Are we well prepared for public health emergencies? COVID-19 pandemic effect on cancer care in Saudi Arabia: A qualitative study.

BACKGROUND: COVID-19 pandemic has significantly disrupted healthcare systems worldwide, raising concerns about its impact on cancer patients' access to healthcare services. This study aims to explore the experiences of cancer patients and assess effect of restrictions, delays, and changes in healthcare delivery on their health. METHODS: A qualitative study was performed through individual interviews and focus group discussions (FGDs) with cancer patients and key informants (KI). Participants with different cancer types, treatment stages, and residency regions in Saudi Arabia were recruited. Thematic analysis identified four major themes: access to healthcare services; impact on appointments, diagnosis, and treatment; healthcare delivery; and cancer condition deterioration due to the pandemic. RESULTS: Cancer patients reported variable responses to the pandemic and its effects on their healthcare seeking behavior. Several patients faced challenges in accessing healthcare services and experienced difficulties in continuing their treatment, others encountered obstacles in seeking timely diagnosis and care. Lockdown measures and travel restrictions posed barriers, affecting patients' ability to reach treatment centers. Delays in appointments, diagnosis, and treatment were also reported. In contrast, some participants did not report any negative impact but received improved care and condition prioritization. Healthcare delivery underwent a shift towards virtual appointments, online access to lab results and medication's home delivery service. Despite these adaptations, a small group of participants experienced health deterioration due to delays in treatment and difficulties in reaching their treating physicians. CONCLUSION: COVID-19 pandemic has had a multifaceted impact on cancer patients. Some participants faced challenges such as care delays and disruptions in accessing healthcare services. Yet others reported positive experiences such as improved communication and utilization of new healthcare delivery modalities. These findings underscore the need for resilient and adaptable healthcare systems to safeguard the well-being of cancer patients in times of crises and public health emergencies.

Long-Term Psychological Effects of the COVID-19 Pandemic: Anxiety and Depression among Physicians in a Tertiary Referral Hospital.

Background: Since the COVID-19 pandemic peaked, few studies have thereafter assessed the continued effects of the COVID-19 pandemic on the mental health of healthcare workers. Objectives: To determine the rate and predictors of self-reported symptoms of depression and anxiety among physicians at a public tertiary care teaching hospital in Saudi Arabia about 2 years after COVID-19 was declared a pandemic. Methods: This cross-sectional study was conducted from September 2021 to April 2022 and targeted all physicians working at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. Patient Health Questionnaire-9 and General Anxiety Disorder-7 were used to elicit self-reported data regarding depression and anxiety, respectively. In addition, sociodemographic and job-related data were collected. Results: A total of 438 physicians responded, of which 200 (45.7%) reported symptoms of depression and 190 (43.4%) of anxiety. Being aged 25-30 years, female, resident, and reporting reduction in work quality were factors significantly associated with both anxiety and depression. Female gender (AOR = 3.570; 95% CI = 2.283-5.582; P < 0.001), working an average 9-11 hours/day (AOR = 2.130; 95% CI = 1.009-4.495; P < 0.047), and self-perceived reduction in work quality (AOR = 3.139; 95% CI = 2.047-4.813; P < 0.001) were significant independent predictors of anxiety. Female gender (AOR = 2.929; 95% CI = 1.845-4.649; P < 0.001) and self-perceived reduction in work quality (AOR = 3.141; 95% CI = 2.053-4.804; P < 0.001) were significant independent predictors of depression. Conclusions: About half of the physicians reported symptoms of anxiety and depression. These findings are suggestive of the need for large-scale studies to determine the ongoing effects of the COVID-19 pandemic on the mental health of healthcare workers in Saudi Arabia.

Physicians' Perspective of Telemedicine Regulating Guidelines and Ethical Aspects: A Saudi Experience.

Methods: This was an observational cross-sectional study conducted among physicians working at the College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), and its affiliated academic tertiary hospital, King Fahad Hospital of the University (KFHU), Eastern province-KSA. Data were collected between August 2019 and March 2020 via a structured, pretested, self-administered questionnaire distributed to 220 eligible physicians at KFHU. A final sample of 101 physicians completed our survey. Collected data was coded and analysed using SPSS, and the results presented as frequencies, percentages, and summary statistics. Results: Among our respondents, 62 (61.4%) were males, 46 (45.5%) were in the age group of 35 to 44 years, and 62 (61.3%) were Saudi. Two-thirds of physicians (58 (57.4%)) use smart devices in healthcare delivery, and 51 (50.5%) are satisfied with this use. A minority (21 (20.8%)) knew about telemedicine guidelines, 8 (7.9%) had encountered legal issues related to telemedicine use, and 52 (51.5%) were doubtful about patients' readiness for virtual care. Regarding physicians' awareness of the ethical aspects regulating the use of social media and medical apps in patient care, only 44 (45.3%) were aware of the proper reporting system if they found accounts sharing unreliable information. Nevertheless, the majority (91 (92.9%)) agreed it is essential for healthcare providers to report such accounts. Concerning physicians' awareness of the rules and regulations of online self-promotion, the majority of our respondents were unsure or unaware of such regulations (46 (45.6%) and 18 (17.8%)), respectively. Nonetheless, 67 (66.3%) of the physicians would not pay SM influencers to advertise for them. Conclusion: Two-thirds of our physicians use smart devices in healthcare delivery, with 1 in 13 having encountered related legal issues. Nonetheless, only a minority was aware of telemedicine use regulating guidelines, including physicians' online self-promotion regulations. These results highlight the necessity of targeted physicians' training on telemedicine use related guidelines, thereby ensuring the safety of both patients and healthcare professionals and the optimum utilization of online health-related interactions.