Post-traumatic stress symptomatology and adjustment of medical oncology practice during the COVID-19 pandemic among adult patients with cancer in a day care hospital.
Adult
COVID-19
/ psychology
Communicable Disease Control
Day Care, Medical
Female
France
Hospitals
Humans
Male
Medical Oncology
Middle Aged
Neoplasms
/ epidemiology
Pandemics
Prospective Studies
Quality of Life
Sleep Initiation and Maintenance Disorders
/ epidemiology
Stress Disorders, Post-Traumatic
/ epidemiology
COVID-19
lockdown
patients with cancer
post-traumatic stress disorder (PTSD)
treatment adjustments
Journal
Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236
Informations de publication
Date de publication:
15 12 2021
15 12 2021
Historique:
revised:
16
07
2021
received:
06
04
2021
accepted:
17
07
2021
pubmed:
17
8
2021
medline:
24
12
2021
entrez:
16
8
2021
Statut:
ppublish
Résumé
The COVID-19 pandemic may induce post-traumatic stress disorder (PTSD) symptoms among patients with cancer, who also face adaptations to their treatment. The authors assessed the occurrence of PTSD symptoms, investigated pandemic-induced adjustments in medical oncology practice in patients with cancer, and explored risk factors for PTSD and the association between PTSD symptoms, insomnia, and quality of life (QoL). This prospective French study was conducted in patients with solid/hematologic tumors who were receiving medical treatment in the day care departments of 2 cancer centers during the lockdown. Adjustments to medical oncology practice were collected from medical records. PTSD (measured using the Impact of Event Scale-Revised), insomnia (measured using the Insomnia Severity Index), QoL (measured using the Functional Assessment of Cancer Therapy-General instrument), and cognitive complaints (measured using the Functional Assessment of Cancer Therapy-Cognitive Function instrument) were collected through validated questionnaires. Clinical data and questionnaires were available for 734 and 576 patients, respectively. The median patient age was 64 years, and 69% of patients were women. Twenty-one percent of patients had PTSD. Twenty-seven percent (95% CI, 23%-30%) had an adjustment in their medical oncology program, including adjournments (29%), treatment interruptions (16%), modified treatment plans (27%), or adapted monitoring (27%). Women and patients experiencing an adjustment in oncology practice had a higher odds of PTSD (odds ratio= 2.10 [95% CI, 1.07-4.14] and 1.65 [95% CI, 1.03-2.63]; P < .05). PTSD symptoms were correlated with worse scores for QoL, cognition, and insomnia. Twenty-one percent of patients with cancer experienced PTSD symptoms associated with poor QoL during the first COVID-19-induced lockdown. Medical oncology practice was adjusted in approximately one-quarter of patients and was associated with the occurrence of PTSD symptoms. Psychosocial support should be offered in cancer centers to promote emotional resilience and avoid PTSD symptoms in patients.
Sections du résumé
BACKGROUND
The COVID-19 pandemic may induce post-traumatic stress disorder (PTSD) symptoms among patients with cancer, who also face adaptations to their treatment. The authors assessed the occurrence of PTSD symptoms, investigated pandemic-induced adjustments in medical oncology practice in patients with cancer, and explored risk factors for PTSD and the association between PTSD symptoms, insomnia, and quality of life (QoL).
METHODS
This prospective French study was conducted in patients with solid/hematologic tumors who were receiving medical treatment in the day care departments of 2 cancer centers during the lockdown. Adjustments to medical oncology practice were collected from medical records. PTSD (measured using the Impact of Event Scale-Revised), insomnia (measured using the Insomnia Severity Index), QoL (measured using the Functional Assessment of Cancer Therapy-General instrument), and cognitive complaints (measured using the Functional Assessment of Cancer Therapy-Cognitive Function instrument) were collected through validated questionnaires.
RESULTS
Clinical data and questionnaires were available for 734 and 576 patients, respectively. The median patient age was 64 years, and 69% of patients were women. Twenty-one percent of patients had PTSD. Twenty-seven percent (95% CI, 23%-30%) had an adjustment in their medical oncology program, including adjournments (29%), treatment interruptions (16%), modified treatment plans (27%), or adapted monitoring (27%). Women and patients experiencing an adjustment in oncology practice had a higher odds of PTSD (odds ratio= 2.10 [95% CI, 1.07-4.14] and 1.65 [95% CI, 1.03-2.63]; P < .05). PTSD symptoms were correlated with worse scores for QoL, cognition, and insomnia.
