Correlational Study of Emotional Stress, Pain, and the Presence of Inpatient Companions for Cancer Inpatients during the COVID-19 Pandemic
Abstract
:1. Introduction
2. Method
2.1. Research Design
2.2. Measurements
2.2.1. The Numeric Rating Scale
2.2.2. Brief Symptom Rating Scale (BSRS-5)
2.3. Statistical Analysis
3. Results
3.1. Demographic Data of Cancer Inpatients and Inpatient Companions
3.2. Emotional Assessment Scores of Cancer Inpatients
4. Discussion
5. Conclusions
6. Limitations and Future Studies
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- World Health Organization. Coronavirus Disease (COVID-19) Outbreak Situation. 2020. Available online: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 (accessed on 23 March 2020).
- Taiwan Centers for Diseases Control (CDC). COVID-19 (SARS-CoV-2 Infection). Available online: https://sites.google.com/cdc.gov.tw/2019-ncov/ (accessed on 5 January 2022).
- Jazieh, A.R.; Akbulut, H.; Curigliano, G.; Rogado, A.; Alsharm, A.A.; Razis, E.D.; Mula-Hussain, L.; Errihani, H.; Khattak, A.; De Guzman, R.B.; et al. Impact of the COVID-19 pandemic on cancer care: A global collaborative study. JCO Glob. Oncol. 2020, 6, 1428–1438. [Google Scholar] [CrossRef] [PubMed]
- Cheng, Y.H.; Lieu, A.S.; Liu, Y.; Chen, H.M. Exploring the care needs of primary caregivers of patients awaiting brain tumor surgery and related factors. Hu Li Za Zhi 2016, 63, 31–41. [Google Scholar] [PubMed]
- Wild, C.P.; Weiderpass, E.; Stewart, B.W. World Cancer Report: Cancer Research for Cancer Prevention; International Agency for Research on Cancer; World Health Organization: Geneva, Switzerland, 2020. [Google Scholar]
- Chou, L.N. The urgently principle for contemporary people on visiting patients. Health World 2007, 254, 97–999. [Google Scholar]
- Taiwan Association of Family Caregivers. Press Conference-Inpatient Care Experience and Stress. 2017. Available online: https://www.familycare.org.tw/sites/default/files/家庭照顧者關懷總會-住院照顧經驗與壓力記者會新聞稿1060925.pdf (accessed on 2 June 2020).
- Li, Z.Y.; Zhuang, Z.H. Discussion on the care load of primary caregivers of cancer patients. Changhua Nurs. 2018, 25, 12–19. [Google Scholar]
- Hung, S.H.; Kuo, S.C.; Fen, J.J.; Tseng, K.J.; Sun, Y.C.; Ming, J.L. Visiting in disguise: Analysis of inpatient companions in the time of COVID-19. J. Chin. Med. Assoc. 2020, 83, 1111–1116. [Google Scholar] [CrossRef] [PubMed]
- Yabroff, K.R.; Kim, Y. Time costs associated with informal caregiving for cancer survivors. Cancer 2009, 115, 4362–4373. [Google Scholar] [CrossRef] [PubMed]
- Hsu, T.; Loscalzo, M.; Ramani, R.; Forman, S.; Popplewell, L.; Clark, K.; Katheria, V.; Feng, T.; Strowbridge, R.; Rinehart, R.; et al. Factors associated with high burden in caregivers of older adults with cancer. Cancer 2014, 120, 2927–2935. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Liu, Y.A.; Hsu, Y.C.; Lin, M.H.; Chang, H.T.; Chen, T.J.; Chou, L.F.; Hwang, S.J. Hospital visiting policies in the time of coronavirus disease 2019: A nationwide website survey in Taiwan. J. Chin. Med. Assoc. 2020, 83, 566–570. [Google Scholar] [CrossRef] [PubMed]
- Taiwan Centers for Disease Control. Principles of Visitor Restrictions at Medical Facilities in the Time of COVID-19. 2020. Available online: https://www.cdc.gov.tw/Bulletin/Detail/twI9DaxIl4NEwJvfUiZJqQ?typeid=48 (accessed on 28 March 2021).
