Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA5042, Australia.
School of Nursing, Queensland University of Technology, Kelvin Grove, Australia.
Support Care Cancer. 2022 Feb;30(2):1293-1302. doi: 10.1007/s00520-021-06524-y. Epub 2021 Sep 3.
To evaluate for inter-individual differences in financial distress and identify demographic, clinical, and symptom characteristics associated with higher levels of financial distress.
Patients (n = 387) were enrolled prior to breast cancer surgery and followed for 12 months. Financial distress was measured using a 0 (no problem) to 10 (severe problem) numeric rating scale. Hierarchical linear modeling was used to evaluate for inter-individual differences in trajectories of financial distress and characteristics associated with financial distress at enrollment and over 12 months.
Patients' mean age was 55.0 (± 11.7) years and the majority underwent breast conservation surgery (80.6%). Mean financial distress score prior to surgery was 3.3 (± 3.4; range 0 to 10). Unconditional model for financial distress demonstrated no significant changes over time (-0.006/month). Younger age, lower income, receipt of an axillary lymph node dissection and adjuvant chemotherapy, and lower attentional function were associated with higher preoperative levels of financial distress.
Risk factors identified in this study can be used to inform clinicians regarding the need to initiate financial discussions and social work referrals for some patients. Additional clinical or system level interventions should be considered for vulnerable groups with these risk factors.
评估个体间财务困境的差异,并确定与较高财务困境水平相关的人口统计学、临床和症状特征。
在乳腺癌手术前招募了 387 名患者,并随访了 12 个月。使用 0(无问题)到 10(严重问题)的数字评分量表来衡量财务困境。采用分层线性模型评估财务困境轨迹的个体间差异以及与入组时和 12 个月期间财务困境相关的特征。
患者的平均年龄为 55.0(±11.7)岁,大多数患者接受了保乳手术(80.6%)。手术前的平均财务困境评分是 3.3(±3.4;范围 0 到 10)。财务困境的无条件模型显示随时间没有显著变化(每月减少 0.006)。年龄较小、收入较低、接受腋窝淋巴结清扫术和辅助化疗、以及注意力功能较低与术前较高的财务困境水平相关。
本研究确定的风险因素可用于告知临床医生需要为一些患者启动财务讨论和社会工作转介。对于具有这些风险因素的弱势群体,应考虑额外的临床或系统层面的干预措施。