Abstract

Patients newly diagnosed with malignancies amidst the COVID19 pandemic outbreak face the psychological double whammy of a gruesome diagnosis and a public health crisis. We conducted a cross-sectional survey to examine the association between common psychological disorders and cancer patients’ perception of COVID19’s real-life impact. Newly diagnosed cancer patients were surveyed with a two-part questionnaire constructed by oncologists and clinical psychologists. It first explored patients’ perceptions of pandemic’s impact on cancer care resources, treatment quality, health-seeking behaviour and other concerns. The second part involved the measurement of post-traumatic stress disorder (PTSD) (abbreviated PCL-5), anxiety and depression (emotion thermometer) and intolerance to uncertainty (IUS12), where patients were assigned into high and low-risk groups accordingly. Their associations were observed and analysed using chi-square test. 103 new cancer patients in Hong Kong were surveyed in May 2020. Results revealed there were more worries about the impact of COVID19 on cancer care manpower, and secondly about risk of infection during OPD waiting time, in patients of high risk group for PTSD (p= 0.011; p=0.015 respectively), anxiety (p=0.013; p=0.034), depression (p=0.017; p=0.043) and uncertainty tolerance (p=0.004; p=0.044). High IUS12 score was associated with more worry on pandemic’s impact on progress of cancer research and drug development (p=0.03). Patients of the high anxiety risk group were less likely to accept hospital’s “no visitor” policy during admission (p=0.013). High-risk group for anxiety (p=0.024) and depression (p=0.044) tend to consider the availability of media information on COVID19’s impact on cancer as inadequate. Patients of high PTSD risk group showed greater fear of being infected by family/carers (p=0.005). This original survey revealed the potential value of psychometrics in understanding cancer patient’s perception of COVID19’s impact and predicting particular concerns in patients with different psychological phenotypes, allowing better-tailored pandemic time cancer care.

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