Anxiety Due to COVID-19 in Different Palliative Care Settings in Germany

Epidemics exert significant psychological impact. We conducted a survey in different palliative care settings focusing on anxiety caused by coronavirus disease 2019 (COVID-19). A questionnaire was given from April 1 through May 8, 2020, to 154 patients in 3 distinct populations: (1) hospice patients, (2) patients under ambulatory palliative care, (3) as controls, patients visiting a general practitioner (GP) practice. Items captured were age, anxiety caused by COVID-19 on a visual analog scale from 0 to 10, influence on everyday life, insomnia, and appetite loss. Palliative care patients were older than GP visitors (median [interquartile range], 72 [61-78] years in the hospice, 76 [67-83] years in ambulatory palliative care, and 62 [56-74] years in GP practice, P < .001). Anxiety scores were 0 (0-2) in the hospice, 3 (0-6) in ambulatory palliative care and 4.5 (2-6) in the GP practice (P = .004 for hospice vs GP practice, P = .177 for ambulatory palliative care vs GP practice). Age did not correlate with anxiety (P = .063). Anxiety-caused insomnia ranged from 0% to 12%. Patients' everyday life was influenced in 15% to 31% in the 3 groups (P = .480). Patients in ambulatory palliative care experienced comparable anxiety caused by COVID-19 with other patients, whereas anxiety was negligible in hospice patients. Addressing the psychological impact of the pandemic should be considered in management of palliative patients.