Cancer treatment shared decision-making and coping during the COVID-19 pandemic (CAN-DECIDE): a mixed-methods study

Sep 23, 2026

Uploaded by dhado

A mixed-methods investigation examines how cancer patients, family caregivers, and oncology and palliative care practitioners experienced COVID-19–related stress and changes in cancer care. The study characterizes drivers of coping and satisfaction, linking survey and interview findings gathered during the pandemic. Results show patients often pursued curative upper gastrointestinal surgeries, reported generally steady quality-of-life measures, and expressed trust despite limited awareness of care changes.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

Methods

Aslakson etal. BMC Palliative Care (2025) 24:303 BMC Palliative Care [https://doi.org/10.1186/s12904-025-01944-7](https://doi.org/10.1186/s12904-025-01944-7) RESEARCH Open Access Cancer treatment shared decision-making and coping during the COVID-19 pandemic (CAN-DECIDE): a mixed-methods study Rebecca A. Aslakson 1*, Rachel Siden2, Laura M. Holdsworth2, Kathryn Col born3, MaeVerano2, Bonnie Odelia Wong4, Fabian Johnston5, Richard Nudotor5, Amn Siddiqi5, Elizabeth Rickerson6,7, Caroline Hollahan6, Bridget Fahy8, Isaac Lira9, Brittany Waterman 10, Kemba Johnson 11, Shelley Fuld Nasso 12, Holly Tabor2 and Lidia Schapira 13 Abstract Background We hypothesized that cancer patients, their family members, and cancer and palliative care practitioners were experiencing significant COVID-related stress and changes to cancer care and sought to characterize contributing factors. Methods We completed a mixed methods study to explore cancer care-related experiences during the COVID-19 pandemic of cancer patients, family members, and cancer and palliative care practitioners. Participants were recruited from an ongoing clinical trial. Results Patients were pursuing curative-intent surgeries for upper gastrointestinal cancers. Between October 2020 and July 2021, we collected 491 surveys from 181 cancer patients and 26 family caregivers and conducted 71 in-depth interviews with 48 cancer patients, 6 family caregivers, and 19 practitioners. Patient-reported quality-oflife measurements were not associated with a corresponding COVID surge. Patients and caregivers were generally satisfied with their care, trusted providers, and were often unaware of pandemic-related changes. In contrast, practitioners reported significant pandemic-related changes to cancer care delivery with associated practitioner anxiety, fatigue, and moral distress. All felt that visitor restrictions negatively impacted care. Conclusions Our data suggest that cancer patients coped well overall despite pandemic-related disruptions whereas cancer care clinicians experienced significant stress. These findings can inform future disaster-preparedness planning and policy-setting in institutions providing cancer care. Keywords Burnout, COVID-19, Cancer, Quality of life, Cancer care, Palliative care, COVID *Correspondence: Rebecca A. Aslakson [Rebecca.Aslakson@uvmhealth.org](Rebecca.Aslakson@uvmhealth.org) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Aslakson et al. BMC Palliative Care (2025) 24:303 Introduction COVID-19 disproportionately impacted populations with underlying conditions, such as cancer [1–4]. During the first months of the COVID-19 pandemic, healthcare systems intermittently delayed or deferred cancer care, [2, 4] increased telehealth care delivery, [5, 6] and enacted new visitor restrictions [7]. Patients may also have had delayed cancer screenings o

FAQs

What study question does CAN-DECIDE address?

It explores cancer care-related experiences and coping during the COVID-19 pandemic for patients, family caregivers, and cancer and palliative care clinicians.

How were participants recruited and what data were collected?

Participants were recruited from an ongoing clinical trial, using 491 surveys from 181 patients and 26 family caregivers plus 71 in-depth interviews with patients, caregivers, and practitioners.

What were the key differences between patients/caregivers and practitioners?

Patients and caregivers were generally satisfied, trusted their providers, and often were unaware of pandemic-related care changes, while practitioners reported significant delivery changes linked to anxiety, fatigue, and moral distress.

Sep 23, 2026

Uploaded by dhado