National Cancer Registry Ireland, Cork, Ireland.
BMC Gastroenterol. 2012 Jun 7;12:62. doi: 10.1186/1471-230X-12-62.
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.
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.
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.
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.
近年来，关于癌症对患者及其家属/照顾者的经济影响的证据基础有所增加，但对于癌症如何影响患者的经济负担知之甚少。我们研究了癌症患者情绪对经济影响的经济成本，以及这些情绪如何影响患者和家庭的负担。
六家医院的卫生保健专业人员邀请在过去一年中被诊断患有结直肠癌（ICD10 C18-C20）的患者参加研究。对患者进行了半结构化的面对面访谈，如果可能的话，还对其家庭成员进行了访谈。访谈内容包括癌症导致的医疗和非医疗费用，以及这些费用对患者及其家庭生活的影响。访谈进行了录音。录音逐字转录，使用主题内容分析对这些数据进行了定性分析。
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；其中 6 名患者有家属陪同。与医院预约相关的旅行和停车费用；治疗费用；增加的家庭账单；以及新衣服等，都是重要的与癌症相关的财务支出。癌症影响了在职患者的工作能力并降低了他们的收入。护工/家庭成员的非正式护理的机会成本，尤其是在诊断后立即，是一个强烈的主题。所有患者都谈到了结直肠癌的精神负担，并描述了这种负担如何通过限制工作和阻碍他们有效地管理开支的能力，给自己和家人带来进一步的经济负担。一些患者还谈到了经济和情感负担如何相互影响。雇主、家庭/照顾者和国家/卫生服务以及患者自身的态度等因素影响了这种相互关系。
结直肠癌对患者及其家庭的经济影响是复杂的。本研究表明，癌症的经济成本和心理影响往往是相关的，并可能相互加剧，但各种因素可以调节这种相互关系。
