Cancer Research Institute, University of South Australia, Adelaide, South Australia.
Department of Rural Health, Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, South Australia.
Support Care Cancer. 2021 Sep;29(9):5487-5496. doi: 10.1007/s00520-021-06086-z. Epub 2021 Mar 12.
To explore strategies rural Australians use to cope with the financial consequences of their cancer diagnosis and how that impacts on their lives.
Twenty adult cancer patients/survivors residing in regional-remote areas of Australia were purposively sampled and participated in audio-recorded, semi-structured interviews. When data saturation was reached, thematic analysis was employed to analyse the data.
Participants were 20-78 years (M=60), 70% female, 35% were undergoing treatment and the remaining 65% had finished treatment within the past 5 years. Three themes provide context to rural financial toxicity-related experiences (travelling to access cancer treatment away from home is expensive, being single or lacking family support exacerbates the financial strain, and no choice other than to adopt cost-saving strategies if wanted to access treatment). Strategies commonly employed to minimise financial toxicity include: accessing travel-related support, changes to lifestyle (buying cheaper food, saving on utilities), accessing savings and retirement funds, missing holidays and social activities, reduced car use and not taking a companion to cancer-related appointments at metropolitan treatment areas. Although cost-saving strategies can effectively increase the ability of rural people to cover cancer treatment-related and other costs, most have broader negative psychological, social and practical consequences for them and their families.
Increasing rural cancer patients' and survivors' awareness of various cost-saving strategies and their impact (positive and negative) may decrease their risk of experiencing financial toxicity and unexpected unintended consequences of adopting cost-saving measures.
探讨澳大利亚农村居民应对癌症诊断财务后果的策略，以及这些策略如何影响他们的生活。
在澳大利亚偏远地区，采用目的抽样法选取了 20 名成年癌症患者/幸存者进行音频记录的半结构式访谈。当达到数据饱和时，采用主题分析对数据进行分析。
参与者年龄为 20-78 岁（M=60），70%为女性，35%正在接受治疗，其余 65%在过去 5 年内完成了治疗。三个主题为农村与财务毒性相关的经验提供了背景（到离家治疗癌症的地方旅行费用昂贵，单身或缺乏家庭支持会加剧经济压力，而如果想要接受治疗，除了采用节省成本的策略别无选择）。为了尽量减少财务毒性，常见的策略包括：获得旅行相关的支持、改变生活方式（购买更便宜的食物、节省水电费）、动用储蓄和退休基金、不休假和参加社交活动、减少汽车使用、在大都市治疗区就诊时不带同伴。虽然节省成本的策略可以有效地提高农村居民支付癌症治疗相关费用和其他费用的能力，但对他们及其家庭来说，大多数策略都有更广泛的负面心理、社会和实际影响。
提高农村癌症患者和幸存者对各种节省成本策略及其影响（积极和消极）的认识，可能会降低他们体验财务毒性和因采取节省成本措施而产生意外的、非预期后果的风险。
