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Cancer treatment shared decision-making and coping during the COVID-19 pandemic (CAN-DECIDE): a mixed-methods study
Rebecca A Aslakson1, Rachel Siden2, Laura M Holdsworth2
1Department of Anesthesiology, Larner College of Medicine at the University of Vermont, 111 Colchester Ave., West Pavilion 2-240, Burlington, VT, USA. Rebecca.Aslakson@uvmhealth.org.
Background:
We hypothesized that cancer patients, their family members, and cancer and palliative care practitioners were experiencing significant COVID-related stress and changes to cancer care and sought to characterize contributing factors.
Methods:
We completed a mixed methods study to explore cancer care-related experiences during the COVID-19 pandemic of cancer patients, family members, and cancer and palliative care practitioners. Participants were recruited from an ongoing clinical trial.
Results:
Patients were pursuing curative-intent surgeries for upper gastrointestinal cancers. Between October 2020 and July 2021, we collected 491 surveys from 181 cancer patients and 26 family caregivers and conducted 71 in-depth interviews with 48 cancer patients, 6 family caregivers, and 19 practitioners. Patient-reported quality-of-life measurements were not associated with a corresponding COVID surge. Patients and caregivers were generally satisfied with their care, trusted providers, and were often unaware of pandemic-related changes. In contrast, practitioners reported significant pandemic-related changes to cancer care delivery with associated practitioner anxiety, fatigue, and moral distress. All felt that visitor restrictions negatively impacted care.
Conclusions:
Our data suggest that cancer patients coped well overall despite pandemic-related disruptions whereas cancer care clinicians experienced significant stress. These findings can inform future disaster-preparedness planning and policy-setting in institutions providing cancer care.
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