BrintzenhofeSzoc Karlynn, Krok-Schoen Jessica I, Pisegna Janell L, MacKenzie Amy R, Canin Beverly, Plotkin Elana, Boehmer Leigh M, Shahrokni Armin
College of Allied Health Sciences, School of Social Work, University of Cincinnati, United States.
School of Health and Rehabilitation Sciences, The Ohio State University, United States.
J Geriatr Oncol. 2021 Mar;12(2):196-205. doi: 10.1016/j.jgo.2020.09.028. Epub 2020 Oct 5.
Care for older adults with cancer became more challenging during the COVID-19 pandemic. We sought to examine cancer care providers' attitudes toward the barriers and facilitators related to the care for these patients during the pandemic.
Members of the Advocacy Committee of the Cancer and Aging Research Group, along with the Association of Community Cancer Centers, developed the survey distributed to multidisciplinary healthcare providers responsible for the direct care of patients with cancer. Participants were recruited by email sent through four professional organizations' listservs, email blasts, and messages through social media.
Complete data was available from 274 respondents. Only 15.4% had access to written guidelines that specifically address the management of older adults with cancer during the COVID-19 pandemic. Age was ranked fifth as the reason for postponing treatment following comorbid conditions, cancer stage, frailty, and performance status. Barriers to the transition to telehealth were found at the patient-, healthcare worker-, and institutional-levels. Providers reported increased barriers in accessing basic needs among older adults with cancer. Most respondents agreed (86.3%) that decision making about Do Not Resuscitate orders should be the result of discussion with the patient and the healthcare proxy in all situations. The top five concerns reported were related to patient safety, treatment delays, healthcare worker mental health and burnout, and personal safety for family and self.
These findings demand resources and support allocation for older adults with cancer and healthcare providers during the COVID-19 pandemic.
在新冠疫情期间，为老年癌症患者提供护理变得更具挑战性。我们试图研究癌症护理提供者对于疫情期间这些患者护理相关障碍和促进因素的态度。
癌症与衰老研究小组宣传委员会成员，以及社区癌症中心协会，制定了该调查问卷，并分发给负责直接护理癌症患者的多学科医疗服务提供者。通过四个专业组织的邮件列表、群发邮件以及社交媒体消息发送电子邮件来招募参与者。
共有274名受访者提供了完整数据。只有15.4%的人能够获取专门针对新冠疫情期间老年癌症患者管理的书面指南。年龄在因共病情况、癌症分期、身体虚弱和体能状态而推迟治疗的原因中排第五。在患者、医护人员和机构层面都发现了向远程医疗过渡的障碍。提供者报告称，老年癌症患者在获取基本需求方面的障碍增加。大多数受访者（86.3%）同意，在所有情况下，关于“不要复苏令”的决策都应该是与患者及医疗代理人讨论的结果。报告的五大担忧与患者安全、治疗延误、医护人员心理健康和职业倦怠以及家人和自身的人身安全有关。
这些研究结果要求在新冠疫情期间为老年癌症患者和医疗服务提供者分配资源并提供支持。
