ABSTRACT
Since March 2020, COVID-19 has affected the physical and mental health of older adults. However, when faced with adversity, studies have shown older adults to be at least, if not more, resilient than younger cohorts. This study aimed to understand the extent of psychosocial impact the pandemic had on older adults with and without depression currently enrolled in the Neurobiology of Late-Life Depression (NBOLD) Study. We hypothesized that over the course of the pandemic depression and resilience scores would increase. There is still little research available regarding outcomes and factors from COVID-19 impacting older adults' depression and resilience, which this study aims to address while strengthening the validity of the EPII-G. The study population included older adults previously diagnosed with Major Depressive Disorder (MDD) and non-depressed controls, enrolled in the N-BOLD study at the University of Connecticut Health Center. Inclusion criteria were: age of 60 or greater, ability to read and write English, and Mini-Mental State Examination score of 25 or greater. Depressed subjects met the criteria for MDD. The study utilized the EPII-G, Brief Carroll Depression Scale (BC), and Brief Resilience Scale (BRS). The surveys were verbally administered by the research staff in both in-person and via phone interviews. From mid-2020 to summer 2021, both older adults with a history of depression and emotional controls saw BC scores and BRS scores increase, as seen in the included table. We found a negative correlation between positive home life on EPII-G and BC scores, with a correlation coefficient of -0.3645 and a p-value of 0.0616. There was also a positive correlation with positive home life and social activities and BRS scores, with correlation coefficients of 0.26304 and 0.29869 and p-values of 0.0845 and 0.0489 respectively. Individuals who didn't see disruption to their normal routine and had the means to communicate with loved ones had strong psychosocial supports in place but were still vulnerable to the detrimental effects of isolation. Through their years of experience, older adults have had the time needed to develop protective factors such as selfreliance. They have also lived through poignant events such as war and economic depression, putting suffering into perspective. This strong foundation has contributed to the resilience needed to overcome the stressors that surfaced during the pandemic.
ABSTRACT
Aims: Survival of people with advanced colorectal cancer (CRC) can be prolonged through treatment pathways including cytoreductive surgery and hypothermic intraperitoneal chemotherapy (CRS-HIPEC), pelvic exenteration, liver resection, and palliative chemotherapy without surgery. Virtually no qualitative research has compared the experiences and needs of advanced CRC survivors who receive these treatments. This study aims to fill this gap. Methods : Adult survivors of CRC who have undergone the aforementioned treatments are being recruited 0.5-2 years post-surgery or, for palliative chemotherapy participants, 0.5-2 years post-diagnosis of advanced CRC. Recruitment will continue until approximately N = 40 or data saturation is reached. Quantitative data include: demographic and clinical data, Functional Assessment of Cancer Therapy - Colorectal (FACT-C), Distress Thermometer, and Comprehensive Score for Financial Toxicity (COST). Quantitative data will undergo descriptive analysis to characterise the sample. All participants will participate in a qualitative semi-structured telephone interview exploring quality of life, employment, finances, stigma, supportive care needs, social functioning, perceptions of survivorship, and impacts of COVID-19. Interviews are analysed via the framework approach of thematic analysis. Results : Preliminary analysis of 36 interviews (n = 10 CRS-HIPEC, n = 10 pelvic exenteration, n = 9 liver resection, n = 7 palliative chemotherapy) reveals some advanced CRC survivors report post-surgical complications and chemotherapy-induced peripheral neuropathy, which can limit physical activity. CRC impacted some participants' psychosocial well-being ability to work, and sense of identity. Participants reportedly manage these impacts through distraction, positive reframing, and contact with other CRC survivors. Most participants appeared satisfied with their cancer treatment teams. Some viewed GPs as important healthcare coordinators. COVID-19 made some participants more cautious when leaving the house. Telehealth was considered less personal, but convenient. Conclusions : The study's findings will help guide development of interventions to improve the survivorship experience of patients who receive treatment for advanced CRC. This may include an information booklet, patient-reported outcome measure, clinical pathway, or targeted intervention.
ABSTRACT
Background: Approximately 18% of colorectal cancer (CRC) diagnoses are advanced cancer, whereas 30%-40% of patients develop recurrence after treatment with curative intent. More modern treatments enable longer survival for people with advanced CRC, including cytoreductive surgery and hypothermic intraperitoneal chemotherapy (CRS-HIPEC), pelvic exenteration, liver resection, and palliative chemotherapy without surgery. Yet, virtually no qualitative research has compared the perspectives and quality of life (QoL) experiences of survivors of these different treatments. This study aims to fill this gap. Methods: Approximately N = 40 adult survivors of CRC are being recruited from two major Australian hospitals 0.5-2 years posttreatment or post-diagnosis. All participants will complete the Functional Assessment of Cancer Therapy - Colorectal (FACT-C), Distress Thermometer and Comprehensive Score for Financial Toxicity (COST) questionnaires. Questionnaire data, participant demographics and clinical data will undergo descriptive analysis to characterise the sample. Participants will participate in a qualitative semi-structured telephone interview, analysed via the framework approach of thematic analysis. Qualitative interviews explore QoL, survivorship experiences, employment and finances, supportive care needs, stigma and social functioning and impacts of COVID-19. Results: Preliminary analysis of 30 interviews (n=10 CRS-HIPEC, n=9 pelvic exenteration, n = 5 liver resection, n = 6 palliative chemotherapy) reveals someadvancedCRCsurvivors report post-surgical complications and chemotherapy-induced peripheral neuropathy, which can limit physical activity and daily functioning. Participants reportedly manage these through distraction, positive reframing and contacting other CRC survivors. Most participants appeared satisfied with their cancer treatment teams. Some viewed their GPs as important coordinators in their health care. Some CRC survivors viewed the change to telehealth due to COVID-19 as less personal;however, rural/regional participants prefer its convenience. Conclusions: The study findings will help guide development of interventions to improve the survivorship experience of patients who receive treatment for advanced CRC. This may include an information booklet, patient-reported outcome measure, clinical pathway or targeted intervention.