Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
Nova Scotia Health Authority, Cape Breton Regional Hospital, Sydney, NS, Canada.
Int J Health Policy Manag. 2022 Sep 1;11(9):1814-1822. doi: 10.34172/ijhpm.2021.83. Epub 2021 Aug 15.
Cancer patients experience financial hardship due to rising expenses related to cancer treatment and declining income levels associated with reduced employability. Employment Insurance Sick Benefits (EI-SB) is a social income support program which provides temporary income replacement to Canadians when they fall ill. Although EI-SB is designed to maintain continuity of income during an illness, little is known about the perspectives of cancer patients who receive EI-SB. This knowledge can inform the development of public policies which are responsive to the needs and priorities of cancer patients.
We conducted a theory-informed thematic analysis of data collected from twenty semi-structured interviews with participants who were receiving care in a cancer centre in Cape Breton, Nova Scotia and had received EI-SB. A coding framework was developed using Taplin and colleagues' intermediate outcomes of patient care across the cancer care continuum. Interpretation of findings was guided by the synergies of oppression theoretical lens.
Three overarching themes describe the experiences of cancer patients receiving social income support: Economic exclusion, in which the structure of the labour market and social welfare system determine access to workplace benefits and continuity of reasonable income; financial toxicity, a vicious cycle of financial burden and increasing financial distress; and constrained choices, where cancer influences employability and lowered income influences the need to be employed.
Cancer patients need income support programs that are tailored to match their healthcare priorities. In addition, policies which strengthen working conditions and facilitate a reintegration to work when possible will be important in addressing the structural drivers of income insecurity experienced by cancer patients.
癌症患者由于癌症治疗相关费用的增加和就业能力下降导致收入水平降低而面临经济困难。就业保险病假津贴（EI-SB）是一项为加拿大人生病时提供临时收入替代的社会收入支持计划。尽管 EI-SB 的设计目的是在患病期间维持收入的连续性，但对于接受 EI-SB 的癌症患者的观点却知之甚少。这些知识可以为制定响应癌症患者需求和优先事项的公共政策提供信息。
我们使用 Taplin 及其同事在癌症护理连续体中患者护理的中间结果对来自新斯科舍省布雷顿角癌症中心接受护理并接受 EI-SB 的 20 名半结构化访谈参与者收集的数据进行了理论导向的主题分析。使用 Taplin 及其同事在癌症护理连续体中患者护理的中间结果开发了一个编码框架。发现的解释受压迫理论视角的协同作用指导。
三个总体主题描述了接受社会收入支持的癌症患者的体验：经济排斥，其中劳动力市场和社会福利制度的结构决定了获得工作场所福利和合理收入连续性的机会；财务毒性，财务负担和不断增加的财务困境的恶性循环；和受限的选择，其中癌症会影响就业能力，降低的收入会影响就业的必要性。
癌症患者需要量身定制的收入支持计划，以满足他们的医疗保健优先事项。此外，加强工作条件和促进在可能的情况下重新融入工作的政策对于解决癌症患者所经历的收入不安全的结构性驱动因素将非常重要。
