The benefits and consequences of the COVID-19 pandemic for patients diagnosed with cancer and their family caregivers.

BACKGROUND: The objectives of this study were to examine benefits and consequences of the COVID-19 pandemic for patients diagnosed with cancer and their family caregivers. METHODS: A 23-item questionnaire assessing COVID-19-related issues, the Patient Health Questionnaire-2, Generalized Anxiety Disorder-2, Pittsburgh Sleep Quality Index, and the Perceived Stress Scale (PSS)-4 were administered to patients diagnosed with cancer and their family caregivers. RESULTS: Of the 161 patients and 78 caregivers who participated, 38.1% and 32.8 were male, 95% and 84.6% Caucasian, and the mean age was 66 and 64.6 years, respectively. A total of 16.5% and 15.2% reported depressive symptoms, 18.4% and 19% reported anxiety; 35.5% and 26.6% reported poor sleep quality, and 66% and 63.3% scored one standard deviation above the norms for the PSS, respectively. Predictors of poorer patient- and caregiver-reported outcomes included greater loneliness, worry about self or family being infected by the COVID-19, and worsening relationships with family. The fear of COVID-19 led to 20.8% of patients and 24.4% of family caregivers cancelling medical appointments, procedures, and treatments. A total of 52.5% of patients and 53.2% caregivers reported that the pandemic led to benefit finding but these changes were not associated with any of the measured patient- or caregiver-related outcomes. CONCLUSIONS: Psychological functioning for patients and caregivers was similar to that of pre-pandemic levels, however the decrease in health care utilization secondary to fear of COVID-19 was notable. While there were many negative effects of the pandemic, the majority of patients and caregivers reported some benefit to the pandemic.

Early unplanned transfers from inpatient rehabilitation.

OBJECTIVE: To identify characteristics of patients who transfer off inpatient rehabilitation to a surgical or medical unit before completion of their rehabilitation program. DESIGN: A retrospective 9-yr chart review of patients transferred off the rehabilitation unit at a regional level 1 trauma center due to medical complications. RESULTS: Of 3072 patient admissions, 250 (8%) were transferred to an acute medical or surgical unit, and 55 (22%) of those transfers were within 3 days. Of the 250 patients, 33% had traumatic brain injury, 23% had spinal cord injury, 24% had stroke, 2% had amputations, 18% were in other diagnostic groups, and 23% were >64 yrs of age. When patients transferred early, only 47% were ultimately discharged to home, compared with approximately 72% of all discharges. The most common reasons for early transfer in these patients were infection (22%) and pulmonary complications (14%). Risk factors for early discharge included age of >64 yrs, spinal cord injury, or amputation. CONCLUSION: Patients admitted to the inpatient rehabilitation unit who have spinal cord injuries, amputations, or are >64 yrs old may have more medical/surgical complications. More detailed study of this patient population may help reduce the number of early transfers off the inpatient rehabilitation unit.