Perceived financial hardship among patients with advanced cancer
Background Patients with advanced cancer experience distress in many forms. Perceived financial hardship is increasingly recognized as a toxicity of cancer, and much has been written about it in general – what it is, what causes and aggravates it, the implications on patient outcomes and cost and quality of care/life, and possible interventions to ease the impact on patients. However, it has not been extensively considered in patients with advanced cancer.
Objective To describe the financial challenges of persons with advanced cancer, and the association of financial distress with quality of life, symptom severity, and overall cancer-related distress.
Methods This is a cross-sectional, comparative, descriptive study of 100 patients with advanced cancer in outpatient medical oncology clinics in Western Pennsylvania. Five instruments measured patient demographics, symptom severity, quality of life, perceived financial hardship, and overall cancer-related distress. Descriptive statistics and correlation coefficients were used. Quality of life, symptom severity and cancer-related distress were compared with high or low levels of perceived financial hardship using a 2-sample t test.
Results The mean age of participants was 63.43 years (n = 100). Perceived financial hardship was mildly correlated with overall cancer-related distress (r, 0.409; P < .001), symptom distress (r, 0.409; P < .001), and overall quality of life scores (r, 0.323; P < .001). In addition, patients experiencing higher levels of perceived financial hardship experienced worse quality of life overall (P = .002), higher levels of cancer-related distress (P < .001), and worse symptom distress (P < .001).
Limitations Cross-sectional design
Conclusions These results illuminate our understanding of disparities that may be present in end of life care. Perceived financial hardship appears to negatively influence symptom severity and quality of life. These results illuminate targeted areas for cancer-related distress mitigation.
Funding/sponsorship The Center on Race and Social Problems, University of Pittsburgh
Accepted for publication April 13, 2017
Correspondence Sarah Gallups, MPH, RN; sfg11@pitt.edu
Disclosures The authors report no disclosures/conflicts of interest.
Citation JCSO 2017;15(3):e163-e169
©2017 Frontline Medical Communications
doi https://doi.org/10.12788/jcso.0341
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Acknowledgments
The authors acknowledge the patients and staff at the UPMC Mercy Cancer Center in Pittsburgh, Pennsylvania, who made this study possible, and Peggy Tate for her role in data collection. They also recognize the support of the Robert Wood Johnson Foundation through the Future Nursing Scholars program. They would also like to acknowledge that permission was granted for the use of the Psychological Sense of Economic Hardship study instrument.