- National Health Insurance Administration Ministry of Health and Welfare. Integrating Travel Record Data into the National Health Insurance Administration Cloud Database. 2020. Available online: https://www.nhi.gov.tw/News_Content.aspx?n=FC05EB85BD57C709&sms=587F1A3D9A03E2AD&s=012016EE70C9A226 (accessed on 23 March 2020).
- Hjermstad, M.J.; Fayers, P.M.; Haugen, D.F.; Caraceni, A.; Hanks, G.W.; Loge, J.H.; Fainsinger, R.; Aass, N.; Kaasa, S. Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: A systematic literature review. J. Pain Symptom Manag. 2011, 41, 1073–1093. [Google Scholar] [CrossRef] [PubMed]
- Paice, J.A.; Cohen, F.L. Validity of a verbally administered numeric rating scale to measure cancer pain intensity. Cancer Nurs. 1997, 20, 88–93. [Google Scholar] [CrossRef] [PubMed]
- Lee, M.B.; Liao, S.C.; Lee, Y.J.; Wu, C.H.; Tseng, M.C.; Gau, S.F.; Rau, C.L. Development and verification of validity and reliability of a short screening instrument to identify psychiatric morbidity. J. Formos. Med. Assoc. 2003, 102, 687–694. [Google Scholar] [PubMed]
- Chen, H.C.; Wu, C.H.; Lee, Y.J.; Liao, S.C.; Lee, M.B. Validity of the five-item Brief Symptom Rating Scale among subjects admitted for general health screening. J. Formos. Med. Assoc. 2005, 104, 824–829. [Google Scholar] [PubMed]
- Lee, J.I.; Lee, M.B.; Liao, S.C.; Chang, C.M.; Sung, S.C.; Chiang, H.C.; Tai, C.W. Prevalence of suicidal ideation and associated risk factors in the general population. J. Formos. Med. Assoc. 2010, 109, 138–147. [Google Scholar] [CrossRef] [Green Version]
- Mehta, A.K.; Smith, T.J. Palliative care for patients with cancer in the COVID-19 era. JAMA Oncol. 2020, 6, 1527–1528. [Google Scholar] [CrossRef] [PubMed]
- Sha, Z.; Chang, K.; Mi, J.; Liang, Z.; Hu, L.; Long, F.; Shi, H.; Lin, Z.; Wang, X.; Pei, X. The impact of the COVID-19 pandemic on lung cancer patients. Ann. Palliat. Med. 2020, 9, 3373–3378. [Google Scholar] [CrossRef] [PubMed]
- Ciążyńska, M.; Pabianek, M.; Szczepaniak, K.; Ułańska, M.; Skibińska, M.; Owczarek, W.; Narbutt, J.; Lesiak, A. Quality of life of cancer patients during coronavirus disease (COVID-19) pandemic. Psychooncology 2020, 29, 1377–1379. [Google Scholar] [CrossRef] [PubMed]
- Alom, S.; Chiu, C.M.; Jha, A.; Lai, S.H.D.; Yau, T.H.L.; Harky, A. The effects of COVID-19 on cancer care provision: A systematic review. Cancer Control. 2021, 28, 1–29. [Google Scholar] [CrossRef] [PubMed]
- Khaleghparast, S.; Joolaee, S.; Ghanbari, B.; Maleki, M.; Peyrovi, H.; Bahrani, N. A review of visiting policies in intensive care units. Glob. J. Health Sci. 2016, 8, 267. [Google Scholar] [CrossRef] [PubMed]
- Lee, Y.H.; Liao, Y.C.; Shun, S.C.; Lin, K.C.; Liao, W.Y.; Chang, P.H.; Jhang, S.Y.; Yu, C.J.; Yang, P.C. Trajectories of caregiver burden and related factors in family caregivers of patients with lung cancer. Psychooncology 2018, 27, 1493–1500. [Google Scholar] [CrossRef] [PubMed]
