Economic Impact of Advanced Pediatric Cancer on Families
Economic Impact of Advanced Pediatric Cancer on Families
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DOI：
10.1016/j.jpainsymman.2013.04.003
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发表时间：
2014-03-01
影响因子：
4.7
通讯作者：
Wolfe, Joanne
中科院分区：
文献类型：
--
作者：
Bona, Kira;Dussel, Veronica;Wolfe, Joanne
上下文尽管有新的证据表明患有复杂疾病的儿童的家庭存在严重的经济困难，但对晚期癌症儿童家庭的经济困难知之甚少。描述在晚期癌症儿童家庭中，根据联邦贫困水平（FPL）分层的经济困难、工作中断、收入损失和相关的经济影响。对三家儿童医院86名进行性、复发性或无反应性癌症患儿父母的横断面调查有完整收入数据的71个家庭（82%）被纳入本分析。父母的工作中断在所有收入水平都很普遍，67个（94%）家庭报告了一些中断。在29个（42%）家庭中，至少有一位父母因为孩子的疾病而辞职。19个（27%）家庭将孩子的疾病描述为巨大的经济困难。工作中断造成的收入损失对所有家庭来说都是巨大的;然而，FPL等于或低于200%的家庭受到的影响不成比例。六个（50%）最贫穷的家庭失去了超过40%的年收入相比，两个（5%）最富有的家庭（P = 0.006）。由于收入损失，9个（15%）以前非贫困家庭从高于200%FPL下降到低于200%FPL。儿童晚期癌症对所有收入水平家庭的经济影响都很大，尽管较贫困的家庭遭受的损失不成比例。改善干预策略的发展是必要的。J Pain Symptom Manage 2014; 47：594-603. (C)2014 U. S.癌症疼痛缓解委员会。爱思唯尔公司出版All rights reserved.
Context. Despite emerging evidence of substantial financial distress in families of children with complex illness, little is known about economic hardship in families of children with advanced cancer.Objectives. To describe perceived financial hardship, work disruptions, income losses, and associated economic impact in families of children with advanced cancer stratified by federal poverty level (FPL).Methods. Cross-sectional survey of 86 parents of children with progressive, recurrent, or nonresponsive cancer at three children's hospitals. Seventy-one families with complete income data (82%) are included in this analysis.Results. Parental work disruptions were prevalent across all income levels, with 67 (94%) families reporting some disruption. At least one parent quit a job because of the child's illness in 29 (42%) families. Nineteen (27%) families described their child's illness as a great economic hardship. Income losses because of work disruptions were substantial for all families; families at or below 200% FPL, however, were disproportionately affected. Six (50%) of the poorest families lost more than 40% of their annual income as compared with two (5%) of the wealthiest families (P = 0.006). As a result of income losses, nine (15%) previously nonpoor families fell from above to below 200% FPL.Conclusion. The economic impact of pediatric advanced cancer on families is significant at all income levels, although poorer families suffer disproportionate losses. Development of ameliorative intervention strategies is warranted. J Pain Symptom Manage 2014; 47: 594-603. (C) 2014 U. S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.