CONCLUSIONS
Twenty-one percent of patients with cancer experienced PTSD symptoms associated with poor QoL during the first COVID-19-induced lockdown. Medical oncology practice was adjusted in approximately one-quarter of patients and was associated with the occurrence of PTSD symptoms. Psychosocial support should be offered in cancer centers to promote emotional resilience and avoid PTSD symptoms in patients.
Identifiants
pubmed: 34398970
doi: 10.1002/cncr.33856
pmc: PMC8426939
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
4636-4645Subventions
Organisme : GEFLUC Normandie ("Les entreprises contre le cancer/Compagnies against cancer Rouen-Normandie)
Organisme : Fondation ARC
ID : COVID202001320
Informations de copyright
© 2021 American Cancer Society.
Références
Palliat Med. 2009 Jan;23(1):46-53
pubmed: 18838488
Oncologist. 2021 Feb;26(2):e342-e344
pubmed: 33210442
Sleep. 2011 May 01;34(5):601-8
pubmed: 21532953
Target Oncol. 2020 Jun;15(3):249-259
pubmed: 32445083
J Pain Symptom Manage. 2012 Oct;44(4):520-31
pubmed: 22743157
Dermatol Ther. 2020 Sep;33(5):e13778
pubmed: 32515033
Psychooncology. 2017 Jan;26(1):29-36
pubmed: 26868950
Euro Surveill. 2020 Feb;25(6):
pubmed: 32070465
J Clin Oncol. 1998 Jan;16(1):139-44
pubmed: 9440735
Lancet. 2020 Feb 22;395(10224):565-574
pubmed: 32007145
Med J Aust. 2020 Jun;212(10):481-489
pubmed: 32401360
Head Neck. 2020 Jun;42(6):1179-1186
pubmed: 32459061
PLoS One. 2020 Oct 30;15(10):e0241741
pubmed: 33125442
J Psychosom Res. 2020 Jan 21;131:109939
pubmed: 32018216
Sleep. 2016 Oct 01;39(10):1795-1806
pubmed: 27450687
Clin Breast Cancer. 2020 Oct;20(5):e651-e662
pubmed: 32709505
Cancer Med. 2020 Dec;9(23):8875-8883
pubmed: 33022134
Lancet Oncol. 2020 May;21(5):619-621
pubmed: 32220659
Behav Res Ther. 2003 Dec;41(12):1489-96
pubmed: 14705607
Lancet Psychiatry. 2017 Apr;4(4):330-338
pubmed: 28109647
Gen Hosp Psychiatry. 2009 Jul-Aug;31(4):318-26
pubmed: 19555791
Front Psychol. 2020 Aug 24;11:2033
pubmed: 32982846
Gynecol Oncol. 2020 Nov;159(2):470-475
pubmed: 32981694
J Pain Symptom Manage. 2020 Nov;60(5):e25-e34
pubmed: 32889039
JCO Glob Oncol. 2021 Feb;7:311-323
pubmed: 33617304
Breast. 2020 Aug;52:110-115
pubmed: 32502796
Cancer. 2021 Sep 1;127(17):3246-3253
pubmed: 33905528
Psychooncology. 2008 Sep;17(9):948-53
pubmed: 18213677
Support Care Cancer. 2012 Dec;20(12):3297-305
pubmed: 22549504
Addict Behav. 2008 Aug;33(8):1039-47
pubmed: 18501524
J Endocrinol Invest. 2021 May;44(5):989-994
pubmed: 32803662
Eur Ann Otorhinolaryngol Head Neck Dis. 2020 May;137(3):159-160
pubmed: 32303485
Updates Surg. 2020 Sep;72(3):867-869
pubmed: 32537687
Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):296-306
pubmed: 29963592
Otolaryngol Head Neck Surg. 2020 Jul;163(1):86-88
pubmed: 32423298
Psychol Methods. 2002 Mar;7(1):19-40
pubmed: 11928888
Cancer. 2007 Jul 1;110(1):196-202
pubmed: 17546575
Front Oncol. 2020 Jul 10;10:1270
pubmed: 32754447
J Natl Cancer Inst. 2017 Oct 1;109(10):
pubmed: 28521364
J Anxiety Disord. 2010 Jan;24(1):1-15
pubmed: 19716676
Cancer. 2021 Dec 15;127(24):4636-4645
pubmed: 34398970
Risk Manag Healthc Policy. 2020 Sep 23;13:1711-1721
pubmed: 33061705
Psychooncology. 2015 Apr;24(4):371-81
pubmed: 25146298
Front Psychol. 2015 Feb 24;6:118
pubmed: 25759675