Impact of COVID-19 on the Organization of Cancer Care in Belgium: Lessons Learned for the (Post-)Pandemic Future.

The COVID-19 pandemic has posed tremendous challenges to healthcare systems. Care for oncology patients, a vulnerable population during the pandemic, was disrupted and drastically changed. A multicenter qualitative study was conducted in 11 Belgian hospitals with the aim to provide an overview of the most important changes that were made in the care of oncology patients in Belgium. In each hospital, a nurse or physician was interviewed by telephone. Two rounds of structured interviews-during the first and second waves of the pandemic-were conducted. The data were analyzed using content analysis. The impact of COVID-19 on care practices for patients with cancer was enormous during the first wave. Major changes, including good but also less patient-centered practices, were implemented with unprecedented speed. After the initial wave, regular care was resumed and only limited new care practices were maintained. In only a few hospitals, healthcare teams reflected on lessons learned and on the maintenance of good practices that came from the COVID-19 experience. As a result, opportunities for healthcare innovation and quality improvement seemed to be missed. Our recommendations aim to support policymakers, hospital managers, and healthcare professionals to learn from the COVID-19 pandemic and to drive patient-centered initiatives in future cancer care.

Experiences of patients with cancer and their relatives confronted with COVID-19 related delay or change in care: A qualitative study.

AIMS: To provide in-depth insight into how patients and their relatives experienced change or delay in cancer treatment and care due to COVID-19. DESIGN: A qualitative study including semi-structured interviews with patients with cancer and their relatives. METHODS: Between July and October 2020, 42 patients who were confronted with a change or delay in cancer treatment or care, and 11 relatives were interviewed. Data collection and analysis were performed according to the most important methods of grounded theory, including iterative data collection and analysis, theoretical sampling, constant comparative analysis and theoretical sensitivity. RESULTS: This study shows that patients with cancer and relatives experienced paradoxical feelings when confronted with change or delay in treatment or care due to COVID-19. Patients and relatives felt relieved (e.g. less risk of infection), but were also concerned and anxious (e.g. fear for progression, fear for more side effects). Due to these ambivalent feelings, it was difficult for patients and relatives to cope with the change or delay in treatment or care, both when this was decided by the physician and by themselves. In combination with the general impact of COVID-19 on their daily lives, the change or delay led to additional distress. The interviews showed that exploring the meaning of change or delay of care for patients and their relatives and discussing what would help them might prevent or relieve distress. CONCLUSION: The findings of our study show that COVID-19 and the associated delay or changes in cancer treatment and care had a major impact on the well-being of patients and their relatives. Person-oriented care is even more important during (emergency) situations in which care might be changed or delayed.