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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 6  |  Page : 1341-1344  

A qualitative study of the impact of COVID 19, on health care providers for cancer patients: An original research


1 Department of Surgical Oncology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
2 Department of General Surgery, Jubilee Mission Medical College Hospital and Research Institute, Thrissur, Kerala, India
3 Department of Dentistry, PRM Medical College and Hospital, Baripada, Odisha, India
4 MPH Biostatistics, University of Cincinnati, Cincinnati, Ohio, USA
5 Consultant Dental Surgeon Cancer Care initiative TATA TRUSTS, Cuttack Odisha, Cuttack, Odisha, India
6 Department of Prosthodontics, Kalinga Institute of Dental Sciences, KIIT-Deemed to be University, Bhubaneswar, Odisha, India
7 MPH Biostatistics, King Saud University, Riyadh, Kingdom of Saudi of Arabia

Date of Submission09-Mar-2021
Date of Decision24-Apr-2021
Date of Acceptance16-Jun-2021
Date of Web Publication10-Nov-2021

Correspondence Address:
Rohit Kumar Jha
Department of Surgical Oncology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpbs.jpbs_149_21

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   Abstract 


Introduction: In the challenging times of the COVID-19, the care of individuals with the debilitating diseases such as cancers has been an additional burden to the medical team. We aim to find out about the obstacles for the clinical care of the patients in the COVID, the questions frequently asked by cancer patients, and the medical care and support teams' general experience in taking care of cancer patients during the times of the pandemic. Materials and Methods: We conducted a Qualtrics survey that was developed by Cancer and Aging Research Group among 275 health care providers to cancer patients during. There were twenty questions in the survey. Of these 20, three open-ended questions were included that inquired about the barriers to the clinical care of cancer patients during COVID-19; the questions asked to the health care team by cancer patients or the attendants; health care teams general experience in the situations of the COVID-19. Two different reviewers performed the quality analysis for the open-ended questions after they were assigned a code. SPSS ver-23 was used for the descriptive statistics. Results: Medical services organizational difficulties and addressing necessities and support were generally reported. Hindrances to the medical health teams included the included administrative difficulties, access of the patient to the support and basic resources, uncertainties for patients' psychological and physical well-being, and teleconsultation challenges. The most common concern of the patients was the safety and the need for the treatment. Medical health care teams were seen to worry for the mental and the physical health of cancer patient. There was also reported concern for the medical team's own safety, obstruction in multi-level establishments; also the health team was seen feeling positive leadership and communications. Conclusion: The medical health provider teams felt a need for thorough support at the organizational level for cancer patients. Medical teams were expected to comprehend the short-term and long-term impact of the COVID-19 on cancer patients. It was accepted that there has been an increased workload and mental stress among the providers. Appreciating the experiences of the medical teams during the pandemic may help in the future guidance in the care of cancer patients.

Keywords: Cancer, COVID-19, impact on healthcare team


How to cite this article:
Jha RK, Pareed K D, Sahoo SR, Kapalavayi A, Hiralkar P, Perti S, Al Salem A. A qualitative study of the impact of COVID 19, on health care providers for cancer patients: An original research. J Pharm Bioall Sci 2021;13, Suppl S2:1341-4

How to cite this URL:
Jha RK, Pareed K D, Sahoo SR, Kapalavayi A, Hiralkar P, Perti S, Al Salem A. A qualitative study of the impact of COVID 19, on health care providers for cancer patients: An original research. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Jun 26];13, Suppl S2:1341-4. Available from: https://www.jpbsonline.org/text.asp?2021/13/6/1341/329984




   Introduction Top


In the challenging times of the COVID-19, the care of individuals with the debilitating diseases such as cancers has been an additional burden to the medical team. The health care team needs greater supports from the federal government to manage cancer patients who are undergoing treatment are more in danger than usual times. In doing these tasks, the medical team is already reached a high emotional stress level.[1],[2] Furthermore, there has been a shift in the practice methods do to the ever-evolving pandemic protocols, that may influence the treatment outcomes in cancer patients.[3] Moreover, being the first means of medical help and advice to the patients the medical team has always been at the risk of the burnout irrespective of the pandemic.[4],[5] Hence, in the present study, we aim to find out about the obstacles for the clinical care of the patients in the COVID, the questions frequently asked by cancer patients, and the medical care and support teams' general experience in taking care of cancer patients during the times of the pandemic.


