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COVID-19 大流行对德国柏林黑色素瘤患者护理的影响:Mela-COVID 调查。

Effects of the COVID-19 pandemic on care of melanoma patients in Berlin, Germany: the Mela-COVID survey.

机构信息

Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, 10249 Berlin, Germany

Faculty of Medicine, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany

出版信息

Eur J Dermatol. 2022 Jul 1;31(4):521-529. doi: 10.1684/ejd.2021.4098. Epub 2021 Aug 26.

Abstract

BACKGROUND

The COVID-19 pandemic imposes major challenges for care of cancer patients.

OBJECTIVES

Our aim was to assess the effects of the pandemic on treatment and appointments of patients with malignant melanoma based on a large skin cancer centre in Berlin, Germany, and identify reasons for, and impact factors associated with these changes.

MATERIALS & METHODS: Patients with melanoma treated from January 1st 2019 received a postal survey with questions on impairment due to the pandemic, fear of COVID-19, fear of melanoma, changes in therapy and/or appointments, including reasons for the changes. Impact factors on postponed/missed appointments were examined using descriptive analyses and multivariate logistic regression.

RESULTS

The response rate was 41.3% (n = 324; 57.4% males; mean age: 67.9 years). Among 104 participants currently receiving therapy, four (3.8%) reported treatment changes due to the pandemic. Postponements or cancellations of appointments occurred in 48 participants (14.8%), most frequently, at their own request (81.3%) due to fear of SARS-CoV-2 infection (68.8%). Current treatment was associated with a reduced chance of post-poning/missing appointments (OR = 0.208, p = 0.003), whereas a high or very high level of concern for COVID-19 (OR = 6.806, p = 0.034; OR= 10.097, p = 0.038), SARS-CoV-2 infection among close acquaintances (OR = 4.251, p = 0.026), anxiety disorder (OR = 5.465, p = 0.016) and AJCC stage IV (OR = 3.108, p = 0.048) were associated with a higher likelihood of postponing/missing appointments.

CONCLUSION

Among our participants, treatment changes were rare and the proportion of missed/delayed appointments was rather small. The main reasons for delays/cancellations of appointments were anxiety and concern for COVID-19.

摘要

背景

COVID-19 大流行给癌症患者的护理带来了重大挑战。

目的

我们旨在评估大流行对德国柏林一家大型皮肤癌中心的恶性黑色素瘤患者治疗和预约的影响,并确定这些变化的原因和相关影响因素。

材料与方法

2019 年 1 月 1 日起接受治疗的黑色素瘤患者收到了一份邮寄调查,内容包括大流行导致的障碍、对 COVID-19 的恐惧、对黑色素瘤的恐惧、治疗和/或预约的变化,包括变化的原因。使用描述性分析和多变量逻辑回归来检查影响预约推迟/错过的因素。

结果

回复率为 41.3%(n=324;男性占 57.4%;平均年龄:67.9 岁)。在 104 名正在接受治疗的患者中,有 4 人(3.8%)因大流行而改变了治疗方案。48 名患者(14.8%)的预约被推迟或取消,最常见的原因是出于对 SARS-CoV-2 感染的恐惧(68.8%)而自行要求(81.3%)。目前的治疗与推迟/错过预约的可能性降低有关(OR=0.208,p=0.003),而对 COVID-19 的高度或非常高的关注(OR=6.806,p=0.034;OR=10.097,p=0.038)、密切接触者中的 SARS-CoV-2 感染(OR=4.251,p=0.026)、焦虑障碍(OR=5.465,p=0.016)和 AJCC 分期 IV(OR=3.108,p=0.048)与推迟/错过预约的可能性增加有关。

结论

在我们的参与者中,治疗方案的改变很少,错过/延迟预约的比例相当小。预约推迟/取消的主要原因是焦虑和对 COVID-19 的担忧。

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