Total (N = 3103) | Year | p Value | Dunn–Bonferroni Post Hoc | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
2019 (n = 975) | 2020 (n = 1179) | 2021 (n = 949) | 2019 vs. 2020 | 2019 vs. 2021 | 2020 vs. 2021 | |||||||
Age | 59.71 | ±12.66 | 59.91 | ±12.70 | 60.56 | ±12.82 | 58.46 | ±12.32 | <0.001 ** | 0.571 | 0.037 * | <0.001 ** |
Gender | 0.058 | |||||||||||
Female | 1644 | 52.98% | 486 | 49.85% | 645 | 54.71% | 513 | 54.06% | ||||
Male | 1459 | 47.02% | 489 | 50.15% | 534 | 45.29% | 436 | 45.94% | ||||
Number of days in hospital | 7.87 | ±10.77 | 8.29 | ±10.45 | 7.69 | ±12.08 | 7.67 | ±9.24 | <0.001 ** | <0.001 ** | 0.059 | 0.397 |
Total nursing hours | 12.94 | ±10.76 | 11.14 | ±9.55 | 13.18 | ±10.16 | 14.5 | ±12.30 | <0.001 ** | <0.001 ** | <0.001 ** | 0.795 |
Pain score ≥ 4 points/time | 1.45 | ±6.36 | 1.53 | ±7.55 | 1.42 | ±6.00 | 1.41 | ±5.39 | 0.113 | |||
Total emotion scale score | 1.75 | ±2.73 | 1.83 | ±2.97 | 1.73 | ±2.76 | 1.7 | ±2.42 | 0.353 | |||
Sleep disturbance | 0.445 | |||||||||||
0 | 1918 | 61.81% | 607 | 62.26% | 740 | 62.77% | 571 | 60.17% | ||||
1 | 752 | 24.23% | 233 | 23.90% | 266 | 22.56% | 253 | 26.66% | ||||
2 | 308 | 9.93% | 88 | 9.03% | 124 | 10.52% | 96 | 10.12% | ||||
3 | 80 | 2.58% | 29 | 2.97% | 31 | 2.63% | 20 | 2.11% | ||||
4 | 45 | 1.45% | 18 | 1.85% | 18 | 1.53% | 9 | 0.95% | ||||
Anxiety | 0.040 * | |||||||||||
0 | 2151 | 69.32% | 692 | 70.97% | 831 | 70.48% | 628 | 66.17% | ||||
1 | 718 | 23.14% | 206 | 21.13% | 261 | 22.14% | 251 | 26.45% | ||||
2 | 184 | 5.93% | 56 | 5.74% | 67 | 5.68% | 61 | 6.43% | ||||
3 | 36 | 1.16% | 15 | 1.54% | 15 | 1.27% | 6 | 0.63% | ||||
4 | 14 | 0.45% | 6 | 0.62% | 5 | 0.42% | 3 | 0.32% | ||||
Hostility | 0.849 | |||||||||||
0 | 2449 | 78.92% | 692 | 70.97% | 831 | 70.48% | 628 | 66.17% | ||||
1 | 480 | 15.47% | 143 | 14.67% | 174 | 14.76% | 163 | 17.18% | ||||
2 | 128 | 4.13% | 37 | 3.79% | 55 | 4.66% | 36 | 3.79% | ||||
3 | 31 | 1.00% | 18 | 1.85% | 10 | 0.85% | 3 | 0.32% | ||||
4 | 15 | 0.48% | 5 | 0.51% | 6 | 0.51% | 4 | 0.42% | ||||
Depression | 0.216 | |||||||||||
0 | 2326 | 74.96% | 712 | 73.03% | 899 | 76.25% | 715 | 75.34% | ||||
1 | 592 | 19.08% | 197 | 20.21% | 204 | 17.30% | 191 | 20.13% | ||||
2 | 131 | 4.22% | 40 | 4.10% | 55 | 4.66% | 36 | 3.79% | ||||
3 | 38 | 1.22% | 19 | 1.95% | 15 | 1.27% | 4 | 0.42% | ||||
4 | 16 | 0.52% | 7 | 0.72% | 6 | 0.51% | 3 | 0.32% | ||||
Inferiority | 0.768 | |||||||||||
0 | 2757 | 88.85% | 863 | 88.51% | 1045 | 88.63% | 849 | 89.46% | ||||
1 | 260 | 8.38% | 73 | 7.49% | 103 | 8.74% | 84 | 8.85% | ||||
2 | 56 | 1.80% | 22 | 2.26% | 19 | 1.61% | 15 | 1.58% | ||||
3 | 21 | 0.68% | 12 | 1.23% | 9 | 0.76% | 0 | 0.00% | ||||
4 | 9 | 0.29% | 5 | 0.51% | 3 | 0.25% | 1 | 0.11% | ||||
Inpatient’s companion’s gender | <0.001 ** | |||||||||||
