Quality of life of palliative care cancer patients during COVID-19 lockdown phase
Abstract
Background: Coronavirus pandemic in 2019 led India to implement a complete lockdown except foressential services. Cancer patients faced hindrances in seeking medical help. This caused stress and worry,leading to reduced quality of life (QoL). This study evaluated QoL and pain management in palliativecare cancer patients during the lockdown.
Patients and methods: This was a cross-sectional observational study at a tertiary cancer hospital,over one month period with convenience sampling. Participants included all who were unable to visitthe palliative outpatient department during the lockdown during the COVID-19 pandemic. They werecontacted telephonically and a valid QoL questionnaire was filled out. Disease, demographic details andpain were assessed.
Results: A total of 51 were interviewed, 45% (n = 23) patients reported difficult access to medicationduring the lockdown; 18 (35.3%) required morphine to alleviate pain and 6 (33.33%) faced difficulty inacquiring morphine tablets. QoL scores did not differ based on access to morphine (p = 0.648). MeanQoL scores were 12.7 ± 3.76 and 15.0 ± 3.60 amongst patients who did not have access to othermedications and those who did have access, respectively (p = 0.03). Overall QoL FACT G7 mean scorewas 14 ± 3.8. The variables NRS (pain intensity) and QoL scores were found to be negatively correlated(Pearson’s Correlation Coefficient: r (49) = −0.69, p < 0.00001).
Conclusions: Evaluation of QoL of palliative care cancer patients during global crises plays an importantrole in the assessment of patients’ overall condition as well as to maintain a continuum of care.
Keywords: COVID-19palliative carequality of lifecanceroncology
References
- Coronavirus disease 2019 (COVID-19) Situation Report – 63. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200323-sitrep-63-covid-19.pdf?sfvrsn=b617302d_4 (6.08.2022).
- Xiang YT, Yang Y, Li W, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020; 7(3): 228–229.
- Yanez B, Pearman T, Lis CG, et al. The FACT-G7: a rapid version of the functional assessment of cancer therapy-general (FACT-G) for monitoring symptoms and concerns in oncology practice and research. Ann Oncol. 2013; 24(4): 1073–1078.
- Webster K, Cella D, Yost K. The functional assessment of chronic illness therapy (FACIT) measurement system: properties, applications, and interpretation. Health Qual Life Outcomes. 2003; 1: 79.
- Conti CM, Maccauro G, Fulcheri M. Psychological stress and cancer. Int J Immunopathol Pharmacol. 2011; 24(1): 1–5.
- Thaker PH, Lutgendorf SK, Sood AK. The Neuroendocrine Impact of Chronic Stress on Cancer. Cell Cycle. 2014; 6(4): 430–433.
- Pearman T, Yanez B, Peipert J, et al. Ambulatory cancer and US general population reference values and cutoff scores for the functional assessment of cancer therapy. Cancer. 2014; 120(18): 2902–2909.
- Garg R, Asthana S, Bhatia S, et al. Quality of life and needs of the Indian advanced cancer patients receiving palliative careAssessment of the quality of life, problems, and needs of the advanced cancer patient receiving palliative care. Cancer Res Stat Treat. 2019; 2(2): 138–144.
- Hui DS, Joynt GM, Wong KT, et al. Impact of severe acute respiratory syndrome (SARS) on pulmonary function, functional capacity and quality of life in a cohort of survivors. Thorax. 2005; 60(5): 401–409.
- 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. Int J Environ Res Public Health. 2020; 17(5).
- Stults-Kolehmainen MA, Sinha R. The effects of stress on physical activity and exercise. Sports Med. 2014; 44(1): 81–121.
- Hall MH, Casement MD, Troxel WM, et al. Chronic stress is prospectively associated with sleep in midlife women: the SWAN sleep study. Sleep. 2015; 38(10): 1645–1654.
- Shanmugasundaram S, Chapman Y, O'Connor M. Development of palliative care in India: an overview. Int J Nurs Pract. 2006; 12(4): 241–246.
- Khosla D, Patel FD, Sharma SC. Palliative care in India: current progress and future needs. Indian J Palliat Care. 2012; 18(3): 149–154.
- McDermott E, Selman L, Wright M, et al. Hospice and palliative care development in India: a multimethod review of services and experiences. J Pain Symptom Manage. 2008; 35(6): 583–593.
- Zimmermann C, Burman D, Swami N, et al. Determinants of quality of life in patients with advanced cancer. Support Care Cancer. 2011; 19(5): 621–629.
- Rajagopal MR, Joranson DE, Gilson AM. Medical use, misuse, and diversion of opioids in India. Lancet. 2001; 358(9276): 139–143.
- Sharma H, Jagdish V, Anusha P, et al. End-of-life care: Indian perspective. Indian J Psychiatry. 2013; 55(Suppl 2): S293–S298.
- Mudigonda T, Mudigonda P. Palliative cancer care ethics: principles and challenges in the Indian setting. Indian J Palliat Care. 2010; 16(3): 107–110.
- Seamark D, Ajithakumari K, Burn G, et al. Palliative care in India. J R Soc Med. 2000; 93(6): 292–295.
- Board of Governors in supersession of the Medical Council of India. Telemedicine Practice Guidelines. Enabling Registered Medical Practitioners to Provide Healthcare Using Telemedicine. https://www.mohfw.gov.in/pdf/Telemedicine.pdf (07.07.2022).
- Adhikari SD, Gupta N, Sharma A, et al. Caring of cancer patients during COVID-19: A real-life challenge. Indian J Cancer. 2020; 57(2): 218–220.
- Correia FR, De Carlo MM. Evaluation of quality of life in a palliative care context: an integrative literature review. Rev Lat Am Enfermagem. 2012; 20(2): 401–410.