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COVID-19期间接受妇科癌症积极治疗:对医疗保健和社会支持影响的定性研究

Undergoing active treatment for gynecologic cancer during COVID-19: A qualitative study of the impact on healthcare and social support.

作者信息

K Moran Hannah, Brooks Joanna Veazey, Spoozak Lori

机构信息

University of Kansas, School of Medicine, United States.

Department of Population Health, University of Kansas, School of Medicine, United States.

出版信息

Gynecol Oncol Rep. 2020 Nov;34:100659. doi: 10.1016/j.gore.2020.100659. Epub 2020 Oct 21.

Abstract

The COVID-19 pandemic poses unique challenges for oncology patients and clinicians. While guidelines for oncology care delivery during the pandemic have been established, there is a paucity of data examining patient experiences of cancer care during the COVID pandemic. This qualitative study captured the perspectives of women undergoing active treatment for gynecologic malignancy at an academic medical center. Hour-long semi-structured interviews were conducted via video-conference and transcribed verbatim. Focused coding was conducted to identify all data related to COVID-19. These data were then categorized into themes that emerged inductively. Seven women (N = 7) were interviewed. Several themes arose under two main categories: 1) Impact of COVID-19 on cancer care delivery and interactions and 2) Intersection of cancer and COVID-19 outside of the healthcare setting. Under category 1, themes included: going to treatment alone; variable access to care and information. Under category 2, themes included: unavailability of cancer-specific social support; mask wearing; COVID-19 & life outlook; adapting coping strategies. Participants' perceptions of having cancer during the COVID-19 pandemic varied and were not always negative. Healthcare systems can draw on our findings to inform interventions to ensure optimal patient care. Additionally, given our finding that noncompliance with mask wearing and physical distancing can be uniquely distressing to cancer patients, healthcare systems should prioritize clear messaging around COVID-19 precautions and ensure compliance of staff and patrons. Due to the rapidly changing nature of the pandemic, outcomes for these patients should be monitored and care guidelines should incorporate first-hand patient narratives.

摘要

新冠疫情给肿瘤患者和临床医生带来了独特的挑战。虽然已经制定了疫情期间肿瘤护理的指导方针,但缺乏关于新冠疫情期间患者癌症护理体验的数据。这项定性研究收集了在一家学术医疗中心接受妇科恶性肿瘤积极治疗的女性的观点。通过视频会议进行了长达一小时的半结构化访谈,并逐字转录。进行了重点编码以识别所有与新冠病毒相关的数据。然后将这些数据归纳为出现的主题。采访了7名女性(N = 7)。在两个主要类别下出现了几个主题:1)新冠病毒对癌症护理提供和互动的影响,以及2)医疗环境之外癌症与新冠病毒的交叉。在类别1下,主题包括:独自去治疗;获得护理和信息的情况不一。在类别2下,主题包括:缺乏针对癌症的社会支持;戴口罩;新冠病毒与生活前景;调整应对策略。参与者对在新冠疫情期间患癌症的看法各不相同,并不总是负面的。医疗系统可以借鉴我们的研究结果来指导干预措施,以确保为患者提供最佳护理。此外,鉴于我们发现不遵守戴口罩和保持身体距离对癌症患者可能特别痛苦,医疗系统应优先围绕新冠疫情预防措施传达明确信息,并确保工作人员和患者遵守规定。由于疫情的性质迅速变化,应监测这些患者的治疗结果,护理指南应纳入患者的第一手叙述。

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