Male | 862 | 36.96% | 268 | 44.30% | 320 | 32.42% | 274 | 37.03% | ||||
Female | 1273 | 54.59% | 336 | 55.54% | 532 | 53.90% | 405 | 54.73% | ||||
Both males and females | 197 | 8.45% | 1 | 0.17% | 135 | 13.68% | 61 | −8.24% | ||||
Number of hours spent with inpatient | 163.55 | ±279.37 | 203.37 | ±359.11 | 152.87 | ±281.37 | 151.28 | ±207.22 | <0.001 ** | <0.001 ** | <0.001 ** | 1.000 |
Total N = 3103 (%) | Year | |||||||
---|---|---|---|---|---|---|---|---|
2019 n = 975 (%) | 2020 n = 1179 (%) | 2021 n = 949 (%) | ||||||
Department | ||||||||
Chest Medicine | 685 | (22.08) | 216 | (22.15) | 275 | (23.32) | 194 | (20.44) |
Hematology and Oncology | 504 | (16.24) | 156 | (16.00) | 171 | (14.50) | 177 | (18.65) |
Gynecology | 418 | (13.47) | 103 | (10.56) | 167 | (14.16) | 148 | (15.60) |
Breast Surgery | 359 | (11.57) | 115 | (11.79) | 126 | (10.69) | 118 | (12.43) |
Genito-Urinary | 235 | (7.57) | 92 | (9.44) | 112 | (9.50) | 31 | (3.27) |
General Surgery | 202 | (6.51) | 84 | (41.58) | 73 | (36.14) | 45 | (22.28) |
Colorectal Surgery | 175 | (5.46) | 48 | (27.43) | 60 | (34.29) | 67 | (38.28) |
Chest Surgery | 132 | (4.25) | 59 | (44.70) | 44 | (33.33) | 29 | (21.97) |
Gastroenterology | 106 | (3.43) | 25 | (23.58) | 46 | (43.40) | 35 | (33.02) |
Ear, Nose, and Throat | 103 | (3.32) | 38 | (36.89) | 34 | (33.00) | 31 | (30.11) |
Neurosurgery | 47 | (1.51) | 3 | (6.38) | 20 | (42.55) | 24 | (51.07) |
Dentistry | 45 | (1.45) | 20 | (44.44) | 11 | (24.44) | 14 | (31.12) |
Thyroid | 40 | (1.29) | 8 | (16.00) | 21 | (52.50) | 11 | (31.50) |
Others | 52 | (1.67) | 8 | (15.38) | 19 | (36.54) | 25 | (48.08) |
Total (N = 3103) | 2019 (n = 975) | 2020 (n = 1179) | 2021 (n = 949) | |||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Without Inpatient Companions n = 771 (%) | With Inpatient Companions n = 2332 (%) | p Value | Without Inpatient Companions n = 370 (%) | With Inpatient Companions n = 605 (%) | p Value | Without Inpatient Companions n = 192 (%) | With Inpatient Companions n = 987 (%) | p Value | Without Inpatient Companions n = 209 (%) | With Inpatient Companions n = 740 (%) | p Value | |||||||||
Total emotion scale score | 1.19 | ±2.18 | 1.93 | ±2.86 | <0.001 ** | 0.99 | ±1.73 | 2.34 | ±3.42 | <0.001 ** | 1.50 | ±2.97 | 1.78 | ±2.71 | 0.004 ** | 1.28 | ±2.01 | 1.81 | ±2.51 | 0.008 ** |
sleep disturbance | 241 | 31.26 | 944 | (40.4) | <0.001 ** | 102 | (27.5) | 266 | (43.97) | <0.001 ** | 63 | (32.8) | 376 | (38.1) | 0.192 | 76 | (36.3) | 302 | (40.8) | 0.280 |
anxiety | 170 | (22.05) | 782 | (33.53) | <0.001 ** | 73 | (19.73) | 210 | (34.71) | <0.001 ** | 43 | (22.4) | 305 | (30.9) | 0.023 * | 54 | (25.8) | 267 | (36.0) | 0.007 ** |
hostility | 109 | (14.14) | 545 | (23.37) | <0.001 ** | 39 | (10.54) | 164 | (27.11) | <0.001 ** | 33 | (17.1) | 212 | (21.4) | 0.214 | 37 | (17.7) | 169 | (22.8) | 0.135 |
