Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
Clin Colorectal Cancer. 2021 Jun;20(2):e120-e128. doi: 10.1016/j.clcc.2020.11.006. Epub 2020 Dec 5.
The Coronavirus disease 2019 (COVID-19) pandemic has imposed significant changes in cancer service delivery resulting in increased anxiety and distress in both patients and clinicians. We aimed to investigate how these changes have been perceived by patients diagnosed with colorectal cancer and identify determinants of increased anxiety.
An anonymized 32-item survey in the specialized lower gastrointestinal cancer outpatient clinics at a tertiary cancer center in North West England between May 18 and July 1, 2020. Self-reported anxiety was based on the General Anxiety Disorder-7 screening tool.
Of 143 participants who completed the survey (response rate, 67%), 115 (82%) were male, and the median age group was 61 to 70 years. A total of 112 (78%) participants had telephone consultation (83% met needs), and 57 (40%) had radiologic scan results discussed over the phone (96% met needs). In total, 23 (18%) participants were considered to have anxiety (General Anxiety Disorder-7 score ≥ 5), with 7 (5.5%) scoring for moderate or severe anxiety. Those concerned about getting COVID-19 infection, and worried COVID-19 would have effect on their mental health, and affect their experience of cancer care, were most likely to have anxiety (P < .05, multivariate analysis). The majority did not feel they needed support during this phase of the pandemic. Participants felt that friends and family had been very supportive, but less so the primary care services (P < .05).
The findings of this survey suggest that some of the service changes implemented may have already improved the overall experience of cancer care among patients with colorectal cancer at our institute. Reassuringly, the incidence of participants with moderate to severe anxiety levels during the peak of COVID-19 in the United Kingdom was much lower than anticipated. Importantly, patients were much more concerned about their cancer treatment than COVID-19, emphasizing the need to continue to provide comprehensive cancer care even with a "second wave" of COVID-19.
2019 年冠状病毒病（COVID-19）大流行对癌症服务的提供方式产生了重大影响，导致患者和临床医生的焦虑和困扰增加。我们旨在调查这些变化对被诊断患有结直肠癌的患者的影响，并确定增加焦虑的决定因素。
2020 年 5 月 18 日至 7 月 1 日，在英格兰西北部一家三级癌症中心的专门下消化道癌症门诊，对 143 名患者进行了匿名 32 项调查。基于广泛性焦虑障碍 7 项筛查工具，报告了患者的自我焦虑程度。
在完成调查的 143 名参与者中（应答率为 67%），115 名（82%）为男性，年龄中位数为 61 至 70 岁。共有 112 名（78%）参与者接受了电话咨询（83%满足需求），57 名（40%）的影像学扫描结果通过电话进行了讨论（96%满足需求）。共有 23 名（18%）参与者被认为存在焦虑（广泛性焦虑障碍 7 项评分≥5），其中 7 名（5.5%）存在中度或重度焦虑。对感染 COVID-19、担心 COVID-19 会对他们的心理健康产生影响以及影响他们的癌症治疗体验的人最有可能感到焦虑（P<.05，多变量分析）。大多数人在大流行期间没有感到需要支持。参与者认为朋友和家人给予了很大的支持，但初级保健服务支持较少（P<.05）。
这项调查的结果表明，在我们的机构中，实施的一些服务变更可能已经改善了结直肠癌患者的整体癌症治疗体验。令人欣慰的是，在英国 COVID-19 高峰期，参与者中中度至重度焦虑水平的发生率远低于预期。重要的是，患者对癌症治疗的担忧甚于 COVID-19，这强调了即使在 COVID-19 的“第二波”期间，也需要继续提供全面的癌症治疗。
