Understanding the Psychological Impact of COVID-19 Pandemic on Patients With Cancer, Their Caregivers, and Health Care Workers in Singapore

JCO Glob Oncol. 2020 Oct:6:1494-1509. doi: 10.1200/GO.20.00374.

Abstract

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has had a global impact, and Singapore has seen 33,000 confirmed cases. Patients with cancer, their caregivers, and health care workers (HCWs) need to balance the challenges associated with COVID-19 while ensuring that cancer care is not compromised. This study aimed to evaluate the psychological effect of COVID-19 on these groups and the prevalence of burnout among HCWs.

Methods: A cross-sectional survey of patients, caregivers, and HCWs at the National Cancer Centre Singapore was performed over 17 days during the lockdown. The Generalized Anxiety Disorder-7 and Maslach Burnout Inventory were used to assess for anxiety and burnout, respectively. Self-reported fears related to COVID-19 were collected.

Results: A total of 624 patients, 408 caregivers, and 421 HCWs participated in the study, with a response rate of 84%, 88%, and 92% respectively. Sixty-six percent of patients, 72.8% of caregivers, and 41.6% of HCWs reported a high level of fear from COVID-19. The top concern of patients was the wide community spread of COVID-19. Caregivers were primarily worried about patients dying alone. HCWs were most worried about the relatively mild symptoms of COVID-19. The prevalence of anxiety was 19.1%, 22.5%, and 14.0% for patients, caregivers, and HCWs, respectively. Patients who were nongraduates and married, and caregivers who were married were more anxious. The prevalence of burnout in HCWs was 43.5%, with more anxious and fearful HCWs reporting higher burnout rates.

Conclusion: Fears and anxiety related to COVID-19 are high. Burnout among HCWs is similar to rates reported prepandemic. An individualized approach to target the specific fears of each group will be crucial to maintain the well-being of these vulnerable groups and prevent burnout of HCWs.

MeSH terms

  • Adult
  • Aged
  • Anxiety / diagnosis
  • Anxiety / epidemiology*
  • Anxiety / psychology
  • Betacoronavirus / pathogenicity
  • Burnout, Professional / diagnosis
  • Burnout, Professional / epidemiology*
  • Burnout, Professional / psychology
  • COVID-19
  • Cancer Care Facilities / organization & administration
  • Cancer Care Facilities / standards
  • Caregivers / psychology*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / prevention & control
  • Coronavirus Infections / psychology*
  • Coronavirus Infections / transmission
  • Cross-Sectional Studies
  • Fear / psychology
  • Female
  • Health Personnel / psychology
  • Health Services Accessibility / organization & administration
  • Health Services Accessibility / standards
  • Humans
  • Infection Control / standards
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control
  • Infectious Disease Transmission, Professional-to-Patient / prevention & control
  • Male
  • Medical Oncology / organization & administration
  • Medical Oncology / standards
  • Middle Aged
  • Neoplasms / psychology*
  • Neoplasms / therapy
  • Pandemics / prevention & control
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / prevention & control
  • Pneumonia, Viral / psychology*
  • Pneumonia, Viral / transmission
  • Prevalence
  • SARS-CoV-2
  • Singapore / epidemiology
  • Workload / psychology