ABSTRACT
Introduction: With the outbreak of the COVID-19 pandemic, clinical practice had to be adapted very quickly. As cancer patients are considered to be at higher risk, in cancer care substantial organizational and treatment related changes had to be implemented. Our presentation will focus on consequences of these changes for oncology nursing. Method(s): The Academic Society for Oncology Nursing in cooperation with the Swiss Oncology Nursing Society organized several webinars with oncology nurses, nurse managers and clinical nurse specialists. Tese experts from French and German speaking regions shared their experiences discussing a) major practice changes and b) needs of nurses to meet the care needs of patients and relatives in two webinars in French and in German. Result(s): The major practice changes included the use of personal protective equipment (PPE), the rapidly implemented changes in treatment and care resulting in changing patients needs. Facemask and protective glasses were standard PPE in many places. PPE impacted nursing interventions and communication with the patient. The lack of visibility of facial expressions hampered nurses' capacity to express empathy or to recognize the emotional state of their patients. Terapies were switched to longer cycles or postponed entirely. This resulted in an increased informational and educational needs of patients. Tey expressed the fear to be exposed to a higher risk of SARS CoV-2 infection or to receive a less efective cancer therapy. In turn, patients who did not come to cancer centers worried that something missed care could have fatal consequences. To meet these needs many centers reinforced remote consultations, mainly via phone. Centers with established procedures for telephone consultations felt better prepared for remote consultation during the pandemic. Overall, webinar participants highlighted the lack of guidelines for conducting telephone consultations and policies for reimbursement. Conclusion(s): The round-table webinars provided a platform for oncology nursing to exchange on challenges and solutions in times of COVID-19. Regarding telephone consultations, the webinars have stimulated the development of nursing guidelines for remote consultations. An important subject for future round-table webinars could be the preparation of oncology nurses for a second epidemic wave.
ABSTRACT
Introduction According to Braun and Clarke, thematic analysis (TA) is a family of methods that entail familiarization with the data;generating initial codes;conceptualizing, reviewing, naming, and defining themes;and writing a report. We conducted a multicentric qualitative study investigating the experiences of individuals treated for cancer during the COVID-19 pandemic in different language regions and countries. We aim to describe our procedures for selecting an approach to TA;generating codes;and conceptualizing themes and sub themes capturing common and distinct experiences across sites. Methods Our team was comprised of multilingual investigators from Switzerland and the United States. We formed site-specific workgroups to recruit local participants and conduct interviews in one of five languages. Principal challenges were to (a) ensure consistency in qualitative data collection;(b) construct shared interpretations of qualitative data while preserving context-specific nuance;and (c) develop and maintain a large data set supporting iterative analyses by multiple workgroups. Results Adopting a pragmatic worldview, we planned and conducted a codebook TA. We validated data collection materials with each workgroup;developed a codebook;analyzed data deductively and inductively;and used MAX QDA software to facilitate data management. Table 1 details our approach. Conclusions Investigators using TA in disparate contexts face unique methodological challenges. Research to establish best practices is warranted.
ABSTRACT
Introduction Literature on the impact of COVID-19 on cancer patients pointed towards an increase in uncertainty, anxiety, fear and distress. Our aim was to analyze cancer patient-reported experiences through a qualitative approach to identify their potential concerns, needs and resources during the pandemic and to evaluate their levels of distress and resilience. Methods Semi-structured telephone interviews were conducted after the second wave, March to July 2021, with cancer patients from three hospitals in the French-speaking part of Switzerland. Transcripts were analyzed using an iterative thematic analysis approach. Quantitative data included measurement of distress and resilience by the NCCN distress thermometer and the 2-item Connor-Davidson Resilience Scale. Results Patients with lung, breast, colon cancer or melanoma were included (n=35). Mean distress score was 2 (SD=2.1) and mean resilience score was 6.7 (SD=1.3). Thematic analysis highlighted five themes evoking changes in life, concerns, cancer care, resources and vaccination. Conclusions Cancer patients from the French-speaking part of Switzerland reported relatively low distress and high resilience. Nevertheless, interviews revealed COVID-related elements having an influence on patients' lives and trajectory of care. These results allow for a better understanding of the cancer patients' experiences during the COVID-19 pandemic in Switzerland and provide suggestions for better support.
ABSTRACT
Introduction Cancer patients have experienced higher rates of distress than the general population during the COVID-19 pandemic. We aimed to provide a thorough overview of studies assessing distress and resilience reflecting distinct temporal and geographical characteristics of the COVID-19 pandemic. Methods A search was conducted through PubMed to identify studies that measured distress and/or resilience in cancer patients during the COVID-19 pandemic. Information about each study's country, instruments, data collection period, and scores were extracted by two researchers as part of an analysis of approaches to capture cancer patients' experiences. Reports of daily new cases per country were retrieved from the WHO database. Results We identified 13 studies that assessed distress and/or resilience from 10 countries. The Distress thermometer (n=9) and the Connor-Davidson Resilience Scale (n=3) were the most common measures. Data collection ranged from December 2019 to August 2021, with 7 studies conducted during the first wave (March-July 2020), 4 between July 2020- March 2021, and 2 after June 2021. Overall, the highest scores of distress were seen in the first phase of the pandemic and resilience scores were similar to the mean score described for cancer patients. Conclusions Distress values might be influenced by temporal and local circumstances. Due to the disparate evolution of the pandemic across countries, special attention should be given to describing the specific context when reporting psycho-social data.