   Materials and Methods Top


We conducted a Qualtrics survey that was developed by Cancer and Aging Research Group among 275 health care providers to cancer patients during. There were twenty questions in the survey. Of these 20, three open-ended questions were included that inquired about the barriers to the clinical care of cancer patients during COVID-19; the questions asked to the health care team by cancer patients or the attendants; health care teams general experience in the situations of the COVID-19. After taking the consent, questionnaire was given to the participants that was prepared from the previous questionnaire studies and noted using Google Forms. The present study was given clearance as it did not involve any human research and as no classified data was procured from the participants. Two different reviewers performed the quality analysis for the open-ended questions after they were assigned a code.[6] SPSS ver-23 (IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. IBM Corp. Released 2016) was used for the descriptive statistics.


   Results Top


Out of the 275 participants in our study, the majority were doctors and social workers (~70%). Equal distribution of the experience of the healthcare team was seen with all the groups having above 15 years of experience. The majority were under government programs (~60%) with very few attending the private programs. As the majority of the treatment centers are in the cities in our study also more than half of the personnel were in the urban setup [Table 1].
Table 1: Distribution of the participants

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Open-ended questions

Barriers to the clinical care in the COVID-19-five barriers were noted in the present study.

Administrative barriers to provide care, availability of support to the patients, mental health of the patient, physical health condition of the patient, and teleconsultation challenges.

In the administrative barriers, there were supply deficit of the PPE kits, delayed appointments, delayed diagnostics, no direct programs to educate cancer patients, and attendants, restriction of the patient attendants due to the fear of contagion. Due to the restriction on transport, the access of the health providers to the patient has decreased in the COVID-19. Allowance during the treatment under the government schemes was also delayed due to the pandemic. Many participants reported the mental stress faced by the patients due to the restriction of the visits in the pandemic. Many patients felt isolated and anxious. Few patients were also unwilling to attend the treatment appointments due to fear of infection. With advent of the internet, there has been a surge in the teleconsultation services. However as many of cancer patients are senior citizens, reluctance has been reported toward telehealth appointments. Furthermore, there was lesser access to the internet in the rural area.

Many social workers reported that the patients undergoing the treatment for cancer was immune-compromised and were feared to be at risk of the infection and associated COVID-19 complication. With reference to the second open-ended question, asked by patients to the health providers were of three categories, about health care, basic needs, and future. Many participants reported that they faced the most common question about the safety during the visit to attend the treatment. Many patients were apprehensive of the benefits of the treatment over the infection of COVID. The patients also were concerned about the safe way to procure the basic needs such as food and medication. Many participants reported that patients were eager to return to Normalcy so that the visitors can attend them and they can have a normal life.

With respect to the third open-ended question, the experiences of the health care teams during the pandemic, many participants were outspoken and considerate about their experiences. The experiences were observed in the following categories mental and physical health of the patients, personal safety issues of the health care providers, dissatisfactory responses at different levels in the administration, some had a positive feeling with the cooperation from the colleagues. Many participants reported an increase in the workload and increased fear and frustration among the health providers. Some participants reported a positive feedback as they have experienced better teamwork and ability of the staff during the crisis.


