Evaluation of Dignity Related Distress before and after COVID-19 in Palliative Cancer Patients

Background/aims: The COVID-19 safety measures and restrictions implemented to combat the COVID-19 pandemic had a significant impact on the quality of life for individuals. It was crucial to consider the concept of dignity during the challenging and restricted period by the COVID-19 pandemic, particularly for cancer patients at the end-of-life. The study aimed to explore the perceptions of dignity among two groups of cancer patients nearing the end-of-life: patients before pandemic and patients after pandemic period. Methods: The research involved 506 participants before pandemic, and 156 patients during post-pandemic period. The Italian version of Patient Dignity Inventory (PDI) was used in this study. Results: Patients before pandemic were on mean younger than patients post pandemic (69.2±12.53 vs 72.4±12.71; W=45700.5; p=.003). Most patients before pandemic were aware of diagnosis but overestimate prognosis (N=177, 35%) versus post-pandemic sample, totally aware (N=59, 37.8%). In both samples, patients present cancer during metastatic stage (N=133, 85.3%; N=353, 69.8). Pre-pandemic sample had a mean PDI Total score lower than those post Covid (57.7±15.8 vs 68.5±19.7; W=52194.5; p<.001). PDI subscales were on mean lower for the patients before pandemic than patients post pandemic (Psychological Distress: 16.1±5.75 vs 17±6.05; W=42541.000; p=0.141; Social Support: 4.11±1.73 vs 5.1±2.51; W=50497.000; p<.001; Physical Symptoms Dependency: 12.2±3.85 vs 13.5±4.06; W=46355.000; p<.001; Existential Distress 17.8±6.15 vs 22.46±7.38; W=54184.000; p<.001; and Loss of Purpose and Meaning 7.5±3.19 vs 10.2±4.03; W=55724.500; p<.001). Conclusions: PDI results suggest that the imposed social isolation and restrictions implemented in response to the COVID-19 pandemic had negative consequences on the cancer patients at the end-of-life perception of dignity.