Inter-relationships between the economic and emotional consequences of colorectal cancer for patients and their families: a qualitative study
Inter-relationships between the economic and emotional consequences of colorectal cancer for patients and their families: a qualitative study
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DOI：
10.1186/1471-230x-12-62
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发表时间：
2012-06-07
影响因子：
2.4
通讯作者：
Sharp, Linda
中科院分区：
文献类型：
--
作者：
Ceilleachair, Alan O.;Costello, Liza;Sharp, Linda
背景：虽然近年来关于癌症对患者及其家人/护理人员的经济影响的证据基础不断增加，但人们对癌症的情绪反应如何影响这种经济影响却知之甚少。我们在患者情绪的背景下调查了癌症的经济成本，以及它们如何影响患者和家庭的负担。方法：来自六家医院的卫生专业人员邀请前一年内诊断为结直肠癌（ICD10 C18-C20）的患者参加研究。对患者及其家庭成员（如果有的话）进行了半结构化的面对面访谈。访谈涵盖了因癌症而产生的医疗和非医疗费用以及这些费用对患者及其家人生活的影响。采访进行了录音。逐字转录录音，并使用主题内容分析对这些数据进行定性分析。结果：对 22 名结直肠癌患者（17 名结肠癌和 5 名直肠癌；14 名女性和 8 名男性）进行了访谈； 6人由一名家庭成员陪同。与癌症相关的重要财务支出包括： 与医院预约相关的旅行和停车费用；程序费用；家庭账单增加；和新衣服。癌症影响就业人员的工作能力并降低他们的收入。照顾者/家庭成员的非正式护理的机会成本，尤其是诊断后立即护理，是一个重要的主题。所有患者都谈到了结直肠癌的情感负担，并描述了这种负担如何限制工作并阻碍他们有效管理费用的能力，从而给自己和家人带来进一步的费用。一些患者还谈到了经济负担和情感负担如何相互作用。雇主、家庭/护理人员和国家/卫生服务机构的支持以及患者自身的态度影响了这种相互关系。结论：结直肠癌对患者及其家庭的经济影响是复杂的。这项研究表明，癌症的经济成本和情感影响往往是相关的，并且可以相互加剧，但多种因素可以调节这种相互关系。
Background: While the evidence-base concerning the economic impact of cancer for patients and their families/carers has grown in recent years, there is little known about how emotional responses to cancer influence this economic impact. We investigated the economic costs of cancer in the context of patients' emotions and how these both shaped the patient and family burden.Methods: Health professionals from six hospitals invited patients diagnosed with colorectal cancer (ICD10 C18-C20) within the previous year to take part in the study. Semi-structured face-to-face interviews were conducted with patients and, where available, a family member. Interviews covered medical and non-medical costs incurred as a result of cancer and the impact of these on the lives of the patient and their family. Interviews were audio-recorded. Recordings were transcribed verbatim and these data were analysed qualitatively using thematic content analysis.Results: Twenty-two patients with colorectal cancer (17 colon and 5 rectal; 14 women and 8 men) were interviewed; 6 were accompanied by a family member. Important cancer-related financial outlays included: travel and parking associated with hospital appointments; costs of procedures; increased household bills; and new clothing. Cancer impacted on employed individuals' ability to work and depressed their income. The opportunity cost of informal care for carers/family members, especially immediately post-diagnosis, was a strong theme. All patients spoke of the emotional burden of colorectal cancer and described how this burden could lead to further costs for themselves and their families by limiting work and hindering their ability to efficiently manage their expenses. Some patients also spoke of how economic and emotional burdens could interact with each other. Support from employers, family/carers and the state/health services and patients' own attitudes influenced this inter-relationship.Conclusions: The economic impact of colorectal cancer on patients and their families is complex. This study suggests that the economic costs and the emotional impact of cancer are often related and can exacerbate each other, but that various factors can meditate this inter-relationship.