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“经济负担令人沮丧,焦虑不安”:关节炎对个人经济影响的定性研究。

"The Financial Impact Is Depressing and Anxiety Inducing": A Qualitative Exploration of the Personal Financial Toll of Arthritis.

机构信息

Monash University, Melbourne, Victoria, Australia.

Curtin University, Perth, Western Australia, Australia.

出版信息

Arthritis Care Res (Hoboken). 2021 May;73(5):671-679. doi: 10.1002/acr.24172.

Abstract

OBJECTIVE

The financial experience faced by working-age people with arthritis includes living below the poverty line for many. Financial distress among people with arthritis is known to contribute to poorer health outcomes, including high psychological distress and more severe pain. Despite the demonstrated societal cost of arthritis care and management, the personal costs borne by the individual are not well understood. The aim of this study was to explore the perceived financial impacts of living with arthritis among younger adults (defined as those ages 18-50 years).

METHODS

A qualitative descriptive study design was used. Participants with inflammatory arthritis or osteoarthritis were recruited from the community, including urban and rural settings. An interview schedule was developed, informed by existing literature, which was piloted prior to data collection. Deductive and inductive coding techniques were used to identify financial-related themes arising from the data.

RESULTS

Semistructured interviews were conducted with 21 adults (90% female) with a mix of arthritis conditions, including rheumatoid arthritis, psoriatic arthritis, and osteoarthritis. Four themes were identified: direct arthritis-attributable medical costs, indirect arthritis-attributable costs, insurance and pension costs, and broader financial impacts on the family. Nonsubsidized costs were frequently referenced by participants as burdensome and existed even within the publicly funded Australian health care system.

CONCLUSION

Adults with arthritis experience significant arthritis-attributable financial burden and related distress. Financial concerns should be actively identified and considered within shared clinical decision-making to provide more patient-centered care for these individuals.

摘要

目的

患有关节炎的劳动年龄段人群所面临的经济状况包括许多人生活在贫困线以下。已知关节炎患者的经济困境会导致更差的健康结果,包括更高的心理困扰和更严重的疼痛。尽管关节炎护理和管理的社会成本已经得到证明,但个人承担的个人成本还没有得到很好的理解。本研究旨在探讨年轻成年人(定义为 18-50 岁)患关节炎对经济的感知影响。

方法

采用定性描述性研究设计。从社区中招募患有炎症性关节炎或骨关节炎的参与者,包括城市和农村环境。根据现有文献制定了访谈计划,并在数据收集前进行了试点。使用演绎和归纳编码技术从数据中确定与财务相关的主题。

结果

对 21 名成年人(90%为女性)进行了半结构式访谈,他们患有各种关节炎,包括类风湿关节炎、银屑病关节炎和骨关节炎。确定了四个主题:直接与关节炎相关的医疗费用、间接与关节炎相关的费用、保险和养老金费用以及对家庭的更广泛的经济影响。参与者经常提到非补贴费用是负担沉重的,即使在澳大利亚的公共资助医疗保健系统中也存在这些费用。

结论

患有关节炎的成年人会经历重大的与关节炎相关的经济负担和相关的困扰。应积极识别和考虑经济方面的问题,并在共同的临床决策中加以考虑,为这些人提供更以患者为中心的护理。

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