School of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
Office of Community Outreach and Engagement, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
PLoS One. 2024 Jul 11;19(7):e0306035. doi: 10.1371/journal.pone.0306035. eCollection 2024.
The COVID-19 pandemic posed unique challenges to cancer-related care as health systems balanced competing risks of timely delivery of care and minimizing exposure to infection in a high-risk, immunocompromised patient population. This study aimed to better understand how pandemic-related factors affected the patient experience of cancer care during this time.
We conducted fifteen semi-structured interviews with adults from rural counties in Maryland who were diagnosed with and/or actively treated for cancer at the TidalHealth healthcare network between January 2020 and October 2022.
Interviews from fifteen participants were analyzed. Two major themes emerged including COVID Impact on Care, and COVID Impact on Mental Health. Subthemes under COVID Impact on Care include Staffing Shortages, Hospital Regulations, Visitation, Importance of Advocacy, and Telehealth Utilization, and subthemes under COVID Impact on Mental Health include Loneliness, Support Networks, and Perceptions of COVID and Personal Protection. Overall, participants described positive care experiences despite notable delays, disruptions to continuity of care, difficult transitions to telemedicine, visitation policies that limited patient support, increased mental health struggles related to social distancing measures, and greater desire for patient advocacy.
Our findings reveal significant impacts of the COVID-19 pandemic on experiences of cancer treatment and survivorship in a more vulnerable, rural patient population with lower healthcare access and income level. Our findings suggest areas for targeted interventions to limit disruptions to quality care in future public health emergencies.
COVID-19 大流行给癌症相关护理带来了独特的挑战，因为卫生系统需要平衡在高风险、免疫功能低下的患者群体中及时提供护理和最大限度减少感染风险的竞争风险。本研究旨在更好地了解大流行相关因素如何在此期间影响癌症护理的患者体验。
我们对 2020 年 1 月至 2022 年 10 月期间在马里兰州农村县接受 TidalHealth 医疗网络治疗和/或正在接受癌症治疗的成年人进行了十五次半结构化访谈。
对十五名参与者的访谈进行了分析。出现了两个主要主题，包括 COVID 对护理的影响和 COVID 对心理健康的影响。COVID 对护理的影响的子主题包括人员配备短缺、医院规定、探视、倡导的重要性和远程医疗利用，COVID 对心理健康的影响的子主题包括孤独感、支持网络以及对 COVID 和个人防护的看法。总体而言，参与者描述了积极的护理体验，尽管存在显著的延迟、护理连续性中断、向远程医疗过渡困难、限制患者支持的探视政策、与社交距离措施相关的更多心理健康问题以及对患者倡导的更大需求。
我们的研究结果揭示了 COVID-19 大流行对农村地区更脆弱、获得医疗保健机会和收入水平较低的癌症患者群体的治疗和生存体验的重大影响。我们的研究结果表明，在未来的公共卫生紧急情况下，有针对性地干预以限制对高质量护理的干扰的领域。