depression | 134 | (17.38) | 643 | (27.57) | <0.001 ** | 67 | (18.11) | 196 | (32.40) | <0.001 ** | 36 | (18.7) | 244 | (24.7) | 0.092 | 31 | (14.8) | 203 | (27.4) | <0.001 ** |
inferiority | 61 | (7.91) | 285 | (12.22) | 0.001 ** | 22 | (5.95) | 90 | (14.8%) | <0.001 ** | 24 | (12.5) | 110 | (11.1) | 0.677 | 15 | (7.18) | 85 | (11.4) | 0.096 |
Age | 56.83 | ±11.90 | 60.66 | ±12.76 | <0.001 ** | 59.67 | ±12.76 | 60.05 | ±12.67 | 0.534 | 54.89 | ±10.18 | 61.66 | ±13.00 | <0.001 ** | 53.59 | ±10.58 | 59.84 | ±12.43 | <0.001 ** |
Gender | 1.000 | 0.004 ** | 0.583 | <0.001 ** | ||||||||||||||||
female | 408 | (52.92) | 1236 | (53.00) | 162 | (43.78) | 324 | (53.55) | 109 | (56.7) | 536 | (54.3) | 137 | (65.5) | 376 | (50.8) | ||||
male | 363 | (47.08) | 1096 | (47.0) | 208 | (56.22) | 281 | (46.45) | 83 | (43.2) | 451 | (45.6) | 72 | (34.4) | 364 | (49.1) | ||||
Length of stay | 4.18 | ±4.68 | 9.09 | ±11.88 | <0.001 ** | 5.23 | ±5.79 | 10.16 | ±12.10 | <0.001 ** | 2.98 | ±2.21 | 8.60 | ±12.97 | <0.001 ** | 3.42 | ±3.65 | 8.87 | ±9.97 | <0.001 ** |
Total nursing hours | 8.71 | ±6.97 | 14.34 | ±11.41 | <0.001 ** | 9.34 | ±7.42 | 12.23 | ±10.49 | <0.001 ** | 8.31 | ±6.11 | 14.13 | ±10.51 | <0.001 ** | 7.97 | ±6.80 | 16.34 | ±12.87 | <0.001 ** |
Pain score ≥ 4 points/times | 0.51 | ±2.81 | 1.76 | ±7.13 | <0.001 ** | 0.64 | ±1.87 | 2.07 | ±9.44 | 0.001 ** | 0.23 | ±1.29 | 1.66 | ±6.51 | <0.001 ** | 0.54 | ±4.62 | 1.66 | ±5.56 | <0.001 ** |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Chen, Y.-H.; Chen, S.-L.; Chang, C.-H.; Wu, P.-O.; Yu, H.-H.; Shih, S.-J.; Chang, M.-Y. Correlational Study of Emotional Stress, Pain, and the Presence of Inpatient Companions for Cancer Inpatients during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2022, 19, 7004. https://doi.org/10.3390/ijerph19127004
Chen Y-H, Chen S-L, Chang C-H, Wu P-O, Yu H-H, Shih S-J, Chang M-Y. Correlational Study of Emotional Stress, Pain, and the Presence of Inpatient Companions for Cancer Inpatients during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health. 2022; 19(12):7004. https://doi.org/10.3390/ijerph19127004
Chicago/Turabian StyleChen, Ya-Huei, Shu-Ling Chen, Chia-Hui Chang, Pi-O Wu, Hsiu-Hui Yu, Sou-Jen Shih, and Mei-Yu Chang. 2022. "Correlational Study of Emotional Stress, Pain, and the Presence of Inpatient Companions for Cancer Inpatients during the COVID-19 Pandemic" International Journal of Environmental Research and Public Health 19, no. 12: 7004. https://doi.org/10.3390/ijerph19127004
APA StyleChen, Y. -H., Chen, S. -L., Chang, C. -H., Wu, P. -O., Yu, H. -H., Shih, S. -J., & Chang, M. -Y. (2022). Correlational Study of Emotional Stress, Pain, and the Presence of Inpatient Companions for Cancer Inpatients during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 19(12), 7004. https://doi.org/10.3390/ijerph19127004