Psychological Impact of COVID-19 on Oncology Patients: Perceptions of Oncology Health Care Providers.

The COVID-19 pandemic profoundly impacted psychological well-being worldwide. Oncology health care professionals' (OHCPs') perceptions of psychological effects of COVID-19 among people in active cancer treatment were explored. Semi-structured interviews with a purposive sample of OHCPs actively providing care were conducted. Interviews were audio-recorded, transcribed, and coded using Atlas.ti v8 and thematic analysis. In total, 30 OHCPs participated. Most were registered nurses (70%), worked in outpatient setting (56.7%) and were in their current position 1-5 years (53.3%). Overarching themes are as follows: (a) cancer treatment disrupted due to patients' fear of exposure to COVID-19; (b) social distancing restrictions caused discontinued social support and supportive services that exacerbated psychological distress; (c) pandemic-related stressors led to overwhelmed coping skills; and (d) OHCPs played a vital role in providing emotional support and connecting patients with family/friends through technology. Behavioral health interventions should focus within the "new world of COVID-19" of reduced face-to-face support and increased online support for patients.

Adapting Research to a Global Pandemic: A Fully Remote Actigraphy and Ecological Momentary Assessment Study.

BACKGROUND: Mandated social distancing practices and quarantines in response to COVID-19 have resulted in challenges for research on healthcare workers, such as hospital nurses. It remains unknown whether nursing studies utilizing complex methodology like sleep actigraphy and ecological momentary assessment (EMA) can be conducted remotely without compromising data quality. OBJECTIVES: We aimed to (a) disseminate our remote study protocol for sleep actigraphy and EMA data from hospital nurses during COVID-19, (b) assess feasibility and acceptability of this approach for studies on hospital nurses, and (c) examine the reliability and ecological validity of sleep characteristics measured across 14 days. METHODS: Using an online platform, we provided 86 outpatient nurses from a cancer hospital with detailed video/text instructions regarding the study and facilitated virtual study onboarding meetings. Feasibility was assessed by comparing adherence rates to a similar in-person study of nurses from the same hospital; acceptability was evaluated through content analysis of qualitative study feedback. Multilevel modeling was conducted to assess changes in sleep characteristics as a function of study day and daily stressful experiences. RESULTS: Adherence to EMA (91.8%) and actigraphy (97.9%) was high. EMA adherence was higher than the in-person study of inpatient day-shift nurses from the same hospital. Content analyses revealed primarily positive feedback, with 51.2% reporting "easy, clear, simple onboarding" and 16.3% reporting the website was "helpful." Six participants provided only negative feedback. Sleep characteristics did not change as a function of study day except for self-reported quality, which increased slightly during Week 1 and regressed toward baseline after that. A higher incidence of stressor days or higher stressor severity followed nights with shorter-than-usual time in bed or poorer-than-usual sleep quality, supporting the ecological validity for these methods of assessing sleep in nurses. DISCUSSION: Findings suggest that a fully remote study protocol for EMA and actigraphy studies in nursing yields robust feasibility, acceptability, reliability, and validity. Given the busy schedules of nurses, the convenience of this approach may be preferable to traditional in-person data collection. Lessons learned from COVID-19 may apply to improving nursing research postpandemic.

Impact of COVID-19 on Oncology Healthcare Providers: The Resilience of a Profession.

BACKGROUND: The novel coronavirus (COVID-19) has plagued countries worldwide. This pandemic has greatly affected healthcare delivery and those providing care to vulnerable, immunocompromised patients undergoing cancer treatment, who are at a higher risk for poorer outcomes related to COVID-19. OBJECTIVE: The aim of this study was to explore the impact of COVID-19 on oncology healthcare professionals (OHCPs). METHODS: An exploratory study design was employed using semistructured interviews. A thematic analysis was completed using Atlas.ti software. RESULTS: Of 30 OHCP participants, most were female (90%), registered nurses (70%), and bachelor's prepared (66%). The following themes emerged: (1) pandemic-related restrictions and stress on personal lives impacted the ability of OHCPs to rejuvenate and reenergize for work; (2) fear of exposure and transmission and concern for high-risk status for contracting COVID-19; (3) limited resources and inconsistent communication about organizational policies caused additional stress, affecting OHCP trust and confidence in the system; (4) concern for the mental health of fellow OCHPs; (5) adaptation and resilience were required amidst shifting workloads, workflow, and new restrictions; and (6) importance of self-care to reduce personal/professional stressors. CONCLUSIONS: Oncology healthcare professionals continue to face challenges of COVID-19 on their personal and professional lives yet have shown resilience during these unprecedented times. IMPLICATIONS FOR PRACTICE: Oncology healthcare professionals need to advocate for appropriate personal protective equipment and reliable mental health support services through employers. They should be engaged in COVID-19 task forces to ensure their challenges are heard and needs are addressed to provide quality oncology care.

The Use of Telehealth to Provide Continuity of Cancer Care during the COVID-19 Pandemic: Advantages, Disparities, and Implications to Promote Health Equity.

Perceptions of oncology health care providers use of telehealth to provide care to patients during the COVID-19 pandemic were explored. A qualitative study using semi-structured interviews and purposive sampling (N = 30) was conducted. Four themes emerged: 1) telehealth provided continuity of cancer care and used to decrease the risk of COVID-19 exposure; 2) advantages brought about convenience and inclusion of family caregivers; 3) telehealth revealed geographic, aging, and racial/ethnic disparities and digital illiteracy; and 4) rapid implementation was challenging. Telehealth provides a number of opportunities to support care for vulnerable cancer patients during this health crisis; however, disparities must be addressed.

Emergency preparedness during the COVID-19 pandemic: Perceptions of oncology professionals and implications for nursing management from a qualitative study.

AIM: To explore oncology health care professionals' perceptions of the COVID-19 pandemic response. BACKGROUND: The pandemic has created health care delivery challenges globally and many countries have exhibited low readiness and emergency preparedness. METHODS: A descriptive design using a qualitative approach was employed. Semi-structured interviews, which were completed via telephone, were audio recorded and transcribed verbatim. A thematic analysis was conducted. RESULTS: Participants (N = 30) were mostly registered nurses (70%). Three themes emerged: (1) ability to adapt and operationalize disaster planning, training and restructure nursing models (subtheme: reactive vs. proactive approach to emergency preparedness); (2) COVID-19 task forces and professional organisations were critical for valid information surrounding the pandemic; and (3) recommendations for emergency preparedness/planning for future pandemics. CONCLUSION: Oncology organisations adapted during the pandemic, but policies and procedures were perceived as reactive and not proactive. Recommendations for planning for future pandemics included (1) adequate personal protective equipment, (2) developing cancer-specific guidelines/algorithms and (3) telehealth training related to billing/reimbursement. Professional organisations were reliable resources of information during the pandemic, but oncology professionals ultimately trusted employers and administration to distribute information needed for safe patient care. IMPLICATIONS FOR NURSING MANAGEMENT: Frontline nurses should hold positions on task forces to develop future emergency preparedness.