Cancer Res Treat.  2022 Jul;54(3):671-679. 10.4143/crt.2021.585.

Functional Impairments in the Mental Health, Depression and Anxiety Related to the Viral Epidemic, and Disruption in Healthcare Service Utilization among Cancer Patients in the COVID-19 Pandemic Era

• Kim K
• Kim H
• Lee J
• Cho IK
• Ahn MH
• Son KY
• Kim JE
• Kim HJ
• Yoon SM
• Kim SH
• Kwon MJ
• Kim HJ
• Koh SJ
• Seo S
• Chung S

• KMID: 2531314
• DOI: http://doi.org/10.4143/crt.2021.585

Abstract

Purpose
Literature is scarce regarding cancer care utilization during the massive outbreak of coronavirus disease 2019 (COVID-19) in the Republic of Korea. We investigated functional impairments in mental health and their relationships with depression, anxiety regarding the viral epidemic, and disruptions in healthcare service utilization among cancer patients in the COVID-19 pandemic era.
Materials and Methods
We used an online survey with questions related to the disturbances faced by patients with cancer in utilizing healthcare services in the pandemic era. Current mental health status was assessed using the Work and Social Adjustment Scale (WSAS), Stress and Anxiety to Viral Epidemics-6 (SAVE-6) scale, Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI), Brief Resilience Scale (BRS), Cancer-Related Dysfunctional Beliefs about Sleep Scale (C-DBS), and Fear of COVID-19 over Cancer (FCC).
Results
Among the 221 responders, 95 (43.0%) reported disruptions in healthcare service utilization during the COVID-19 pandemic. Logistic regression analysis revealed that functional impairment in the mental health of these patients was expected due to disruptions in healthcare service utilization, high levels of depression, anxiety regarding the viral epidemic, fear of COVID over cancer, and low resilience. Mediation analysis showed that patient resilience and cancer-related dysfunctional beliefs about sleep partially mediated the effects of viral anxiety on functional impairment.
Conclusion
In this pandemic era, patients with cancer experience depression, anxiety regarding the viral epidemic, and disruptions in healthcare service utilization, which may influence their functional impairments in mental health.

Keyword

COVID-19; Pandemics; Cancer care facilities; Anxiety; Depression

Figure

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  Fig. 1 Disruption in healthcare service utilization during the coronavirus disease 2019 (COVID-19) pandemic.

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  Fig. 2 Mediation model showing that the effect of anxiety related to the viral epidemic (independent variable) on functional impairment (outcome) is mediated by resilience and dysfunctional beliefs about sleep (mediator). *p < 0.05, **p < 0.01.

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