Dieuwke R Mink van der Molen1, Claudia A Bargon1,2, Marilot C T Batenburg1, Roxanne Gal1, Danny A Young-Afat3, Lilianne E van Stam1, Iris E van Dam4, Femke van der Leij4, Inge O Baas5, Miranda F Ernst6, Wiesje Maarse7, Nieke Vermulst8, Ernst J P Schoenmaeckers9, Thijs van Dalen10, Rhodé M Bijlsma5, Annemiek Doeksen2, Helena M Verkooijen11,12. 1. Division of Imaging and Oncology, University Medical Center Utrecht, Heidelberglaan, Utrecht, The Netherlands. 2. Department of Surgery, St. Antonius Hospital, Soestwetering, Utrecht, The Netherlands. 3. Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, Location VUmc, Amsterdam, The Netherlands. 4. Department of Radiation Oncology, University Medical Center Utrecht, Cancer Center, Utrecht, The Netherlands. 5. Department of Medical Oncology, University Medical Center Utrecht, Cancer Center, Utrecht, The Netherlands. 6. Department of Surgery, Alexander Monro Clinics, Bilthoven, The Netherlands. 7. Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. 8. Department of Surgery, Rivierenland Hospital, Tiel, The Netherlands. 9. Department of Surgery, Meander Medisch Centrum, Amersfoort, The Netherlands. 10. Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands. 11. Division of Imaging and Oncology, University Medical Center Utrecht, Heidelberglaan, Utrecht, The Netherlands. H.M.Verkooijen@umcutrecht.nl. 12. Utrecht University, Heidelberglaan, Utrecht, The Netherlands. H.M.Verkooijen@umcutrecht.nl.
Abstract
PURPOSE: To identify factors associated with (perceived) access to health care among (ex-)breast cancer patients during the COVID-19 pandemic. METHODS: Cross-sectional study within a large prospective, multicenter cohort of (ex-)breast cancer patients, i.e., UMBRELLA. All participants enrolled in the UMBRELLA cohort between October 2013 and April 2020 were sent a COVID-19-specific survey, including the Hospital Anxiety and Depression Scale (HADS) questionnaire. RESULTS: In total, 1051 (66.0%) participants completed the survey. During COVID-19, 284 (27.0%) participants reported clinically relevant increased levels of anxiety and/or depression, i.e., total HADS score ≥ 12. Participants with anxiety and/or depression reported statistically significant higher barriers to contact their general practitioner (47.5% vs. 25.0%, resp.) and breast cancer physicians (26.8% vs. 11.2%, resp.) compared to participants without these symptoms. In addition, a higher proportion of participants with anxiety and/or depression reported that their current treatment or (after)care was affected by COVID-19 compared to those without these symptoms (32.7% vs. 20.5%, resp.). Factors independently associated with symptoms of anxiety and/or depression during COVID-19 were pre-existent anxiety (OR 6.1, 95% CI 4.1-9.2) or depression (OR 6.0, 95% CI 3.5-10.2). CONCLUSION: During the COVID-19 pandemic, (ex-)breast cancer patients with symptoms of anxiety and/or depression experience higher barriers to contact health care providers. Also, they more often report that their health care was affected by COVID-19. Risk factors for anxiety and/or depression during COVID-19 are pre-existent symptoms of anxiety or depression. Extra attention-including mental health support-is needed for this group.
PURPOSE: To identify factors associated with (perceived) access to health care among (ex-)breast cancerpatients during the COVID-19 pandemic. METHODS: Cross-sectional study within a large prospective, multicenter cohort of (ex-)breast cancerpatients, i.e., UMBRELLA. All participants enrolled in the UMBRELLA cohort between October 2013 and April 2020 were sent a COVID-19-specific survey, including the Hospital Anxiety and Depression Scale (HADS) questionnaire. RESULTS: In total, 1051 (66.0%) participants completed the survey. During COVID-19, 284 (27.0%) participants reported clinically relevant increased levels of anxiety and/or depression, i.e., total HADS score ≥ 12. Participants with anxiety and/or depression reported statistically significant higher barriers to contact their general practitioner (47.5% vs. 25.0%, resp.) and breast cancer physicians (26.8% vs. 11.2%, resp.) compared to participants without these symptoms. In addition, a higher proportion of participants with anxiety and/or depression reported that their current treatment or (after)care was affected by COVID-19 compared to those without these symptoms (32.7% vs. 20.5%, resp.). Factors independently associated with symptoms of anxiety and/or depression during COVID-19 were pre-existent anxiety (OR 6.1, 95% CI 4.1-9.2) or depression (OR 6.0, 95% CI 3.5-10.2). CONCLUSION: During the COVID-19 pandemic, (ex-)breast cancerpatients with symptoms of anxiety and/or depression experience higher barriers to contact health care providers. Also, they more often report that their health care was affected by COVID-19. Risk factors for anxiety and/or depression during COVID-19 are pre-existent symptoms of anxiety or depression. Extra attention-including mental health support-is needed for this group.
Entities:
Keywords:
Anxiety; Breast cancer; COVID-19; Depression; Patient-reported outcomes; UMBRELLA
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