Cancer patients attending treatment during COVID-19: intolerance of uncertainty and psychological distress

Miri Cohen, Dana Yagil, Ariel Aviv, Michal Soffer, Gil Bar-Sela

Research output: Contribution to journalArticlepeer-review


Purpose: The COVID-19 pandemic presents specific challenges for cancer patients attending oncology treatment. Using a mixed-methods design (convergent parallel design), we aimed to assess the experience, perceptions, and reactions of cancer patients during the COVID-19 pandemic. Methods: Participants were cancer patients receiving treatment at the hospital during the pandemic (July to August 2020). In study 1, 95 participants filled out a questionnaire measuring COVID-19 experiences and perceptions, psychological distress, and intolerance of uncertainty. In study 2, in-depth interviews were conducted with 10 cancer patients, probing their experience during the COVID-19 period. Results: Most participants experienced the COVID-19 pandemic as a major threat that would affect future health, most attended all or most of their scheduled treatments, and their mean level of psychological distress was low. A mild decrease in social support was reported, and remote contacts and support from the community had not compensated for decreased person-to person contacts. In addition, intolerance of uncertainty was related to higher psychological distress, which was partially mediated by perceptions of threat. The analysis of in-depth interviews strengthened the quantitative findings by elucidating the experience of fear of contagion alongside determination to continue treatment. Conclusions and Implications for Cancer Survivors: The mixed-methods design enabled us to examine the responses of cancer patients attending treatment. The findings suggest that in times of extreme uncertainty such as COVID-19, health experts need to screen cancer patients and survivors for emotional and instrumental support needs and identify patients and survivors with high intolerance of uncertainty as a risk factor for psychological distress.

Original languageEnglish
Pages (from-to)1478-1488
Number of pages11
JournalJournal of Cancer Survivorship
Issue number6
StatePublished - Dec 2022

Bibliographical note

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.


  • COVID-19
  • Intolerance of uncertainty
  • Perceived threat
  • Psychological distress
  • Remote contact
  • Social support

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)


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