National College of Ireland, Dublin, Ireland.
Maynooth University, Maynooth, Ireland.
Psychooncology. 2018 Sep;27(9):2165-2171. doi: 10.1002/pon.4786. Epub 2018 Jun 21.
To estimate the prevalence of financial objective stress and subjective strain among colorectal cancer survivors and assess associated financial coping factors in Ireland, which has a mixed public-private health care system.
Colorectal cancer survivors were identified from the National Cancer Registry, and a sample of 496 respondents were included in the analysis. A postal survey collected information on survivor demographics, socio-economic background, medical characteristics, cancer-related financial hardship, debt accumulation, and asset depletion. Cancer-related financial objective stress and subjective strain were used as dependent variables in logistic regression analysis.
Approximately 2 in 5 survivors experienced objective stress (40.9%) or subjective strain (39.4%). Depletion of savings (49.1%) was the most prevalent form of financial coping strategy. Factors significantly associated with increased objective stress were having a stoma (OR = 2.1; 95% CI, 1.1-3.9), using savings (OR = 9.4; 95% CI, 4.9-18.0), formally borrowing money (OR = 3.1; 95% CI, 1.0-9.6), and loans from family members/friends (OR = 3.8; 95% CI, 1.9-7.8). Not working (excluding retirees) (OR = 0.44; 95% CI, 0.20-0.96) was associated with decreased objective stress. Significant predictors of subjective strain included having dependents, a stoma, using savings (OR = 5.3; 95% CI, 2.9-9.5), and loans from family members/friends (OR = 2.0; 95% CI, 1.1-3.9) but excluded borrowing money.
Cancer-related financial objective stress and subjective strain are common in colorectal cancer survivors, even where all citizens are entitled to publicly funded care, but the financial coping strategies significantly associated with these 2 measures differed. These findings will help inform targeted measures across disparate health care systems and survivor groups to alleviate financial hardship.
评估爱尔兰结直肠癌幸存者的财务目标压力和主观压力的患病率，并评估与财务应对因素相关的因素，爱尔兰有混合的公共-私人医疗保健系统。
从国家癌症登记处确定结直肠癌幸存者，对 496 名受访者进行了抽样分析。通过邮寄调查收集幸存者人口统计学、社会经济背景、医疗特征、与癌症相关的经济困难、债务积累和资产耗竭的信息。将与癌症相关的财务目标压力和主观压力作为逻辑回归分析中的因变量。
大约五分之二的幸存者经历了客观压力（40.9%）或主观压力（39.4%）。储蓄枯竭（49.1%）是最常见的财务应对策略。与客观压力增加显著相关的因素包括造口（OR=2.1；95%CI，1.1-3.9）、使用储蓄（OR=9.4；95%CI，4.9-18.0）、正式借款（OR=3.1；95%CI，1.0-9.6）和向家庭成员/朋友借款（OR=3.8；95%CI，1.9-7.8）。不工作（不包括退休人员）（OR=0.44；95%CI，0.20-0.96）与客观压力降低相关。主观压力的显著预测因素包括有家属、造口、使用储蓄（OR=5.3；95%CI，2.9-9.5）和向家庭成员/朋友借款（OR=2.0；95%CI，1.1-3.9），但不包括借款。
即使所有公民都有权获得公共资助的医疗保健，与癌症相关的财务目标压力和主观压力在结直肠癌幸存者中也很常见，但与这两个措施显著相关的财务应对策略有所不同。这些发现将有助于为不同的医疗保健系统和幸存者群体提供有针对性的措施，以减轻经济困难。
