ABSTRACT
Background: Burnout (BO) is a recognized challenge among oncology workforce. It affects both genders with a higher frequency among women. This study examined the factors contributing to the development of burnout among women in oncology from the Middle East and North Africa (MENA). Methods: An online crosssectional survey was distributed to oncology professionals from different countries in the MENA region. The validated Maslach Burnout Inventory (MBI) of emotional exhaustion (EE), Depersonalization (DE), and Personal Achievement (PA) plus questions about demography/work-related factors and attitudes toward oncology were included. Data were analyzed to measure BO prevalence and related factors. Results: Between February 10 and March 15, 2020, 545 responses were submitted by female professionals. The responses pre-dated the COVID-19 pandemic emergence in the region. BO prevalence was 71% among female professionals. Women aged < 44 years represented 85% of the cohort. Sixty-two percent were married, 52% with children and one-third practiced a hobby. Twothirds worked in medical oncology, worked for < 10 years and 35% worked in academia. The majority (73%) spent > 25% on administrative work daily. Nearly half of the respondents (49%) expressed a recurring thought of quitting oncology and 70% had no burnout support or education. Inability to deliver optimal care was reported as distressing for career development in 82%. Factors significantly influencing the BO risk are listed in Table. Marital status, having children, academia and years in practice did not impact the risk of BO among female oncologists form MENA. Conclusions: High BO prevalence was reported among female oncology professionals from MENA. The majority of women oncology workforce were young and early- to mid-career in this cohort. Younger age, practicing in North African countries, high administrative load and the recurring thought of quitting were associated with increased risk of burnout. Whereas, practicing a hobby and enjoying oncology communication decreased the BO risk. Burnout support and education specifically for women in oncology is needed.
ABSTRACT
Background: As frontline workers facing COVID-19 pandemic, healthcare providers should be well prepared to fight the disease and prevent harm to their patients and themselves. Our study aims to evaluate knowledge, attitude, and practice (KAP) of oncologists in response to COVID-19 pandemic and its impact on them. Methods: A cross-sectional study was conducted using a validated questionnaire disseminated to oncologists by SurveyMonkey©. The tool had 42 questions that captured participants’ KAP, their experiences and the impact of the pandemic. Country sub-investigators in Middle East and North Africa region, Brazil, and the Philippines distributed the survey to their contacts via emails and text messaging between April 24 and May 15, 2020. Results: Among 910 physicians that participated in the study, 55% were males, 67% medical or clinical oncologists and 58% worked in public hospitals. Only 213 (23%) reported being officially involved in COVID-19 control efforts. Level of knowledge regarding the prevention and transmission of the virus was good among 63% of participants. Majority (92%) were worried about contracting the virus either extremely (30%) or mildly (62%) and 85% were worried about transmitting the virus to their families. 77% reported they would take the COVID-19 vaccine once available, although only 38% got the flu vaccine regularly. Adherence to strict precautions was variable including social distancing outside work (68%), no hand shaking (58%), and hand washing (98%). Participation in virtual activities included clinics (54%), tumor boards (45%), administrative meetings (38%);and educational activities (68%) and majority reported plans to continue them after pandemic. Participants reported a negative impact of the pandemic on relations with coworkers (16%), relations with family (27%), their emotional and mental wellbeing (49%), research productivity (34%) and financial income (52%). Conclusions: COVID-19 pandemic has negative effects on various personal and professional aspects of oncologists. Interventions should be implemented to mitigate the negative impact and to prepare oncologists to manage future crises with more efficiency and resilience. Editorial acknowledgement: On behalf the International Research Network on COVID-19 Impact on Cancer Care (IRN-CICC). Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: A.R. Jazieh: Research grant/Funding (self): MSD. All other authors have declared no conflicts of interest.
ABSTRACT
Background: COVID-19 pandemic impacted healthcare systems globally and resulted in the interruption of usual care in many healthcare facilities exposing vulnerable cancer patients to significant risks. Our study aimed to evaluate the impact of this pandemic on cancer care worldwide. Methods: We conducted a cross-sectional study using validated electronic questionnaire of 51 items via SurveyMonkey©. The tool was distributed to leaders in oncology centers worldwide. The questionnaire obtained information on the capacity and services offered at these centers, magnitude of interruption of care, reasons for interruption, challenges faced, interventions implemented, and the estimation of patient harm during the pandemic. Results: 356 centers from 54 countries across six continents participated between April 21 and May 8, 2020. These centers serve about 700,000 new cancer patients a year. Most of them (88%) reported facing challenges in providing care during the pandemic. 54% and 45% of centers reported cases of COVID-19 infection among their patients and staff, respectively. Although 51% reduced services as part of a preemptive strategy, other common reasons included overwhelmed system (20%), lack of personal protective equipment (19%), staff shortage (18%), and restricted access to medications (9.7%). Missing at least one cycle of therapy by more than 10% of patients was reported in 46% of the centers. Most centers implemented virtual clinics (83.6%) and virtual tumor boards (93%) and participants believed these will persist beyond the pandemic (55.5% and 60%, respectively). Centers performed routine tests in laboratories near patients’ homes (76%) and shipped medications to patients (68.6%). Participants reported patients’ exposure to harm from interruption of cancer-specific care (36.5%) and non-cancer related care (39%) with some centers estimating up to 80% of their patients exposed to some harm. Only 16% of the centers reported services are back to baseline at the time of completing the survey. Conclusions: The detrimental impact of COVID-19 pandemic on cancer care is widespread with varying magnitude among centers worldwide. Further research to assess this impact at the patient level is required. A “new normal” of cancer care emerged with emphasis on telehealth and care delivery closer to home. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: A.R. Jazieh: Research grant/Funding (self): MSD. C.D. Rolfo: Speaker Bureau/Expert testimony: AstraZeneca;Advisory/Consultancy: Inivata;Archer;MD Serono;Mylan;Oncompass;Honoraria (self): Elsevier. All other authors have declared no conflicts of interest.
ABSTRACT
Background: COVID-19 pandemic presented serious challenge to oncology care due to the associated risks form infection and from disruption of care delivery. Therefore, many professional societies published recommendations to help manage cancer care during the crisis. The objective of our study was to assess the national responses of MENA countries in terms of publishing relevant guidelines and analyse various components of these guidelines. Methods: A survey based on literature review regarding cancer care adaptation was developed then completed by senior oncologists representing the following countries: Algeria, Egypt, Iraq, Jordan, Kuwait, Lebanon, Morocco, Oman, Saudi Arabia, Syria, Tunisia, UAE and Yemen. The survey queried about instructions of the national recommendations regarding (1) general measures of COVID-19 prevention in oncology, (2) cancer care adaptations during the pandemic. Results: Analysis of the guidelines revealed 31 essential recommendations categorized into seven essential components with specific recommendations for each component. These components are patients’ management, health care workers (HCW) management, facility management, testing for COVID-19, measures to reduce hospital visits, measures to reduce complications, and site-specific recommendations. The table showed compliance of these guidelines with having the required components and relevant recommendations. [Formula presented] Conclusions: There is inconsistency in the components of the guidelines across the region, which may reflect the evolving nature of the pandemic and lack of clear evidence for many issues in question. There is a need from clear framework on essential components to be included in the guidelines to assure providing the best guidance to the oncology community. Editorial acknowledgement: On behalf of the International Research Network on COVID-19 Impact on Cancer Care (IRN-CICC). Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: M.A.M.A. AlNassar: Research grant/Funding (institution): Roche. A. Jazieh: Research grant/Funding (institution): MSD. All other authors have declared no conflicts of interest.