ABSTRACT
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.
ABSTRACT
Background: The spread of Coronavirus disease brought the need to reorganize clinical activity in oncology. Cancer patients are very vulnerable and it is well known that their treatment has to be strictly planned. The most critical considerations still relate to the entry of the virus into hospitals, the heart of healthcare, where cancer patients are protected. Instead, during COVID19 pandemic the oncologic department had to limit access to care to protect patients from a more dangerous disease for them, witnessing a paradox of health care. This brought with it worries in oncologic healthcare professionals in replanning activities in order to guarantee therapeutic continuity and quality of care. It is well known that physicians and nurses have different role concepts and role expectations. The purpose of our study was to investigate doctors and nurses' perception on cancer patient reorganization during the COVID19 pandemic in a sample of Italian healthcare professionals in oncology. Methods: We submitted a survey to oncologic healthcare workers (physicians and nurses) of Italian National Health Care System during Pandemic to investigate clinical activity reorganization and cancer patient management through 12 closed questions. The survey promoted by Clinica Oncologica, AOU Riuniti di Ancona-Universita Politecnica delle Marche was electronic and anonymous. Results: A total of 383 oncology health workers completed the survey, 60 nurses (15%) and 323 physicians (85%). 60% of interviewed physicians perceived qualitatively lower than usual the therapeutic path of patients taken in charge in this historical moment, while 45% of nurses declared it was the same (p<0.01). The continuity of the multidisciplinary team was defined as guaranteed for 68% of oncologists, while almost 40% of nurses declared to not know it. Almost all physicians (95%) answered that their clinical activity was reorganized, compared to a lower portion of nurses (80%) that replanned their care role (p<0.01). Deferring treatments caused fear and anxiety in 62% of physicians and 46% of nurses (p=0.027). Conclusions: The survey underlined the need to integrate skills and involve all professional figures in planning cancer patients' treatment to guarantee optimal therapeutic strategies and a global take in charge in all its details, even during emergencies.
ABSTRACT
Background: After COVID-19 was declared a pandemic by the World Health Organization, a response from the Italian Health System to react to an unprecedented condition became necessary and sudden. COVID-19 pandemic required oncologists to redefine clinical organization and management of cancer patients. The aim of our study was to take a picture of the situation of Italian oncologies and to evaluate the difficulties in patients management. Methods: Between 18th March and 9th April 2020 we conducted an online survey (Google Forms). It consisted of 45 questions ranging from individual perception of pandemic management by oncological centers to physicians and nurses psychological distress and patient care. The survey was anonymous and broadcasted to oncology health workers by mailing contacts, word of mouth and social networks. Results: A total of 383 oncology health workers participated in the survey. The majority was female (72%) and from central Italy (46%). Impressively, a total of 357 (93%) participants declared the Oncologic Department reorganized routine clinical activity, but only 41% was adequately trained about the required procedures. 20% of the survey attendees think they have not received adequate and timely protective devices with respect to clinical needs and according to 58% the supply of these devices was only partial. 34% of professionals declared they do not have or know a defined common guideline to reschedule patients' treatments. More than 80% of interviewees declared to feel worry about being at greater risk of contagion than the general population, 92% feared to transmit virus to family members. Deferring treatments has caused fear / anxiety in 228 of the interviewed (60%). Symptoms of stressful situations emerged with a deterioration in sleep quality in 62% of professionals, worsening of mood (69%) and lower concentration ability (49%). Conclusions: Our survey demonstrated the flexibility of oncologic teams. However, the emergency response quality has been heterogeneous, and several drawbacks emerged from this first analyses. Information, protection, testing and training of healthcare professionals are keywords that should be kept in mind to encourage recovery after this tragedy and to be ready to face a similar emergency in the next future.
ABSTRACT
Background: After COVID-19 was declared a pandemic by the World Health Organization, a response from theItalian Health System to react to an unprecedented condition became necessary and sudden. COVID- 19 pandemicrequired oncologists to redefine clinical organization and management of cancer patients. The aim of our study wasto take a picture of the situation of Italian oncologies and to evaluate the difficulties in patients' management. Methods: Between 18th March and 9th April 2020 we conducted an online survey (Google Forms). It consisted of45 questions ranging from individual perception of pandemic management by oncologic centers to physicians' andnurses' psychological distress and patient care. The survey was anonymous and broadcast to oncology healthworkers by mailing contacts, word of mouth, and social networks. Results: A total of 383 oncology health workers participated in the survey. The majority was female (72%) and fromcentral Italy (46%). Impressively, a total of 357 (93%) participants declared the Oncologic Department reorganizedroutine clinical activity, but only 41% were adequately trained about the required procedures. 20% of the surveyattendees thought they had not received adequate and timely protective devices with respect to clinical needs, andaccording to 58% the supply of these devices was only partial. 34% of professionals declared that they did not haveor know a defined common guideline to reschedule patients' treatments. More than 80% of interviewees declaredfeeling worried about being at greater risk of contagion than the general population, and 92% feared to transmitvirus to family members. Deferring treatments has caused fear/anxiety in 228 of the interviewed (60%). Symptomsof stressful situations emerged with a deterioration in sleep quality in 62% of professionals, worsening of mood(69%), and lower concentration ability (49%). Conclusions: Our survey demonstrated the flexibility of oncologic teams. However, the emergency response qualityhas been heterogeneous, and several drawbacks emerged from this first analysis. Information, protection, testing, and training of health care professionals are keywords that should be kept in mind to encourage recovery after thistragedy and to be ready to face a similar emergency in the near future.
ABSTRACT
Background: The spread of coronavirus disease brought the need to reorganize clinical activity in oncology. Cancerpatients are very vulnerable, and it is well known that their treatment has to be strictly planned. The most criticalconsiderations still relate to the entry of the virus into hospitals, the heart of health care, where cancer patients areprotected. Instead, during the COVID19 pandemic the oncologic department had to limit access to care to protectpatients from a more dangerous disease for them, witnessing a paradox of health care. This brought with it worriesin oncologic health care professionals in replanning activities in order to guarantee therapeutic continuity and qualityof care. It is well known that physicians and nurses have different role concepts and role expectations. The purposeof our study was to investigate doctors' and nurses' perception of cancer patient reorganization during the COVID19pandemic in a sample of Italian health care professionals in oncology. Methods: We submitted a survey to oncologic health care workers (physicians and nurses) of Italian NationalHealth Care System during the pandemic to investigate clinical activity reorganization and cancer patientmanagement through 12 closed questions. The survey promoted by Clinica Oncologica, AOU Riuniti di Ancona-Università Politecnica delle Marche was electronic and anonymous. Results: A total of 383 oncology health workers completed the survey, 60 nurses (15%) and 323 physicians (85%).60% of interviewed physicians perceived qualitatively lower than usual the therapeutic path of patients taken incharge in this historical moment, while 45% of nurses declared it was the same (P<0.01). The continuity of themultidisciplinary team was defined as guaranteed for 68% of oncologists, while almost 40% of nurses declared tonot know it. Almost all physicians (95%) answered that their clinical activity was reorganized, compared to a lowerportion of nurses (80%) who replanned their care role (p<0.01). Deferring treatments caused fear and anxiety in62% of physicians and 46% of nurses (P=0.027). Conclusion: The survey underlined the need to integrate skills and involve all professional figures in planningcancer patients' treatment to guarantee optimal therapeutic strategies and a global take in charge in all its details, even during emergencies.