TY - JOUR
T1 - Financial distress and its associations with physical and emotional symptoms and quality of life among advanced cancer patients
AU - Delgado-Guay, Marvin
AU - Ferrer, Jeanette
AU - Rieber, Alyssa G.
AU - Rhondali, Wadih
AU - Tayjasanant, Supakarn
AU - Ochoa, Jewel
AU - Cantu, Hilda
AU - Chisholm, Gary
AU - Williams, Janet
AU - Frisbee-Hume, Susan
AU - Bruera, Eduardo
N1 - Publisher Copyright:
© Alpha Med Press 2015.
PY - 2015/7/23
Y1 - 2015/7/23
N2 - Objective. There are limited data on the effects of financial distress (FD) on overall suffering and quality of life (QOL) of patients with advanced cancer (AdCa). In this cross-sectional study, we examined the frequency of FD and its correlates in AdCa. Patients and Methods. We interviewed 149 patients, 77 at a comprehensive cancer center (CCC) and 72 at a general public hospital (GPH). AdCa completed a self-rated FD (subjective experience of distress attributed to financial problems) numeric rating scale (0 5 best, 10 5 worst) and validated questionnaires assessing symptoms (Edmonton Symptom Assessment System [ESAS]), psychosocial distress (Hospital Anxiety and Depression Scale [HADS]), and QOL (Functional Assessment of Cancer Therapy-General [FACT-G]). Results. The patients’ median age was 60 years (95% confidence interval [CI]: 58.6-61.5 years); 74 (50%) were female; 48 of 77 at CCC (62%) versus 13 of 72 at GPH (18%) were white; 21 of 77 (27%) versus 32 of 72 (38%) at CCC and GPH, respectively, were black; and 7 of 77 (9%) versus 27 of 72 (38%) at CCC and GPH, respectively, were Hispanic (p,.0001). FD was present in 65 of 75 at CCC (86%; 95% CI: 76%-93%) versus 65 of 72 at GPH (90%; 95% CI: 81%-96%; p 5.45). The median intensity of FD at CCC and GPH was 4 (interquartile range [IQR]: 1-7) versus 8 (IQR: 3-10), respectively (p 5.0003). FD was reported as more severe than physical distress, distress about physical functioning, social/family distress, and emotional distress by 45 (30%), 46 (31%), 64 (43%), and 55 (37%) AdCa, respectively (all significantly worse for patients at GPH) (p,.05). AdCa reported that FD was affecting their general well-being (0 5 not at all, 10 5 very much) with a median score of 5 (IQR: 1-8). FD correlated (Spearman correlation) with FACT-G (r 5 20.23, p 5.0057); HADS-anxiety (r 5.27, p5.0014),ESAS-anxiety(r5.2,p5.0151),andESAS-depression (r 5.18, p 5.0336). Conclusion. FD was very frequent in both groups, but median intensity was double among GPH patients. More than 30% of AdCa rated FD to be more severe than physical, family, and emotional distress. More research is needed to better characterize FD and its correlates in AdCa and possible interventions.
AB - Objective. There are limited data on the effects of financial distress (FD) on overall suffering and quality of life (QOL) of patients with advanced cancer (AdCa). In this cross-sectional study, we examined the frequency of FD and its correlates in AdCa. Patients and Methods. We interviewed 149 patients, 77 at a comprehensive cancer center (CCC) and 72 at a general public hospital (GPH). AdCa completed a self-rated FD (subjective experience of distress attributed to financial problems) numeric rating scale (0 5 best, 10 5 worst) and validated questionnaires assessing symptoms (Edmonton Symptom Assessment System [ESAS]), psychosocial distress (Hospital Anxiety and Depression Scale [HADS]), and QOL (Functional Assessment of Cancer Therapy-General [FACT-G]). Results. The patients’ median age was 60 years (95% confidence interval [CI]: 58.6-61.5 years); 74 (50%) were female; 48 of 77 at CCC (62%) versus 13 of 72 at GPH (18%) were white; 21 of 77 (27%) versus 32 of 72 (38%) at CCC and GPH, respectively, were black; and 7 of 77 (9%) versus 27 of 72 (38%) at CCC and GPH, respectively, were Hispanic (p,.0001). FD was present in 65 of 75 at CCC (86%; 95% CI: 76%-93%) versus 65 of 72 at GPH (90%; 95% CI: 81%-96%; p 5.45). The median intensity of FD at CCC and GPH was 4 (interquartile range [IQR]: 1-7) versus 8 (IQR: 3-10), respectively (p 5.0003). FD was reported as more severe than physical distress, distress about physical functioning, social/family distress, and emotional distress by 45 (30%), 46 (31%), 64 (43%), and 55 (37%) AdCa, respectively (all significantly worse for patients at GPH) (p,.05). AdCa reported that FD was affecting their general well-being (0 5 not at all, 10 5 very much) with a median score of 5 (IQR: 1-8). FD correlated (Spearman correlation) with FACT-G (r 5 20.23, p 5.0057); HADS-anxiety (r 5.27, p5.0014),ESAS-anxiety(r5.2,p5.0151),andESAS-depression (r 5.18, p 5.0336). Conclusion. FD was very frequent in both groups, but median intensity was double among GPH patients. More than 30% of AdCa rated FD to be more severe than physical, family, and emotional distress. More research is needed to better characterize FD and its correlates in AdCa and possible interventions.
KW - Advanced cancer
KW - Financial distress
KW - Quality of life
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U2 - 10.1634/theoncologist.2015-0026
DO - 10.1634/theoncologist.2015-0026
M3 - Article
C2 - 26205738
AN - SCOPUS:84940663659
SN - 1083-7159
VL - 20
SP - 1092
EP - 1098
JO - Oncologist
JF - Oncologist
IS - 9
ER -