Patient reported experiences of Swedish patients being investigated for cancer during the Covid-19 pandemic

Abstract

Background: Patient reported experiences in individuals being investigated for cancer have been recorded in a nationwide survey in Sweden, providing an opportunity to assess the impact of the Covid-19-pandemic.

Material and methods: Questionnaires from 45920 patients were analyzed to assess the experience of being investigated for cancer. Data from before the Covid-19-pandemic (2018-2019) was compared to data acquired during the pandemic (2020-2021), using chi-square and Wilcoxon rank sum tests. Both, patients who were cleared from suspicion of cancer and those who were diagnosed with cancer were included.

Results: Fewer patients in total visited health services during the pandemic. However, patients that did seek help did so to a similar extent during as prior to the pandemic. Patient waiting time was perceived to be shorter during the pandemic and judged as neither too long nor too short by most patients. The emotional support to patients improved during the pandemic, whereas the support to next of kin declined. A majority of patients received the results from the investigation in a meeting with the physician. Although there was a preference for receiving results in a meeting with the physician, the pandemic has brought an increasing interest in receiving results by phone.

Conclusion: Swedish cancer healthcare has shown resilience during the Covid-19-pandemic, maintaining high patient satisfaction while working under conditions of extraordinary pressure. Patients became more open to alternatives to physical "in person" health care visits which could lead to more digital visits in the future. However, support to significant others demands special attention.

Keywords: Cancer; Covid-19; Emotional support; Oncology; Patient reported experience measures; Patient satisfaction.

Fig. 1

Patient delay before and during the Covid-19 pandemic. The chi-square test was used to compare the proportions between”before covid” and”during covid” within each possible answer. In order to account for multiple testing, a p value of < 0.01 was considered to be statistically significant (*). Percentages does not add up to 100 due to rounding. The figure includes both patients that received a cancer diagnosis and those freed from cancer suspicion

Fig. 2

Changes in how patients experienced to be informed about the results of the investigation (a) in relation to their preferred way of receiving that information (b). The chi-square test was used to compare the proportions between”before covid” and”covid” within each possible answer. In order to account for multiple testing, a p value of < 0.01 was considered to be statistically significant (*). The figure includes both patients that received a cancer diagnosis and those freed from cancer suspicion

Fig. 3

Differences in patient experience of receiving emotional support presented for women (a) and men (b). The Chi-square test was used to compare the proportions between”before covid” and”covid” within each possible answer. In order to account for multiple testing, a p value of < 0.01 was considered to be statistically significant (*). The figure includes both patients that received a cancer diagnosis and those freed from cancer suspicion

Fig. 4

Differences in emotional support to patients’ next of kin and extended family presented for women (a) and men (b). The chi-square test was used to compare the proportions between”before covid” and”covid” within each possible answer. In order to account for multiple testing, a p value of < 0.01 was considered to be statistically significant (*). The figure includes both patients that received a cancer diagnosis and those freed from cancer suspicion

Fig. 5

Patients’ experience of the length of the investigation before and during the Covid-19 pandemic. The chi-square test was used to compare the proportions between”before covid” and”covid” within each possible answer. In order to account for multiple testing, a p value of < 0.01 was considered to be statistically significant (*).The figure includes both patients that received a cancer diagnosis and those freed from cancer suspicion