A qualitative study: The impact of COVID-19 on gynecologic oncology care

Abstract

The purpose of this study was to use a semi-structured interview framework to identify patient defined barriers and facilitators to gynecologic oncology care during the COVID-19 pandemic. As health care delivery has changed due to COVID-19, it is imperative to identify the changes needs of cancer care delivery. From October 2020–December 2020, we conducted semi-structured phone interviews with individuals receiving gynecologic cancer care at the Sidney Kimmel Cancer Center (SKCC). Individual interviews were conducted with 32 individuals with a confirmed gynecologic malignancy. We employed purposive sampling to establish patients with varying disease sites and sociodemographic characteristics. Respondents were recruited until thematic saturation was achieved. Interviews were semi-structured utilizing eight questions focused on personal challenges related to accessing cancer care. Interviews were audio-recorded, transcribed, and summarized using NVivo 12 software. Of the 32 individuals in our study, 16 (50%) stated their biggest concern was contracting COVID-19. Nine (28%) patients were specifically concerned about exposure to COVID-19 in the clinical setting including office visits, chemotherapy, and/or radiation treatments. Four (12.5%) were more concerned about being exposed in the community. Fifteen (47%) patients stated they had no concern about exposure to COVID-19. Seven (22%) patients reported transportation issues and seven (22%) of 32 patients also reported worries regarding cancer recurrence or progression due to delayed appointments. Participants were generally supportive of telehealth visits. Two patients preferred the virtual appointments, while 30 patients preferred in-person visits. Our qualitative study showcases the importance of understanding the concerns gynecologic oncology patients face during the COVID-19 pandemic at a large urban NCI designated cancer center.