Patient-reported financial toxicity, quality of life, and health behaviors in insured US cancer survivors.
Patient-reported financial toxicity, quality of life, and health behaviors in insured US cancer survivors.
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DOI：
10.1007/s00520-020-05468-z
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发表时间：
2021-01
影响因子：
3.1
通讯作者：
Hamann, Heidi A.
中科院分区：
文献类型：
--
作者：
Ver Hoeve, Elizabeth S.;Ali-Akbarian, Leila;Price, Sarah N.;Lothfi, Nurhyikmah M.;Hamann, Heidi A.
关键词：
抗击癌症是一场代价高昂的战斗，了解患者报告的经济毒性(FT)与健康结果之间的关系有助于为治疗后癌症幸存者提供干预措施。I-III期实体瘤，参保的美国癌症幸存者(N=103)完成了一项调查，内容包括FT(以标准化成本衡量)和临床相关的健康结果(包括与健康相关的生活质量[HRQOL]和坚持推荐的生存健康行为)。用单变量和多变量分析来评估FT的人口学和疾病特异性相关性，并评估FT对HRQOL和对生存健康行为的坚持的预测价值。大约18%的受访者注意到英国《金融时报》的水平与巨大的财务负担相关。在单变量分析中，在校正了多次比较后，较大的FT与无伴侣地位、不退休和较低的教育水平相关。更大的FT也与HRQOL的焦虑、疲劳、疼痛、身体功能和社会功能显著相关。FT与任何可测量的生存健康行为没有显著关联。在多变量分析中，FT被发现是患者报告的焦虑、疲劳、身体功能和社会功能的有意义的预测指标，超过了理论和统计上相关的人口统计特征。尽管与先前研究中评估的积极治疗患者相比，本样本中癌症幸存者的总体FT水平较低，但经济负担仍然是相当少数癌症幸存者的担忧，并与HRQOL降低的部分因素有关。需要进一步的研究来了解FT在保险不足的幸存者和在社区肿瘤学环境中接受治疗的人中的情况。将FT评估纳入生存护理计划可以加强对幸存者FT脆弱性的临床评估，帮助应对生存的动态和持久的挑战，并帮助识别整个癌症护理连续过程中最需要干预的人。
Fighting cancer is a costly battle, and understanding the relationship between patient-reported financial toxicity (FT) and health outcomes can help inform interventions for post-treatment cancer survivors. Stage I-III solid tumor, insured U.S. cancer survivors (N=103) completed a survey addressing FT (as measured by the standardized COST measure) and clinically relevant health outcomes (including health-related quality of life [HRQOL] and adherence to recommended survivorship health behaviors). Univariate and multivariate analyses were used to assess demographic and disease-specific correlates of FT, and to assess the predictive value of FT on HRQOL and adherence to survivorship health behaviors. Approximately 18% of respondents noted FT levels associated with significant financial burden. In univariate analyses, after correcting for multiple comparisons, greater FT was associated with unpartnered status, non-retirement and lower level of educational attainment. Greater FT was also significantly associated with HRQOL components of anxiety, fatigue, pain, physical functioning, and social functioning. FT was not significantly associated with any measured survivorship health behaviors. In multivariate analyses, FT was found to be a meaningful predictor of patient-reported anxiety, fatigue, physical functioning, and social functioning above and beyond theoretically and statistically relevant demographic characteristics. Although overall levels of FT were lower among cancer survivors in this sample, as compared with active treatment patients assessed in previous studies, financial burden continued to be a concern for a significant minority of cancer survivors and was associated with components of reduced HRQOL. Further research is needed to understand FT among underinsured survivors and those treated in community oncology settings. Incorporation of FT assessment into survivorship care planning could enhance clinical assessment of survivors’ FT vulnerability, help address the dynamic and persistent challenges of survivorship, and help identify those most in need of intervention across the cancer care continuum.
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影响因子：
6.2
作者：
de Souza JA;Yap BJ;Wroblewski K;Blinder V;Araújo FS;Hlubocky FJ;Nicholas LH;O'Connor JM;Brockstein B;Ratain MJ;Daugherty CK;Cella D
通讯作者：
Cella D
影响因子：
3.6
作者：
Ezeife, Doreen A.;Morrstein, Brandon Josh;Leighl, Natasha B.
通讯作者：
Leighl, Natasha B.
影响因子：
12.7
作者：
Braveman, Paula A.;Cubbin, Catherine;Pamuk, Elsie
通讯作者：
Pamuk, Elsie
影响因子：
5
作者：
Millar, Morgan M.;Kinney, Anita Y.;Sweeney, Carol
通讯作者：
Sweeney, Carol
影响因子：
5.4
作者：
Drentea, P;Lavrakas, PJ
通讯作者：
Lavrakas, PJ