Use of Electronic Communication with Clinicians Among Cancer Survivors: Health Information National Trend Survey in 2019 and 2020.

Purpose: To describe cancer survivors' use of electronic communication (e-communication) with clinicians and identify factors associated with their use, including the COVID-19 pandemic. Methods: Secondary analysis included cancer survivors (N = 1,482) from the combined Health Information National Trends Survey HINTS 5 Cycle 3 and Cycle 4. Survivors' use of e-communication was defined by at least one of four e-communication use behaviors in the past 12 months. Bivariate analysis and logistic regression were conducted to examine factors associated with e-communication use. All analyses considered the complex survey design using the jackknife replication method. Results: The prevalence of e-communication use was 64% among cancer survivors. The overall e-communication use slightly increased after the start of the COVID-19 pandemic (63% vs. 64%, p = 0.79). Older adults (≥65 years old) were less likely to use e-communication (odds ratio [OR] = 0.55; 95% confidence interval [CI], 0.36-0.86); survivors who were white (OR = 2.30; 95% CI, 1.36-3.86), living in a metro area (OR = 2.47; 95% CI, 1.44-4.27), diagnosed with breast cancer (OR = 2.03; 95% CI, 1.06-3.88), seeking cancer-related information previously (OR = 2.89; 95% CI, 1.83-4.58), or having a regular health care provider (OR = 2.07,; 95% CI, 1.10-3.88) were more likely to use e-communication. The start of the COVID-19 pandemic was marginally associated with the increased e-communication use (p = 0.053) when other variables were controlled. Conclusion: This nationally representative survey analysis has identified disparities in e-communication use among cancer survivors and revealed the potential increase in e-communication use under the impact of the COVID-19 pandemic. Additional support is clearly warranted for those older, nonwhite, living in rural areas, or without a regular provider, to promote their e-communication use for the delivery of optimal and high-quality cancer care.

A cross-sectional examination of the relationship between nurses' experiences of skin lesions and anxiety and depression during the COVID-19 pandemic: Exploring the mediating role of fear and resilience.

AIM: To explore the mediating role of fear and resilience on the relationship between clinical nurses' reporting of skin lesions and their anxiety and depression during the coronavirus disease 2019 (COVID-19) pandemic. BACKGROUND: Prolonged personal protective equipment wearing may cause severe skin lesions among clinical nurses. The possible relationship between clinical nurses' reporting of skin lesions and their anxiety and depression remains unknown. Moreover, little is known about what factors could mediate such a relationship. METHODS: This is a cross-sectional online survey. CHERRIES was used to report results. RESULTS: Of 2014 participants, 94.8% (n = 1910) reported skin lesions. Skin lesions were positively related to anxiety (p < .001, ß = .228, SE = .099) and depression (p < .001, ß = .187, SE = .093). Fear activated while resilience buffered the relationship between clinical nurses' reporting of skin lesions and anxiety and between skin lesions and depression. CONCLUSION: Reduced fear and enhanced resilience level were related to decreased levels of anxiety and depression among clinical nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should evaluate the occurrence and severity of clinical nurses' skin lesions, arrange reasonable working duration to relieve skin lesions, provide appropriate psychological support to reduce clinical nurses' fear and implement various strategies to enhance their resilience, thereby decreasing their anxiety and depression. CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR2000030290.

Factors Associated With the Use of Telehealth in Middle-Aged and Older Adults During the COVID-19 Pandemic

The COVID-19 pandemic has promoted the adoption and use of telehealth, particularly in the early months of the pandemic. However, people with diverse characteristics may, or may not, be able to use telehealth, presenting digital divide in health care and potential health equity-related issues. This study aimed to assess the use of telehealth among middle-aged and older adults during COVID-19, and to explore factors associated with their telehealth utilization. We used publicly available data from the California Health Interview Survey collected during January 2019 and December 2020 (N=15, 279;mean age= 64.23±11.59;female: 52.7%). Approximately 11.0% of the sample used telehealth at least once. Bivariate and multivariate logistical regression analyses found that, compared with non-users, telehealth users were more likely to be having higher numbers of chronic conditions, with self-reported mental distress, living in urban areas, born in the US, with higher English proficiency, higher education, and having higher incomes. Age, race/ethnicity, and gender were not significantly correlated with telehealth usage. Logistic regression revealed that having mental distress (OR=1.48, 95% CI=1.29-1.71, p<0.01), more chronic conditions (OR=1.48, 95% CI=1.29-1.71, p<0.001) and living in an urban area (OR=1.93, 95% CI=1.36-2.74, p<0.001) were independently related to telehealth use. These findings suggest that telehealth, while being beneficial during the pandemic, might also introduce new challenges that exacerbate existing health inequity and disparities. Policy and community-based interventions are needed to promote the use of telehealth among middle-aged and older adults with diverse characteristics.