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Title: Managing cancer in context of pandemic : a qualitative study to explore the emotional and behavioural responses of patients with cancer and their caregivers to COVID-19
Authors: Chia, Jace Ming Xuan
Goh, Zack Zhong Sheng
Chua, Zi Yang
Ng, Kennedy Yao Yi
Ishak, Diana
Fung, Si Ming
Ngeow, Joanne Yuen Yie
Griva, Konstadina
Keywords: Science::Medicine
Issue Date: 2021
Source: Chia, J. M. X., Goh, Z. Z. S., Chua, Z. Y., Ng, K. Y. Y., Ishak, D., Fung, S. M., . . . Griva, K. (2021). Managing cancer in context of pandemic : a qualitative study to explore the emotional and behavioural responses of patients with cancer and their caregivers to COVID-19. BMJ Open, 11(1), e041070-. doi:10.1136/bmjopen-2020-041070
Project: NMRC/CSA-INV/0017/2017 
Journal: BMJ Open 
Abstract: Objectives: Having to access life-sustaining treatment during the emerging COVID-19 outbreak has placed patients with cancer at an especially vulnerable position notwithstanding their immunocompromised condition. The present study aimed to elucidate cancer patients’ and their caregivers’ experiences during this outbreak. Design: Face-to-face semistructured interviews were conducted. Setting: A tertiary cancer care facility. Participants: 16 patients with cancer and 14 caregivers. Inclusions criteria were: (A) diagnosed with cancer, (B) receiving active treatment or follow-ups, (C) aged 21 years and above and (D) fluent in English or Mandarin. Results: Thematic analysis was conducted. Five themes were identified: heightened sense of threat, impact on healthcare experience, responsibility falls on oneself, striving for normalcy and sense of safety and trust. Heightened threat of COVID-19 was more pronounced in patients and linked to vulnerability and fear, uncertainty and actions of socially irresponsible others. Dominant in their healthcare experience was prioritising cancer and treatment amidst heightened threat and anticipatory worry about treatment disruptions. Both noted on the importance of taking responsibility for one’s health, with caregivers reporting a reinforced sense of duty towards patients. They strived to maintain normalcy by viewing COVID-19 as beyond personal control, downplaying and living life as usual. Their resolve was supported by a sense of safety from the actions of authorities, hospitals and trust towards healthcare providers. Conclusions: Cancer intensifies threat and the emotional impact of COVID-19 and may trigger specific concerns related to treatment. Psychoeducation interventions led by healthcare providers over digital platforms could help address cancer-specific concerns and support patients and caregivers during the pandemic.
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2020-041070
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Research Centres: Centre for Population Health Sciences 
Rights: © 2021 The Author(s). Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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