Citation: Barbos, V.; Feciche, B.;
Bratosin, F.; Tummala,D.; Shetty,
U.S.A.; Latcu, S.; Croitor, A.; Dema,
V.; Bardan, R.; Cumpanas, A.A.
Pandemic Stressors and Adaptive
Responses: A Longitudinal Analysis
of the Quality of Life and
Psychosocial Dynamics among
Urothelial Cancer Patients. J. Pers.
Med. 2023, 13, 1547. https://
doi.org/10.3390/jpm13111547
Academic Editors: Murat Yildirim,
Francesco Chirico and Gökmen
Arslan
Received: 19 September 2023
Revised: 24 October 2023
Accepted: 25 October 2023
Published: 28 October 2023
Copyright: © 2023 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
Journal of
Personalized
Medicine
Article
Pandemic Stressors and Adaptive Responses: A Longitudinal
Analysis of the Quality of Life and Psychosocial Dynamics
among Urothelial Cancer Patients
Vlad Barbos
1,2
, Bogdan Feciche
3,
*, Felix Bratosin
2,4
, Durganjali Tummala
5
, Uday Shree Akkala Shetty
6
,
Silviu Latcu
1
, Alexei Croitor
1
, Vlad Dema
1
, Razvan Bardan
1
and Alin Adrian Cumpanas
1
1
Department XV, Discipline of Urology, Victor Babes University of Medicine and Pharmacy,
300041 Timisoara, Romania; vlad.barbos@umft.ro (V.B.); silviu.latcu@umft.ro (S.L.);
alexei.croitor@umft.ro (A.C.); vlad.dema@yahoo.com (V.D.); razvan.bardan@umft.ro (R.B.);
cumpanas.alin@umft.ro (A.A.C.)
2
Doctoral School, Victor Babes University of Medicine and Pharmacy, E. Murgu Square, Nr. 2,
300041 Timisoara, Romania; felix.bratosin@umft.ro
3
Department of Urology, Emergency County Hospital Oradea, Strada Gheorghe Doja 65,
410169 Oradea, Romania
4
Department XIII, Discipline of Infectious Diseases, Victor Babes University of Medicine and Pharmacy,
E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
5
Department of General Medicine, K.S. Hegde Medical Academy, Mangaluru 575018, India;
anju9899@gmail.com
6
Malla Reddy Institute of Medical Sciences, Suraram Main Road 138, Hyderabad 500055, India;
udayshree98@gmail.com
* Correspondence: dr.feciche@yahoo.com
Abstract: The 2019 coronavirus disease (COVID-19) pandemic has had a profound influence on
different sectors of society, including health. This study hypothesized a significant impact of the
pandemic on the quality of life and psychosocial well-being of urothelial cancer patients, specifically
anticipating a decrease in anxiety and depression scores as the pandemic progressed. The primary
objectives were to assess longitudinal changes in quality of life indexes, evaluate Healthcare Anxiety
and Depression Scale (HADS) score trends over three years (2020–2022), and identify any correlational
patterns between the progression of the pandemic and anxiety, depression, and stress levels among
this cohort. A cross-sectional analysis was conducted on Eastern Cooperative Oncology Group
(ECOG) 1 and Tumor Node Metastasis (TNM) stage 1 bladder cancer patients from the Timis County
Emergency Clinical Hospital in Romania. Sixty patients were evaluated each year from 2020 to
2022, utilizing a detailed selection process involving the review of both the hospital database and
paper records. Key data included demographic information, medical history, and responses to the
Patient Health Questionnaire (PHQ-9), Short Form (SF-36), HADS, and Generalized Anxiety Disorder
(GAD-7) questionnaires. A total of 163 completed questionnaires were analyzed, providing insight
into various aspects of patients’ experiences during the pandemic. Notably, the mean hospitalization
days ranged from 3.6 ± 2.1 days in 2020 to 4.0 ± 2.4 days in 2022 (p = 0.663). Concerns that current
symptoms might be pandemic-related spiked to 63.5% in 2021, but reduced to 50.9% in 2022, with
this fluctuation being significant (p = 0.026). The perception of decreased quality of or accessibility
to medical care was significant over the years, with a decline to 52.7% in 2022 (p = 0.033). Quality
of life assessments demonstrated an upward trend, from an average score of 55.9 ± 8.9 in 2020
to 59.3 ± 8.8 in 2022 (p = 0.049). Interestingly, anxiety levels, as indicated by the HADS survey,
revealed a significant decline from a score of 7.8 in 2020 to 6.5 in 2022 (p = 0.008). On the other hand,
GAD-7 scores displayed a downward trend over the years, potentially indicative of developed coping
strategies (p = 0.034). This study provides a comprehensive insight into the fluctuating dynamics of
psychosocial factors and quality of life among urothelial cancer patients during the pandemic years.
It underscores a potential adaptive response, as evidenced by the decrease in anxiety levels and an
upward trend in the quality of life scores over the period. These findings highlight the resilience and
adaptability of this patient cohort amidst the challenges posed by the pandemic, potentially guiding
future interventions and supports in similar health crises.
J. Pers. Med. 2023, 13, 1547. https://doi.org/10.3390/jpm13111547 https://www.mdpi.com/journal/jpm