School of Population Health, Royal College of Surgeons Ireland, Dublin, Ireland.
Data Science Centre, School of Population Health, Royal College of Surgeons Ireland, Dublin, Ireland.
JNCI Cancer Spectr. 2023 May 2;7(3). doi: 10.1093/jncics/pkad033.
The aims of this study were to explore the impact of COVID-19 on health-care services and quality of life (QoL) in women diagnosed with breast cancer (BC) in Ireland and whether the impact varied by social determinants of health (SDH).
Women diagnosed with BC completed a questionnaire measuring the impact of COVID-19, disruption to BC services, QoL, SDH, and clinical covariates during COVID-19 restrictions. The association between COVID-19 impact and disruption to BC services and QoL was assessed using multivariable regression with adjustment for SDH and clinical covariates. An interaction between COVID-19 impact and health insurance status was assessed within the regression models.
A total of 30.5% (n = 109) of women reported high COVID-19 impact, and these women experienced more disruption in BC services (odds ratio = 4.95, 95% confidence interval = 2.28 to 10.7, P < .001) and lower QoL (β = -12.01, SE = 3.37, P < .001) compared with women who reported low COVID-19 impact. Health insurance status moderated the effect of COVID-19 on disruption to BC services and QoL. Women who reported high COVID-19 impact experienced more disruption to BC services and lower QoL compared with women with low COVID-19 impact; however, the magnitude of these unfavorable effects differed by insurance status (Pinteraction < .05).
There was a large disruption to BC services and decrease in QoL for women with BC in Ireland during the pandemic. However, the impact was not the same for all women. It is important that women with BC are reintegrated into proper care and QoL is addressed through multidisciplinary support services.
本研究旨在探讨 COVID-19 对爱尔兰乳腺癌（BC）患者医疗服务和生活质量（QoL）的影响，以及这种影响是否因健康的社会决定因素（SDH）而异。
在 COVID-19 限制期间，诊断为 BC 的女性完成了一份问卷，该问卷测量了 COVID-19 的影响、BC 服务中断、QoL、SDH 和临床协变量。使用多变量回归评估 COVID-19 影响与 BC 服务和 QoL 中断之间的关联，并调整 SDH 和临床协变量。在回归模型中评估 COVID-19 影响与健康保险状况之间的交互作用。
共有 30.5%（n=109）的女性报告 COVID-19 影响较高，与报告 COVID-19 影响较低的女性相比，这些女性经历了更多的 BC 服务中断（优势比=4.95，95%置信区间=2.28 至 10.7，P<.001）和较低的 QoL（β=-12.01，SE=3.37，P<.001）。健康保险状况调节了 COVID-19 对 BC 服务中断和 QoL 的影响。报告 COVID-19 影响较高的女性与报告 COVID-19 影响较低的女性相比，BC 服务中断更多，QoL 更低；然而，这些不利影响的程度因保险状况而异（Pinteraction<.05）。
在大流行期间，爱尔兰的 BC 女性的 BC 服务受到了很大的干扰，生活质量下降。然而，并非所有女性都受到同样的影响。重要的是，要将 BC 女性重新纳入适当的护理中，并通过多学科支持服务来解决她们的生活质量问题。
