ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA, USA.
University of North Carolina, Chapel Hill, NC, USA.
J Cancer Surviv. 2024 Jun;18(3):1051-1058. doi: 10.1007/s11764-023-01356-7. Epub 2023 Mar 22.
The COVID-19 pandemic has caused great strain on older adults with cancer and their healthcare providers. This study explored healthcare providers' reported changes in cancer care, clinical barriers to care, patient questions, and the overall experiences of caring for older adults with cancer during the COVID-19 crisis.
The Advocacy Committee of the Cancer and Aging Research Group and the Association of Community Cancer Centers developed a survey for healthcare providers of adults with cancer, inquiring about their experiences during the pandemic. Responses from the survey's four open-ended items were analyzed by four independent coders for identification of common themes using deductive and inductive methods.
Participants (n = 137) represented a variety of demographic and clinical experiences. Six overall themes emerged, including (1) telehealth use, (2) concerns for patient mental health, (3) patient physical and social isolation, (4) patient fear of contracting COVID-19, (5) continued disruptions to cancer care, and (6) patients seeking guidance, particularly regarding COVID-19 vaccination. Questions fielded by providers focused on the COVID-19 vaccination's safety and efficacy during older adults' cancer treatment.
Additional resources (e.g., technology support, established care guidelines, and sufficient staffing) are needed to support older adults with cancer and healthcare providers during the pandemic. Future research should explore universally effective in-person and virtual treatment strategies for older adults with cancer.
Persistence of telehealth barriers, particularly a lack of infrastructure to support telehealth visits, social isolation, and restrictive visitor policies as a result of COVID-19, negatively impacted the mental health of older adults with cancer.
COVID-19 大流行给癌症老年患者及其医疗保健提供者带来了巨大压力。本研究探讨了医疗保健提供者报告的癌症护理变化、护理临床障碍、患者问题，以及在 COVID-19 危机期间照顾老年癌症患者的总体经验。
癌症与老龄化研究组倡导委员会和社区癌症中心协会为成年癌症患者的医疗保健提供者开发了一项调查，询问他们在大流行期间的经历。使用演绎和归纳方法，由四位独立编码员对调查的四个开放式项目的回复进行分析，以确定共同主题。
参与者（n=137）代表了各种人口统计学和临床经验。出现了六个总体主题，包括（1）远程医疗的使用，（2）对患者心理健康的关注，（3）患者身体和社会隔离，（4）患者对感染 COVID-19 的恐惧，（5）癌症护理的持续中断，以及（6）患者寻求指导，特别是关于 COVID-19 疫苗接种的指导。提供者提出的问题集中在 COVID-19 疫苗接种在癌症治疗期间对老年患者的安全性和有效性。
需要额外的资源（例如，技术支持、既定的护理指南和足够的人员配备）来支持大流行期间的癌症老年患者和医疗保健提供者。未来的研究应该探索针对癌症老年患者普遍有效的面对面和虚拟治疗策略。
远程医疗障碍的持续存在，特别是缺乏支持远程医疗访问的基础设施、社交隔离以及 COVID-19 导致的限制性访客政策，对老年癌症患者的心理健康产生了负面影响。