ABSTRACT
Compared with the general population, oncology patients face a higher morbidity and mortality caused by the COVID-19 pandemic. As a result, health systems had to quickly adapt cancer care in order to maintain the best quality and patient safety. From March to May and from October to December 2020, 254 patients diagnosed with cancer and tested positive for SARS-CoV-2 benefited from a tele-health monitoring at the Oncology Department at CHUV. This article describes the key points of the development, implementation and operation of this tele-health monitoring, enabled by an interdisciplinary and inter-professional collaboration between different units and healthcare professionals.
ABSTRACT
Background: The COVID-19 outbreak forced healthcare providers to adapt the clinical practice routines. In Switzerland, oncology care has been adjusted following national and international recommendations and guidelines. Two Swiss oncology associations collaborated to organize webinars to enable oncology nurses to share their experience with the COVID-19 pandemic. Methods: Ten nursing experts and managers from different cancer settings (outpatient, hospital, rehabilitation, and community) participated at two webinars held in April and May 2020. The discussions were organized along four questions: 1) How changed COVID-19 oncology nursing practice? 2) What tools do nurses need to support patients? 3) What would nurses additionally need? 4) Which further supporting tools / guidelines and actions would be needed?. Results: Among the main themes discussed, the remote consultation for SARS-CoV-2 negative and positive patients was the most prominent one. Another very important issue was the personal protective equipment (PPE) for nurses and patients. Some experts and participants described shortness of appropriate PPE as a main challenge. For all experts, but particularly those working in hospitalized units, the visiting restrictions were mentioned as a very difficult and emotionally challenging situation. One center used diaries and many video devices to support hospitalized patients affected by restricted visiting policies to keep in touch with their families. Further, nurses expressed the need for regularly updated evidence-based recommendations related to COVID-19 nursing care, and the need for appropriate tools and resources adapted to COVID-19 context. Conclusions: All participants suggested organizing regular webinars to foster the exchange on lessons learned and helpful strategies. The demand to find solutions has facilitated new intra- and extra-hospital communication on current practices. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: M. Eicher: Research grant/Funding (institution): Roche;Research grant/Funding (self): BMS;Research grant/Funding (self): Kaiku Health;Travel/Accommodation/Expenses: Vifor;Honoraria (institution): Roche. S. Colomer-Lahiguera: Travel/Accommodation/Expenses: Vifor;Honoraria (institution): Vifor. All other authors have declared no conflicts of interest.
ABSTRACT
Background: Impact of the COVID-19 outbreak on cancer patients may be high in terms of anxiety, fear and psychological distress;however, this topic remains under-addressed. We aim to describe cancer patient experiences related to the COVID-19 pandemic in Switzerland. Information gained through in-depths interviews will be triangulated with the level of distress and resilience. Methods: Purposive sampling will be used to recruit four patient subgroups diagnosed with melanoma, breast, lung, or colon cancer (i) under adjuvant treatment;(ii) under anti-cancer treatment with palliative intent;(iii) being consulted at institutes for complementary and integrative medicine (ICIM);(iv) being consulted by clinical nurse specialists (CNS). Interview guides were developed based on qualitative analysis of public online cancer patients’ forums from four different countries. We selected main posts related to COVID-19. Semantic and inductive thematic analysis approaches were used to identify meaningful patterns and themes. The level of distress and resilience will be measured by the NCCN Distress Thermometer and the 2-item Connor-Davidson-Resilience Scale. We aim to include 120 patients (10 participants per subgroup in each language region). Recruitment will start in September 2020. Results: The design of the study as well as preliminary data regarding themes and subthemes identified in the patient’s forum analysis will be presented. Conclusions: To the best of our knowledge, no patient experience study with a qualitative design is conducted or planned with cancer patients during COVID-19 pandemic in Europe. The study will serve to identify concerns, unmet information and clinical needs and potential positive experiences of patients with cancer in relation to the COVID-19 pandemic. Newly developed patient reported measures should be based on qualitative data. The identification of topics considered important to patients will thus support the development of patient reported experience measures for the current or future epidemics/pandemics. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: S. Colomer-Lahiguera: Travel/Accommodation/Expenses: Vifor pharma. M. Eicher: Travel/Accommodation/Expenses: Vifor pharma;Honoraria (institution): Vifor pharma;Honoraria (institution), Research grant/Funding (institution): BMS;Honoraria (institution), Research grant/Funding (institution): Roche;Research grant/Funding (institution): Kaiku Health. All other authors have declared no conflicts of interest.