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金钱问题:对晚期癌症夫妇财务问题沟通的分析。

Money matters: an analysis of advanced cancer couples' communication about financial concerns.

机构信息

College of Health and Human Sciences, School of Nursing, Purdue University, 502 N. University Street, West Lafayette, IN, 47907-2069, USA.

College of Nursing, University of Utah, 10 2000 E, Salt Lake City, UT, 84112, USA.

出版信息

Support Care Cancer. 2020 May;28(5):2239-2246. doi: 10.1007/s00520-019-05045-z. Epub 2019 Aug 24.

DOI:10.1007/s00520-019-05045-z
PMID:31446485
Abstract

UNLABELLED

Even for the insured, cancer treatment can be expensive and financially burdensome for families, especially in advanced disease.

PURPOSE

To determine if advanced cancer patient-caregiver spousal dyads identified and/or discussed financial concerns.

METHODS

Advanced cancer spousal dyads (n = 26) were asked to discuss their concerns (including finances) for 10 min. Discussions were audio-recorded and transcripts were analyzed for content and depth. We used the constant comparative analysis to analyze communication and demographic data from those who identified financial concerns relevant to cancer treatment.

RESULTS

Of the 26 couples identifying finances as a concern relevant to cancer, there was variability in perception of their overall financial situation, and roughly a third had discordant reports on the degree of financial concern. Thirty-five percent of dyads (n = 9) did not discuss finances during the audio-recorded discussions; for the other dyads, financial conversations varied in depth and breadth for specific concerns.

CONCLUSIONS

Couples were discordant in reports of concern about finances and perceptions of their financial situations. Even if finances were identified as a concern, many couples chose not to discuss financial concerns in depth. Some degree of shielding or avoidance between spouses may be beneficial, but couple financial discussions are important, especially when decisions may impact long-term plans. More research is needed to determine how to facilitate financial conversations to improve patient's and caregiver's well-being.

摘要

目的

确定晚期癌症患者-照顾者配偶对财务问题的识别和/或讨论情况。

方法

让 26 对晚期癌症配偶对(n=26)就他们的担忧(包括财务问题)进行 10 分钟的讨论。讨论过程被录音,并对其内容和深度进行转录分析。我们使用恒比分析方法,分析了那些认为癌症治疗相关的财务问题至关重要的患者和照顾者的沟通和人口统计学数据。

结果

在 26 对将财务问题视为与癌症相关的关注的夫妇中,他们对整体财务状况的看法存在差异,大约三分之一的人对财务担忧的程度存在不一致的报告。在录音讨论中,有 35%的夫妇(n=9)没有讨论财务问题;对于其他夫妇,具体财务问题的讨论在深度和广度上存在差异。

结论

夫妇对财务问题的担忧和对财务状况的看法存在差异。即使确定了财务问题是一个关注点,许多夫妇也选择不深入讨论财务问题。配偶之间可能存在某种程度的隐瞒或回避,但夫妻之间的财务讨论很重要,特别是当决策可能影响长期计划时。需要进一步研究如何促进财务对话,以提高患者和照顾者的幸福感。

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Unmet need for clinician engagement regarding financial toxicity after diagnosis of breast cancer.乳腺癌诊断后临床医生对财务毒性关注度不足。
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Death or Debt? National Estimates of Financial Toxicity in Persons with Newly-Diagnosed Cancer.
死亡还是负债?新诊断癌症患者的财务毒性的全国估计。
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Support Care Cancer. 2018 Oct;26(10):3517-3526. doi: 10.1007/s00520-018-4201-6. Epub 2018 Apr 25.
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Impacts on employment, finances, and lifestyle for working age people facing an expected premature death: A systematic review.预期早逝的劳动年龄段人群的就业、财务和生活方式的影响:系统综述。
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As if the disease was not enough: coping with the financial consequences of cancer.似乎疾病还不够:应对癌症带来的经济后果。
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