Staying at home in the COVID-19 pandemic: The perspective of people living with cancer participating at the AIIAO survey

Background On March 9th, the lockdown was enforced in Italy to contain the spread of the SARS-CoV-2 pandemic. The request to stay at home particularly applied to cancer patients, who were considered at higher risk for infection and severe events. Patients had to experience substantial psychosocial implications of mass quarantine and they were also faced with special challenges to receive safe cancer care. This study aimed to investigate the perspectives of people living with cancer during mass quarantine. Methods The Italian Association of Cancer Nurses (AIIAO) conducted an online survey from March 29th to May 3rd, 2020, which corresponds to ‘Phase One’ of the COVID-19 Italian emergency plan. People living with cancer and self-isolated at home were invited to fill in the survey via social groups. Data about socio-demographic and clinical characteristics, opinion on the impact of SARS-CoV-2, access to cancer care, behavioural measures implemented, and the perception of being isolated (ISOLA scale) were collected. Results Participants were 195 adults living with cancer (female=76%, mean age=50.3±11.2 years). They were more often affected by haematological malignancy (51.3%) and staying at home with partner and children (38.5%) for more than 4 weeks (70.8%). Only 54% of them believed to be at higher risk for SARS-CoV-2 infection and 51% for severe complications. Measures to prevent the infection included hand washing (95.2%), social distancing (81.5%), face mask (96.3%), gloves (55.6%), and remedies to boost their immune system (29%). Overall, 62% reported diminished/absent access to cancer care and 29% were afraid that their cancer was not under control. The mean scores of the ISOLA scale (range 1-5) were 2.64 (SD=0.81) for isolation-related suffering, 3.31 (SD=1.13) for problems in the relationship with others, and 3.14 (SD=1.06) for difficulties in the relationship with oneself. Greater social isolation in quarantine was reported by the older patients, with lower education, and living without children. Conclusions In the context of grave threats to their physical and mental health, people living with cancer need help from nurses to prioritise their health, cope with isolation-related suffering, and identify effective preventive behaviours.