ABSTRACT
Introduction/BackgroundThe COVID-19 pandemic is a major challenge to healthcare system worldwide. Since December 2020 the COVID -19 vaccine is approved and available. Jet the vaccination rate and the acceptance differs between European countries. Understanding patients’ perspective and giving voice to their fears is of great importance to meet the new challenges in heath care system.MethodologyWe performed a survey among patients with gynecological cancer in 6 European countries between March and June 2021. The questionnaire included questions related to COVID-19 and exploring patients’ attitude towards preventive measures and the HADS (Hospital Anxiety and Depression Scale) score. The survey was promoted by national advocacy groups and was carried out online or as hard – copy version.ResultsWe collected 567 forms from 6 European countries. The median age of the participants was 61.3 in Denmark, 49.8 in Greece, 56.8 in Hungary, 61.2 in Poland, 56.4 in Turkey and 51.8 in UK. For only a small number of patients a change in the therapy plan due to COVID-19-Pandemic was necessary: 11.8% in Denmark, 21.4% in Greece, 12.5% in Hungary, 14.7% in Poland, 26.1% in UK. For patients of different countries the fear of cancer was greater as the fear of COVID-19. At time of the survey 65.4% in Denmark, 66.1% in Greece, 63.5% in Hungary, 47.8% in Poland, 24.7% in Turkey and 52.2% in UK have been already vaccinated and most were willing to get a COVID-19 vaccine. The HADS Scores were borderline abnormal or abnormal and similar between different countries.ConclusionAmong gynecological cancer patients anxiety and fear of cancer progression was stronger than fear of COVID-19. Health care professionalists should be aware of increased psychological burden due to COVID-19 pandemic and develop strategies to address this issue in patient care.
ABSTRACT
BACKGROUND: The impact of the COVID-19 pandemic on European gynaecological cancer patients under active treatment or follow-up has not been documented. We sought to capture the patient perceptions of the COVID-19 implications and the worldwide imposed treatment modifications. METHODS: A patient survey was conducted in 16 European countries, using a new COVID-19-related questionnaire, developed by ENGAGe and the Hospital Anxiety & Depression Scale questionnaire (HADS). The survey was promoted by national patient advocacy groups and charitable organisations. FINDINGS: We collected 1388 forms; 592 online and 796 hard-copy (May, 2020). We excluded 137 due to missing data. Median patients' age was 55 years (range: 18-89), 54.7% had ovarian cancer and 15.5% were preoperative. Even though 73.2% of patients named cancer as a risk factor for COVID-19, only 17.5% were more afraid of COVID-19 than their cancer condition, with advanced age (>70 years) as the only significant risk factor for that. Overall, 71% were concerned about cancer progression if their treatment/follow-up was cancelled/postponed. Most patients (64%) had their care continued as planned, but 72.3% (n = 892) said that they received no information around overall COVID-19 infection rates of patients and staff, testing or measures taken in their treating hospital. Mean HADS Anxiety and Depression Scores were 8.8 (range: 5.3-12) and 8.1 (range: 3.8-13.4), respectively. Multivariate analysis identified high HADS-depression scores, having experienced modifications of care due to the pandemic and concern about not being able to visit their doctor as independent predictors of patients' anxiety. INTERPRETATION: Gynaecological cancer patients expressed significant anxiety about progression of their disease due to modifications of care related to the COVID-19 pandemic and wished to pursue their treatment as planned despite the associated risks. Healthcare professionals should take this into consideration when making decisions that impact patients care in times of crisis and to develop initiatives to improve patients' communication and education.