COVID-19'S IMPACT ON CANCER CARE: INCREASED EMOTIONAL STRESS IN PATIENTS AND HIGH RISK OF PROVIDER BURNOUT
Omid Salehi*1, Sylvia V. Alarcon1, Eduardo A. Vega1, Onur C. Kutlu2, Olga Kozyreva1, Jennifer Chan3, Vera Kazakova1, Dominique Harz3, Claudius Conrad1
1Saint Elizabeth's Medical Center, Brighton, MA; 2University of Miami School of Medicine, Miami, FL; 3Harvard Medical School, Boston, MA
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 a patient and provider perspective.
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 after start of the pandemic. Wilcoxon signed-rank and -rank-sum tests were used to analyze before/after 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 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 (PPE) to be more limited [z=-4.082, p<0.001], and were significantly concerned infecting family members [z=4.965, p<0.001].
CONCLUSION: 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.
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