Francoeur Richard B
Adelphi University School of Social Work, 1 South Avenue, Box 701, Garden City, NY 11530, United States.
Patient Educ Couns. 2007 Dec;69(1-3):84-92. doi: 10.1016/j.pec.2007.07.005. Epub 2007 Sep 4.
A consistent body of knowledge suggests that with advancing age, adults tend to report lower financial strain from their current economic condition. But are more negative perceptions shifted onto their expectations about their future economic condition? This study of seriously ill outpatients investigates whether advancing age is related to more negative expectations of future health-related financial strain, in which illness progression would necessitate greater health care consumption.
Ordinal probit multivariate regression was conducted on survey findings from 268 outpatients initiating palliative radiation for recurrent cancer. Half were retirees age>/=65. Age comparisons are reported when there was no recent work transition.
As age advances (from 40 to 84), outpatients incurring low objective financial stress were more likely to reveal that their health insurance and finances would be less adequate to meet future health needs.
Previously, these outpatients were reported to minimize perceptions of current financial strain as age advances. Therefore, older outpatients may cope with current circumstances by displacing perceptions of financial inadequacy onto plausible future situations of cancer progression demanding greater healthcare consumption.
Financial strain may be hidden in older outpatients initiating palliative radiation. These outpatients appear at risk of foregoing appropriate healthcare. Targeted screening and advocacy are warranted.
一系列连贯的知识表明,随着年龄增长,成年人往往表示当前经济状况带来的经济压力较小。但更多负面认知是否转移到了他们对未来经济状况的预期上呢?这项针对重症门诊患者的研究调查了年龄增长是否与对未来与健康相关的经济压力的更负面预期有关,在这种情况下,疾病进展将需要更多的医疗消费。
对268名因复发性癌症开始接受姑息性放疗的门诊患者的调查结果进行了有序概率多元回归分析。其中一半是年龄≥65岁的退休人员。在没有近期工作变动的情况下报告年龄比较情况。
随着年龄增长(从40岁到84岁),客观经济压力较小的门诊患者更有可能表示他们的医疗保险和财务状况将不足以满足未来的健康需求。
此前有报告称,随着年龄增长,这些门诊患者会尽量减少对当前经济压力的认知。因此,老年门诊患者可能通过将经济不足的认知转移到癌症进展导致医疗消费增加的合理未来情况来应对当前状况。
经济压力可能在开始接受姑息性放疗的老年门诊患者中被隐藏起来。这些门诊患者似乎有放弃适当医疗保健的风险。有必要进行针对性筛查和宣传。