Determining Healthcare Seeking Behavior, Psychosocial Symptoms, and Distress Levels of Women with Gynecological or Breast Cancer During the COVID-19 Pandemic

Abstract

Objective: The study was conducted to determine the health-seeking behaviors, psychosocial symptoms and distress levels and related factors of women diagnosed with gynecological or breast cancer during the pandemic period. Materials and Methods: This descriptive, cross-sectional study was completed with a total of 109 women who had ovary, endometrium, cervix, vagina, vulva, or breast cancer. The study was conducted between October and December 2020, and data were collected online using an information form, Distress Thermometer and The Brief Symptom Inventory. Results: There was a decrease in the frequency of going to the hospital for diagnosis (54.8%), treatment (32.3%), and rehabilitation (58%) services during the COVID-19 pandemic process. Our study results indicated that 89% of women experienced distress, according to Distress Thermometer. The mean Brief Symptom Inventory scores were found to be statistically significantly higher in women who stated that they experienced distress, whose chemotherapy treatment was postponed, and who obtained more information from the Internet during this period. Conclusions: This study highlighted the pandemic’s impact on healthcare-seeking behaviors and distress experiences of women with gynecological or breast cancer. Our results indicate a restriction on receiving health services during this period in women. Also, our results showed that most women experienced distress.

Keywords

• Breast cancer
• COVID-19
• gynecologic neoplasms
• healthcare-seeking behavior
• psychological distress

Jinekolojik Kanser veya Meme Kanserli Kadınların COVID-19 Pandemisi Sırasında Sağlık Bakımı Arama Davranışı, Psikososyal Belirtileri ve Sıkıntı Düzeylerinin Belirlenmesi

Öz

Amaç: Bu çalışmanın amacı pandemi sürecinde jinekolojik veya meme kanseri tanılı kadınların sağlık arama davranışları, psikososyal semptom ile distres düzeyleri ve ilişkili faktörleri belirlemektir. Materyal ve Metot: Bu tanımlayıcı, kesitsel çalışma yumurtalık, endometrium, serviks, vajina, vulva veya meme kanseri olan toplam 109 kadınla tamamlanmıştır. Çalışma Ekim-Aralık 2020 tarihleri arasında gerçekleştirildi ve veriler bilgi formu, Distres Termometresi ve Kısa Semptom Envanteri kullanılarak çevrimiçi olarak toplandı. Bulgular: COVID-19 pandemi sürecinde hastaneye tanı (%54,8), tedavi (%32,3) ve rehabilitasyon (%58) hizmetleri için başvurma sıklığında azalma olmuştur. Çalışma sonuçlarımız, Distres Termometresi’ne göre kadınların %89'unun distres yaşadığını göstermektedir. Distres yaşadığını ifade eden, kemoterapi tedavisi ertelenen, internetten bu süre içinde daha fazla bilgi edinen kadınlarda Kısa Semptom Envanteri puan ortalamaları istatistiksel olarak anlamlı derecede yüksek bulunmuştur. Sonuç: Bu çalışma, pandeminin jinekolojik veya meme kanseri tanılı kadınların sağlık arama davranışları ve distres deneyimleri üzerindeki etkisini anlamaya yardımcı olmuştur. Sonuçlarımız bu dönemde kadınlarda sağlık hizmeti almada bir kısıtlama olduğunu göstermektedir. Ayrıca, sonucumuz çoğu kadının distres yaşadığını göstermektedir.

Anahtar Kelimeler

• Meme kanseri
• Covid-19
• jinekolojik tümörler
• sağlık arama davranışı
• psikolojik sıkıntı

Kaynakça

1. Sohrabi C, Alsafi Z, O’Neill N, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International Journal of Surgery. 2020;76:71-76. doi:10.1016/j.ijsu.2020.02.034
2. World Health Organization (WHO). Coronavirus disease (COVID-19) situation report 126 https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200525-covid-19-sitrep-126.pdf?sfvrsn=887dbd66_2. Accessed May 26, 2020.
3. Anderson RM, Heesterbeek H, Klinkenberg D, et al. How will country-based mitigation measures influence the course of the COVID-19 epidemic? The Lancet. 2020;395 (10228):931-934. doi:10.1016/S0140-6736(20)30567-5
4. Bhatla N, Singhal S. The COVID-19 pandemic and implications for gynaecologic cancer care. Indian Journal of Gynecologic Oncolog. 2020;18(2):48. doi:10.1007/s40944-020-00395-7
5. Frey MK, Ellis AE, Zeligs K, et al. Impact of the COVID-19 pandemic on quality of life for women with ovarian cancer, American Journal of Obstetrics and Gynecology. 2020;223(5):725.e1-725.e9. doi:10.1016/j.ajog.2020.06.049
6. Subbian A, Kaur S, Patel V, et al. COVID-19 and its impact on gynaecologic oncology practice in India -results of a nationwide survey. Ecancer. 2020;14:1067. doi:10.3332/ecancer.2020.1067
7. Cortiula F, Pettke A, Bartoletti M, et al. Managing COVID-19 in the oncology clinic and avoiding the distraction effect. Annals of Oncology. 2020;31(5):553-555. doi:10.1016/j.annonc.2020.03.286
8. Sun YS, Zhao Z, Yang ZN, et al. Risk factors and preventions of breast cancer. International journal of biological sciences. 2017; 13(11): 1387-1397. doi:10.7150/ijbs.21635

