Impacts of COVID-19 on physiotherapy care for women with breast cancer

Introdution: COVID-19 has been declared a public health emergency of international concern by the World Health Organization, with a diverse clinical spectrum. Given the coronavirus prevention measures and recommendations from health authorities, there is a concern about how physiotherapy care is provided to women with breast cancer. The discontinuity of care may favor the emergence of complications, and compromise functionality, quality of care and the provision of complementary treatments. Objective: To assess the impacts of the COVID-19 pandemic on the continuity of physiotherapy care for women with breast cancer. Methods: This is a cross-sectional study. Data were collected through an online questionnaire and the population was composed of physiotherapists, of both sexes, who work in Brazil. Results: Twenty percent of the 40 participants reported no change in their work routine, 48% had their workload reduced, 12% had an increased workload, 25% were relocated to provide assistance to patients affected by COVID-19, and 20% of consultations were suspended. The greatest continuity of care was seen in hospital admissions (40%) and outpatient clinics (42%). The number of women cared for before the pandemic compared to during the restriction period declined by 72%. Conclusion: Most consultations were suspended; however, in most cases, continuity of care was guaranteed through telerehabilitation. Nevertheless, the interviewees reported clinical worsening in women after treatment was interrupted.


Introduction
, caused by the new coronavirus (SARS-CoV-2), was declared a public health emergency of international concern. It exhibits a diverse clinical spectrum, ranging from mild (fever, fatigue and nonproductive cough), to moderate (dyspnea) or severe symptoms, when the patient develops severe acute respiratory syndrome. 1 The preventive measures adopted in Brazil followed World Health Organization (WHO) recommendations, which include frequent hand washing, mask wearing, avoiding touching the eyes, nose and mouth, respiratory hygiene practices, and social distancing. 2 With the advance of the pandemic in the country, there was a need to expand the healthcare infrastructure for people who progressed to the most serious form of the disease. Faced with this emergency health situation, a significant number of people affected by other health conditions continued to need treatment. 3 The Brazilian Society of Surgical Oncology estimates that, in a three- This measure resulted in therapy postponement or discontinuation of those already underway. 6 Thus, there is a concern about physical therapy monitoring in breast cancer patients. Given the above, the present study aimed to assess the impacts of the COVID-19 pandemic on physical therapy care for women with breast cancer. This study is justified due to the importance of identifying the effect of the pandemic on the physiotherapy treatment of patients with breast cancer, in order to minimize it.

Methods
The main object is to assess the impact of the COVID19 pandemic on the physiotherapy treatment of patients with breast cancer.
The data will be collected via an online questionnaire, which you will complete digitally.
The study poses a little risk, since it involves an online questionnaire, with the possibility of embarrassment or a feeling of invasion of privacy when answering the questions.
However,these situations will be minimized because you will complete the instrument anonymously.
By participating in this study you will contribute to our understanding of the effects the pandemic could have on the treatment of patients with breast cancer, helping us to devise strategies to mitigate the effectsidentified.
You are free to participate or not. It is your right to refuse, and you can withdraw consent at any phase of the research, with no repercussions. All the information from this study will be confidential and disseminated only at scientific events or in scientific journals. You will incur no costs during this research.
If you have any questions or wish to receive more information on the study, contact us at: brenda4@hotmail.com    Yes, the workplace provides means to monitor from a distance.
Yes, remote monitoring was recommended, but no resources were made available.
There was no advice from management on remote follow-up.   Guidelines were sent out via email or app and later a phone call was made for clarification.
Only one call/contact with instructions was made.
Appointments were continued online.
No contact was made and no guidelines established.  Telerehabilitation may be an excellent tool, but there is a lack of training and encouragement from management for its satisfactory use, as seen in the present study, where almost 1/3 of professionals did not receive any advice or instructions on remote care or developing guidelines that could help in women's rehabilitation.