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.

Abstract

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.

• Authors: Florence Joly, Olivier Rigal, Lydia Guittet, Sophie Lefèvre-Arbogast, Jean-Michel Grellard, Giulia Binarelli, Marie Lange, Chantal Rieux, Marie Fernette, Laure Tron, François Gernier, Romain Travers, Adeline Morel, Doriane Richard, Bénédicte Griffon, Alexandra Leconte, Etienne Bastien, Florian Quilan, Louis-Ferdinand Pépin, Fabrice Jardin, Marianne Leheurteur, Bénédicte Clarisse, Justine Lequesne, Audrey Faveyrial
• Journal: Cancer (Cancer) Vol. 127 Issue 24 Pg. 4636-4645 (12 15 2021) ISSN: 1097-0142 [Electronic] United States
• PMID: 34398970 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2021 American Cancer Society.

Topics

• Adult
• COVID-19 (psychology)
• Communicable Disease Control
• Day Care, Medical
• Female
• France
• Hospitals
• Humans
• Male
• Medical Oncology
• Middle Aged
• Neoplasms (epidemiology, psychology)
• Pandemics
• Prospective Studies
• Quality of Life
• Sleep Initiation and Maintenance Disorders (epidemiology, etiology)
• Stress Disorders, Post-Traumatic (epidemiology)