other studies examined different dimensions of cancer survivors' responses to COVID in Malaysia 15 and Israel. 16 In the US, in contrast, there was little coordinated federal response, and as a result, both infections and deaths due to COVID increased rapidly (albeit unevenly) as states reopened sectors of their economies and lessened social distancing restrictions.…”