   Discussion Top


In the present study, we intend to investigate the obstructions to clinical care, the patient's and the attendees' inquiries, and the general encounters of medical services providers to cancer patients in the pandemic time. We found that there have been many clinical restrictions to the care that included administrative to personal hindrances during the COVID-19. These findings show a need to ensure a continued flow of care and to improve the framework of patient access. Keeping in mind the goodwill of the institute, the health care team and the patients, the health care providers, doctors should consider simple interventions and hence defer the exposure to the infection during the patient visit.[7] Extra provision for teleconsultation and the basic amenities along with the safe transport should be set up, financially upheld, and imparted to the medical care team and patients. This correspondence is appropriate, as it will guarantee more patients with malignancies receive a better care. We also noticed that over their own and their family's well-being, medical care teams were more concerned with their patient's security and their associate's mental health wellness. This outlines the dedication the health care providers have toward their patients. As there is no known protocol of treatment for COVID-19, there has been a significant exhaustion among the health care providers and the support team. There is also a need for the support ten to take care of their mental and physical wellness.[8],[9],[10],[11] The encounters of the medical team were significant and show the contrast of the COVID-19 pandemic. In our observation, we discovered that the health care providers were flexible and selfless, the contemplation of clinical groups, and the sound authority from health care teams was visible. Notwithstanding, respondents additionally felt that administrations from at various levels have failed to provide the basic amenities like PPE. There should be easy access to the support for both the medical team and the patients to have a good prognosis of the treatment and also for the physical and mental well-being of the health care providers. The lessons learned from the pandemic should be evidence based. The role being played by the health care teams should be thoroughly recognized and appreciated.[12] There were few limitations in our study like the disparity in the healthcare team distribution with the social worker and the doctors and the urban areas constituting the largest in the sample. The participants were from a single country; hence the results from our study are difficult to be generalized to other zones.


   Conclusion Top


Our study elaborated the views during the COVID pandemic, of the health care team of cancer patients. There were few revelations in our study, where the medical health provider teams felt a need for thorough support at the organizational level for cancer patients. The most common question faced by the health care team from the patients or their attendants was related to the need for treatment and the safety during COVID. The medical team was expected to comprehend the short-term and long-term impact of the COVID on cancer patients. It was accepted that there has been an increased workload and mental stress among the providers. Appreciating the experiences of the medical teams during the pandemic may help in the future guidance in the care of cancer patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

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Shanafelt T, Ripp J, Trockel M. Understanding and addressing sources of anxiety Among health care professionals during the COVID-19 pandemic. JAMA 2020;323:2133-4.  Back to cited text no. 1
    
2.
Wall SA, Knauss B, Compston A, Redder E, Folefac E, Presley C, et al. Multidisciplinary telemedicine and the importance of being seen. J Geriatr Oncol 2020;11:1349-51.  Back to cited text no. 2
    
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Cinar P, Kubal T, Freifeld A, Mishra A, Shulman L, Bachman J, et al. Safety at the Time of the COVID-19 Pandemic: How to Keep our Oncology Patients and Healthcare Workers Safe. J Natl Compr Canc Netw. 2020:1-6. doi: 10.6004/jnccn.2020.7572. Epub ahead of print. PMID: 32294617.  Back to cited text no. 3
    
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Semaan A, Audet C, Huysmans E, Afolabi B, Assarag B, Banke-Thomas A, et al. Voices from the frontline: Findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic. BMJ Glob Health 2020;5:e002967. doi: 10.1136/bmjgh-2020-002967. PMID: 32586891; PMCID: PMC7335688.  Back to cited text no. 4
    
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Schreier M. Qualitative content analysis in practice. United Kingdom: Sage Publications; 2012.  Back to cited text no. 6
    
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Mohile S, Dumontier C, Mian H, Loh KP, Williams GR, Wildes TM, et al. Perspectives from the Cancer and Aging Research Group: Caring for the vulnerable older patient with cancer and their caregivers during the COVID-19 crisis in the United States. J Geriatr Oncol 2020;11:753-60.  Back to cited text no. 7
    
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Ueda M, Martins R, Hendrie PC, McDonnell T, Crews JR, Wong TL, et al. Managing cancer care during the COVID-19 pandemic: Agility and collaboration toward a com- mon goal. J Natl Compr Canc Netw 2020;1:1-4.  Back to cited text no. 8
    
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Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry 2020;7:e15-6.  Back to cited text no. 9
    
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Shechter A, Diaz F, Moise N, Anstey DE, Ye S, Agarwal S, et al. Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic. Gen Hosp Psychiatry 2020;66:1-8.  Back to cited text no. 10
    
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Moazzami B, Razavi-Khorasani N, Dooghaie Moghadam A, Farokhi E, Rezaei N. COVID-19 and telemedicine: Immediate action required for maintaining healthcare providers well-being. J Clin Virol 2020;126:104345.  Back to cited text no. 11
    
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