Background: The COVID-19 pandemic has caused widespread disruptions in oncology care, significantly affecting both the quality of life (QoL) and mental health of cancer patients. This study aimed to evaluate the long-term impacts of the pandemic on oncology patients, focusing on the periods before, during, and after the pandemic.Objective: The objective of this study was to assess the changes in QoL, illness acceptance, and mental health indicators, including the risk of depression, generalized anxiety, elevated stress levels, and post-traumatic stress disorder (PTSD) among oncology patients, comparing these factors across the pre-pandemic, pandemic, and post-pandemic periods.Material and Methods: This study included 2000 oncology patients, divided into three cohorts based on the time of assessment: pre-pandemic (2019, n = 600), during the pandemic (2020–2021, n = 800), and post-pandemic (2023, n = 600). This study included a balanced sample of 52% female and 48% male participants, with a mean age of 58 years (SD = 11.9), representing a wide range of cancer types including breast (25.7%), lung (20.9%), and colorectal cancer (14.8%). Additional demographics showed a mean BMI of 25.8, with varied educational levels, marital statuses, income levels, and lifestyle factors such as smoking and alcohol consumption. QoL was assessed using the EORTC QLQ-C30, while the Hospital Anxiety and Depression Scale (HADS) was used to measure depression and anxiety. The PTSD Checklist for DSM-5 (PCL-5) was used to evaluate PTSD symptoms, and stress levels were measured with the Perceived Stress Scale (PSS). Statistical analyses were conducted using ANOVA and chi-square tests to assess differences between the groups.Results: During the pandemic, the prevalence of depression symptoms rose significantly, from 15% pre-pandemic to 32% (p < 0.001), while the risk of generalized anxiety increased from 18% to 40% (p < 0.001). Stress levels also saw a sharp rise, with 45% of patients reporting elevated stress during the pandemic compared to 22% before (p < 0.001). The rate of PTSD symptoms increased from 10% pre-pandemic to 28% during the pandemic (p < 0.001). QoL scores dropped markedly, with the mean EORTC QLQ-C30 global health status score decreasing by 25% during the pandemic (p < 0.01). Illness acceptance declined, with 60% of patients reporting poor acceptance during the pandemic, compared to 35% before. In the post-pandemic period, a slight improvement was observed across all measures. Depression levels dropped to 28% (p < 0.05 compared to the pandemic period), and anxiety levels decreased to 35% (p < 0.05). Stress and PTSD symptoms also showed modest reductions, with 38% reporting elevated stress and 22% exhibiting PTSD symptoms (p < 0.05). However, these post-pandemic values remained significantly higher than pre-pandemic levels (p < 0.001). QoL improved marginally, with a 10% increase in the global health status score compared to the pandemic period, though it remained lower than pre-pandemic scores (p < 0.05).Conclusions: The COVID-19 pandemic had a profound impact on the mental health and QoL of oncology patients, with significant increases in depression, anxiety, stress, and PTSD symptoms, along with a decrease in QoL and illness acceptance. While post-pandemic recovery trends are apparent, the psychological burden remains elevated compared to pre-pandemic conditions. These findings highlight the need for continued mental health support and interventions for oncology patients, even after the immediate pandemic effects have subsided.
背景：COVID-19大流行对肿瘤诊疗服务造成广泛干扰，显著影响癌症患者的生活质量与心理健康。本研究旨在评估大流行对肿瘤患者的长期影响，重点关注疫情前、疫情期间及疫情后三个阶段。 目的：本研究旨在评估肿瘤患者生活质量、疾病接受度及心理健康指标（包括抑郁风险、广泛性焦虑、压力水平升高及创伤后应激障碍）的变化，并对疫情前、疫情期间及疫情后三个时期的相关指标进行比较。 材料与方法：本研究纳入2000名肿瘤患者，根据评估时间分为三组：疫情前组（2019年，n=600）、疫情期间组（2020-2021年，n=800）及疫情后组（2023年，n=600）。样本性别比例均衡（女性52%，男性48%），平均年龄58岁（标准差=11.9），涵盖多种癌症类型（乳腺癌25.7%、肺癌20.9%、结直肠癌14.8%）。其他人口学特征显示平均BMI为25.8，教育程度、婚姻状况、收入水平及吸烟饮酒等生活方式因素存在差异。采用EORTC QLQ-C30量表评估生活质量，医院焦虑抑郁量表（HADS）评估抑郁焦虑症状，DSM-5创伤后应激障碍检查表（PCL-5）评估PTSD症状，感知压力量表（PSS）评估压力水平。采用方差分析与卡方检验进行组间差异分析。 结果：疫情期间抑郁症状发生率从疫情前的15%显著上升至32%（p<0.001），广泛性焦虑风险从18%升至40%（p<0.001）。压力水平急剧上升，疫情期间45%患者报告压力升高（疫情前为22%，p<0.001）。PTSD症状发生率从疫情前10%升至疫情期间28%（p<0.001）。生活质量评分显著下降，EORTC QLQ-C30总体健康状况评分均值在疫情期间下降25%（p<0.01）。疾病接受度降低，疫情期间60%患者报告接受度差（疫情前为35%）。疫情后阶段各项指标略有改善：抑郁水平降至28%（较疫情期间p<0.05），焦虑水平降至35%（p<0.05），压力升高比例降至38%，PTSD症状发生率降至22%（均p<0.05），但仍显著高于疫情前水平（p<0.001）。生活质量小幅改善，总体健康状况评分较疫情期间上升10%，但仍低于疫情前评分（p<0.05）。 结论：COVID-19大流行对肿瘤患者的心理健康与生活质量产生深远影响，抑郁、焦虑、压力及PTSD症状显著增加，生活质量与疾病接受度明显下降。尽管疫情后呈现恢复趋势，但心理负担仍高于疫情前水平。研究结果提示，即使大流行的直接影响已减弱，仍需持续为肿瘤患者提供心理健康支持与干预措施。
COVID-19 Pandemic Conditions Affecting QoL and Mental Health of Oncology Patients in Poland
肿瘤(癌症)患者之家