Caregiving during COVID19 pandemic: the new challenge in oncology assistance?

Introduction: Coronavirus disease 2019 (COVID-19) outbreak has been declared a pandemic unprecedented. Italy has been one of the first and heavily affected countries. The hematologic toxicity due to chemotherapy is the main reason why cancer patients are considered fragile patients, due to the high risk of infection. This led to important restrictions and recommendations during first and even more during second peak of COVID-19 pandemic with the prohibition of caregivers admission. In the above scenario, our study has the aim of evaluating the impact of COVID19 pandemic in caregiving in oncology. Materials and Methods: Between 02/09 and 04/02 2021 our team conducted a cross-sectional study by submitting a survey to caregivers of patients with solid cancer undergoing active treatments in Oncologic Departments of Marche region. An anonymous, paper questionnaire regarding perception of patient safety and continuity of care was submitted. Results: A total of 112 caregivers responded to our survey. The majority of them were between 46 and 65 years old (46.4%), female (57%), declared to take care of the patient for 0-2 hours/day (36.6%) and declared to have increased assistance time during the pandemic (59.3%). Half of the participants declared there were no economic difficulties in assistance of their relatives and more than half (55.4 %, n=62) did not report major change in this setting. Almost all caregivers (99.1%) declared that the Oncology Departments has complied with the safety recommendations to limit virus spread. Although 86 (76.8%) of them confirmed that access has been restricted due to pandemic, only 10 caregivers (8.9%) perceived these precautions too restrictive, while 107 ( 95.5%) of the all sample defined them effective. Despite these constraints, approximately all respondents declared that they had the chance to dialogue with health care providers and had the possibility to access the oncologic department if necessary (respectively 106 subjects, 94.6% and 101, 90.1%). Moreover, more than half of caregivers (n=57, 50.9%) perceived that the quality of care has not been affected by the pandemic. Conclusions: Despite the COVID-19 pandemic has overwhelmed the Italian National Health System, maybe more than in other countries, Oncology Departments was considered worthy of the emergency care in terms of safety and care management by caregivers. Caregivers perceived and believed in an adequate quality of care for their relatives without economic implications.

[The management of nephropathic patients during the Covid-19 pandemic: the experience of Ragusa]

The public emergency caused by Covid-19 has forced health services to reorganize in order to separate positive patients from negative ones. In nephrology, this reorganization involves several levels of assistance concerning hospitalizations, ambulatory care and haemodialysis. Within the Complex Unit of Nephrology in Ragusa, the distribution of nephro-dialytic resources has involved four different hospitals, hence ensuring haemodialysis services for asymptomatic and pauci-symptomatic Covid-19 patients as well as for patients in Covid-Unit, Sub-Intensive Therapy and Intensive Care Unit. In this complex context, we had to create a common protocol involving all the professionals who provide assistance in our Unit, across the different structures. We also report some encouraging data that seem to indicate the effectiveness of the protocols put in place.