9. Vanni G, Pellicciaro M, Materazzo M, et al. Lockdown of breast cancer screening for COVID-19: possible scenario. In vivo. 2020;34(5):3047-3053. doi:10.21873/invivo.12139
10. Sümbüloğlu K, Sümbüloğlu V. Biostatistics. Ankara; Hatipoğlu Publisher; 2012.
11. Türkiye General Directorate of Public Health. Cancer Statistics of Türkiye 2016. https://hsgm.saglik.gov.tr/depo/birimler/kanserdb/istatistik/Trkiye_Kanser_statistikleri_2016.pdf. Accessed December 1, 2020.
12. Roth AJ, Kornblinth AB, Batel-Copel L, et al. Rapid screening for psychologic distress in men with prostate carcinoma: A pilot study. Cancer. 1998;82:1904-1908.
13. Özalp E, Cankurtaran ES, Soygür H, et al. Screening for psychological distress in Turkish cancer patients. Psycho Oncology. 2007;16(4):304-311.
14. Derogatis LR. BSI-18: Brief Symptom Inventory 18- Administration, scoring, and procedures manual-II. Clinical Psychometric Research Inc. 1992.
15. Şahin NH, Durak A. Brief Short symptom: adaptation for Turkish youth. Turkish Journal of Psychology. 1994;9(31):44-56.
16. World Health Organization (WHO). Pulse survey on continuity of essential health services during the COVID-19 pandemic. WHO reference number: WHO/2019nCoV/EHS_continuity/survey/2020.1. https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS_continuity-survey-2020.1. Accessed October 1, 2020.
17. Altın D, Yalçın İ, Khatib G, et al. Management of gynecological cancers in the COVID-19 era: a survey from Türkiye. Journal of the Turkish German Gynecological Association. 2020;21(4):265.doi:10.4274/jtgga.galenos.2020.2020.0071
18. Bhandoria G, Shylasree TS, Bhandarkar P, et al. Impact of COVID-19 pandemic on gynecological oncology care: Glimpse into Association of Gynecological Oncologists of India (AGOI) perspective. Indian Journal of Gynecologic Oncology. 2020;18-71. doi:10.1007/s40944-020-00421-8
19. Bogani G, Ditto A, Bosio S, et al. Cancer patients affected by COVID-19: Experience from Milan, Lombardy. Gynecologic Oncology. 2020;158(2):262-265. doi:10.1016/j.ygyno.2020.06.161
20. Gultekin M, Ak S, Ayhan A, et al. Perspectives, fears and expectations of patients with gynaecological cancers during the COVID‐19 pandemic: A Pan‐European study of the European Network of Gynaecological Cancer Advocacy Groups (ENGAGe). Cancer Medicine. 2021;10:208-219. doi:10.1002/cam4.3605
21. Pelle F, Cappelli S, Graziano F, et al. Breast cancer surgery during the Covid-19 pandemic: a monocentre experience from the Regina Elena National Cancer Institute of Rome. Journal of Experimental & Clinical Cancer Research. 2020;39(1):1-5. doi:10.1186/s13046-020-01683-y
22. Alipour S, Moini A, Orouji M, et al. COVID-19 outbreak and consequent delays in schedules of the breast clinic: Effects on patients’ breast and emotional symptoms. European Journal of Breast Health. 2020;16(4):240-254. doi:10.5152/ejbh.2020.5903
23. Moran HK, Brooks JV, Spoozak L. Undergoing active treatment for gynecologic cancer during COVID-19: A qualitative study of the impact on healthcare and social support. Gynecologic Oncology Reports. 2020;34:100659. doi:10.1016/j.gore.2020.100659
24. Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus Disease (COVID-19) epidemic among the general population in China. International Journal of Environmental Research and Public Health. 2020;17(5):1729. doi:10.3390/ijerph17051729