Dataset Information

Financial distress in patients with advanced cancer.

ABSTRACT:

Purpose

We examined the frequency and severity of financial distress (FD) and its association with quality of life (QOL) and symptoms among patients with advanced cancer in France.

Design

In this cross-sectional study, 143 patients with advanced cancer were enrolled. QOL was assessed using the Functional Assessment of Cancer General (FACT-G) and symptoms assessed using Edmonton Assessment System (ESAS) and Hospital Anxiety and Depression Scale (HADS). FD was assessed using a self-rated numeric scale from 0 to 10.

Results

Seventy-three (51%) patients reported having FD. Patients reported having FD were most likely to be younger (53.8 (16,7SD) versus 62 (10.5SD), p<0.001), single (33 (62%) versus 40(44%), p = 0.03) and had a breast cancer (26 (36%), p = 0.024). Patients with FD had a lower FACT-G score (59 versus 70, p = 0.005). FD decreased physical (14 versus 18, p = 0.008), emotional (14 versus 16, p = 0.008), social wellbeing (17 versus 19, p = 0.04). Patients with FD had higher HADS-D (8 versus 6 p = 0.007) and HADS-A (9 versus 7, p = 0.009) scores. FD was linked to increased ESAS score (59 (18SD) versus 67 (18SD), p = 0.005) and spiritual suffering (22(29SD) versus 13(23SD), p = 0.045).

Conclusion

The high rate of patient-reported FD was unexpected in our studied population, as the French National Health Insurance covers specific cancer treatments. The FD was associated with a poorer quality of life. Having a systematic assessment, with a simple tool, should lead to future research on interventions that will increase patients' QOL.

SUBMITTER: Barbaret C

PROVIDER: S-EPMC5436643 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

Financial distress in patients with advanced cancer.

Barbaret Cécile C Brosse Christelle C Rhondali Wadih W Ruer Murielle M Monsarrat Léa L Michaud Patrick P Schott Anne Marie AM Delgado-Guay Marvin M Bruera Eduardo E Sanchez Stéphane S Filbet Marilène M

PloS one 20170518 5

<h4>Purpose</h4>We examined the frequency and severity of financial distress (FD) and its association with quality of life (QOL) and symptoms among patients with advanced cancer in France.<h4>Design</h4>In this cross-sectional study, 143 patients with advanced cancer were enrolled. QOL was assessed using the Functional Assessment of Cancer General (FACT-G) and symptoms assessed using Edmonton Assessment System (ESAS) and Hospital Anxiety and Depression Scale (HADS). FD was assessed using a self- ...[more]

PMID: 28545063

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Project description:BackgroundCancer diagnosis and therapy can lead to significant financial distress for those affected, even in universal health care systems. We present the development and validation of a patient-reported outcome measure for financial distress in German cancer patients.MethodsValidation of the newly developed instrument followed a two-step approach, including two quantitative paper-pencil surveys (N1 = 111, N2 = 267) with patients of all types of cancer and treatment status at two German university hospitals. Factorial validity, reliability, construct, and criterion validity were assessed using exploratory and confirmatory factor analysis, correlative and linear regression analysis.ResultsThe Financial Distress of Cancer Assessment Tool (FIAT) comprises 19 items across three domains of subjective financial distress: (i) financial worries; (ii) dissatisfaction across various life domains, and (iii) challenging experiences with authorities and benefit providers (e.g. employment agency, health insurance). Confirmatory factor analysis confirmed the instrument's factorial structure. Composite reliability (Raykov's rho) ranges from 0.88 to 0.96, and retest reliability ranges from 0.64 to 0.75. Correlational analyses showed significant associations between FIAT scores and related constructs [e.g. correlations with the EORTC-QLQ-C30 financial distress subscale (Q28) ranging from 0.47 to 0.60], supporting its construct validity. Additionally, higher FIAT scores were significantly associated with lower health-related quality of life measured by Q29 and Q30 of the EORTC-QLQ-C30, with correlations ranging from -0.21 to -0.28. They were also positively correlated with depression (PHQ-4), with correlations ranging from 0.33 to 0.45, and anxiety (PHQ-4) with correlations ranging from 0.25 to 0.36, confirming its criterion validity.ConclusionsThe newly developed patient-reported outcome measure is the first reported measurement tool to assess financial distress in German cancer patients. The instrument can be used for research purposes and to enable the provision of coordinated support services.

Project description:ObjectivesPatient-reported financial effects of a tumour disease in a universal healthcare setting are a multidimensional phenomenon. Actual and anticipated objective financial burden caused by direct medical and non-medical costs as well as indirect costs such as loss of income can lead to subjective financial distress. To better understand subjective financial distress, the presented study explores self-reported determinants for subjective financial distress in German patients with cancer, aiming to inform a new German-language patient-reported outcome measure for determining the financial effects of a tumour disease.DesignSemistructured interviews with n=18 patients with cancer were conducted between May 2021 and December 2021. Patients were recruited based on a purposive sampling strategy in outpatient and inpatient settings. The interviews were audiorecorded, transcribed verbatim and analysed using qualitative content analysis.SettingParticipants were recruited from two German academic cancer centres, that is, the National Center for Tumor Diseases Heidelberg and Jena University Hospital.Participants18 patients who had undergone cancer-related therapy for at least 2 months were interviewed (10 females).ResultsBased on the results of the qualitative content analysis, we developed a multicomponent construct of determinants that could influence subjective financial distress. The self-reported determinants can be classified into material (savings, good salary, shared rent through shared living, employed partner, paid-off house, potential financial support from family and friends, work-related specifics, consumer restrictions, out-of-pocket-costs and anticipated financial changes), social (social support from friends and family), systemic (administrative hurdlers and insurance cover) and inner personal determinants (coping strategies, change of attitude, character traits).ConclusionSubjective financial distress depends not only on material but also on social, systemic and inner personal determinants. Knowledge of these determinants can inform a new comprehensive German-language instrument for measuring self-reported financial effects of a tumour disease.Trial registration numberNCT05319925.

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Dataset Information

Financial distress in patients with advanced cancer.

Purpose

Design

Results

Conclusion

Publications

Financial distress in patients with advanced cancer.

Similar Datasets

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