The psychological burden of waiting for procedures and patient-centred strategies that could support the mental health of wait-listed patients and caregivers during the COVID-19 pandemic: A scoping review

Health Expect. 2021 Jun;24(3):978-990. doi: 10.1111/hex.13241. Epub 2021 Mar 26.

Abstract

Background: Waiting for procedures delayed by COVID-19 may cause anxiety and related adverse consequences.

Objective: To synthesize research on the mental health impact of waiting and patient-centred mitigation strategies that could be applied in the COVID-19 context.

Methods: Using a scoping review approach, we searched 9 databases for studies on waiting lists and mental health and reported study characteristics, impacts and intervention attributes and outcomes.

Results: We included 51 studies that focussed on organ transplant (60.8%), surgery (21.6%) or cancer management (13.7%). Most patients and caregivers reported anxiety, depression and poor quality of life, which deteriorated with increasing wait time. The impact of waiting on mental health was greater among women and new immigrants, and those of younger age, lower socio-economic status, or with less-positive coping ability. Six studies evaluated educational strategies to develop coping skills: 2 reduced depression (2 did not), 1 reduced anxiety (2 did not) and 2 improved quality of life (2 did not). In contrast, patients desired acknowledgement of concerns, peer support, and periodic communication about wait-list position, prioritization criteria and anticipated procedure date.

Conclusions: Findings revealed patient-centred strategies to alleviate the mental health impact of waiting for procedures. Ongoing research should explore how to optimize the impact of those strategies for diverse patients and caregivers, particularly in the COVID-19 context.

Patient or public contribution: Six patients and four caregivers waiting for COVID-19-delayed procedures helped to establish eligibility criteria, plan data extraction and review a draft and final report.

Keywords: anxiety; depression; implementation science; mental health; patient-centred care; quality improvement; quality of life; review; waiting lists.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • COVID-19 / epidemiology
  • COVID-19 / psychology*
  • Caregivers / psychology*
  • Female
  • Humans
  • Mental Health
  • Pandemics*
  • Patient-Centered Care*
  • Quality of Life
  • SARS-CoV-2
  • Waiting Lists*