Nedjat-Haiem Frances R, Cadet Tamara, Parada Humberto, Jones Tessa, Jimenez Elvira E, Thompson Beti, Wells Kristen J, Mishra Shiraz I
7117San Diego State University, San Diego, CA, USA.
1849Simmons College, Boston, MA, USA.
Am J Hosp Palliat Care. 2021 Aug;38(8):938-946. doi: 10.1177/1049909120971829. Epub 2020 Nov 6.
Financial hardship influences health-related quality of life (HRQoL) of older adults. However, little is known about the relationship between financial hardship and HRQoL among vulnerable populations.
We examined the associations between financial hardship and HRQoL among older Latinos living with chronic disease, including cancer.
This cross-sectional study included 68 Latinos (age range 50-87) with one or more chronic health conditions who participated in a pilot randomized clinical trial. Participants responded to 11 financial hardship questions. We used factor analysis to explore constructs of financial hardship. HRQoL was assessed using the 27-item Functional Assessment of Cancer Therapy-General (FACT-G). Multiple linear regression examined the associations between financial hardship and HRQoL subscales (physical, social/family, emotional, functional well-being).
The factor analysis revealed 3 constructs of financial hardship: medical cost concerns, financial hardship treatment adherence, and financial worry. A 1-point increase in the factor score for financial hardship treatment adherence was associated with a 2.1-point (SE = 0.771) decrease in physical well-being and with a 1.71-point (SE = 0.761) decrease in functional well-being. A 1-point increase in the financial stress factor score was associated with a 2.0-point (SE = 0.833) decrease in social/family well-being, and with a 2.1-point (SE = 0.822) decrease in functional well-being.
In this study of older Latinos with chronic diseases, financial hardship was associated with worse HRQoL across several domains. Healthcare providers should refer older Latinos living with chronic disease to appropriate support providers, such as care coordinators, social workers, or patient navigators, who can assist them with obtaining financial assistance and other resources.
经济困难会影响老年人的健康相关生活质量(HRQoL)。然而,对于弱势群体中经济困难与健康相关生活质量之间的关系,我们知之甚少。
我们研究了患有慢性病(包括癌症)的老年拉丁裔人群中经济困难与健康相关生活质量之间的关联。
这项横断面研究纳入了68名患有一种或多种慢性健康状况的拉丁裔(年龄范围50 - 87岁),他们参与了一项试点随机临床试验。参与者回答了11个关于经济困难的问题。我们使用因子分析来探索经济困难的结构。使用27项癌症治疗通用功能评估量表(FACT - G)评估健康相关生活质量。多元线性回归分析了经济困难与健康相关生活质量各子量表(身体、社会/家庭、情感、功能幸福感)之间的关联。
因子分析揭示了经济困难的3个结构:医疗费用担忧、经济困难导致的治疗依从性问题以及经济担忧。经济困难导致的治疗依从性因子得分每增加1分,身体幸福感就下降2.1分(标准误 = 0.771),功能幸福感下降1.71分(标准误 = 0.761)。经济压力因子得分每增加1分,社会/家庭幸福感下降2.0分(标准误 = 0.833),功能幸福感下降2.1分(标准误 = 0.822)。
在这项针对患有慢性病的老年拉丁裔人群的研究中,经济困难与多个领域较差的健康相关生活质量相关。医疗保健提供者应将患有慢性病的老年拉丁裔人群转介给适当的支持提供者,如护理协调员、社会工作者或患者导航员,他们可以帮助这些患者获得经济援助和其他资源。