Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
JCO Oncol Pract. 2023 Aug;19(8):654-661. doi: 10.1200/OP.22.00631. Epub 2023 Jun 9.
Financial navigation services support patients with cancer and address the direct and indirect financial burden of cancer diagnosis and treatment. These services are commonly delivered through a variety of frontline oncology support personnel (FOSP) including navigators, social workers, supportive care providers, and other clinic staff, but the perspective of FOSPs is largely absent from current literature on financial burden in oncology. We surveyed a national sample of FOSPs to understand their perspectives on patient financial burden, resource availability, and barriers and facilitators to assisting patients with cancer-related financial burden.
We used Qualtrics online survey software and recruited participants using multiple professional society and interest group mailing lists. Categorical responses were described using frequencies, distributions of numeric survey responses were described using the median and IQR, and two open-ended survey questions were categorized thematically using a priori themes, allowing additional emergent themes.
Two hundred fourteen FOSPs completed this national survey. Respondents reported a high awareness of patient financial burden and felt comfortable speaking to patients about financial concerns. Patient assistance resources were commonly available, but only 15% described resources as sufficient for the observed needs. A substantial portion of respondents reported moral distress related to this lack of resources.
FOSPs, who already have requisite knowledge and comfort in discussing patient financial needs, are a critical resource for mitigating cancer-related financial burden. Interventions should leverage this resource but prioritize transparency and efficiency to reduce the administrative and emotional toll on the FOSP workforce and reduce the risk of burnout.
财务导航服务为癌症患者提供支持,并解决癌症诊断和治疗的直接和间接经济负担。这些服务通常由各种一线肿瘤支持人员(FOSP)提供,包括导航员、社会工作者、支持性护理提供者和其他诊所工作人员,但 FOSP 的观点在肿瘤学中关于财务负担的现有文献中基本缺失。我们对全国范围内的 FOSP 进行了调查,以了解他们对患者财务负担、资源可用性以及帮助癌症患者减轻相关经济负担的障碍和促进因素的看法。
我们使用 Qualtrics 在线调查软件,并通过多个专业协会和兴趣小组的邮件列表招募参与者。使用频率描述分类响应,使用中位数和 IQR 描述数字调查响应的分布,并使用预先确定的主题对两个开放式调查问题进行主题分类,允许出现其他新主题。
214 名 FOSP 完成了这项全国性调查。受访者报告对患者财务负担有很高的认识,并对与患者讨论财务问题感到舒适。患者援助资源通常是可用的,但只有 15%的受访者表示资源足以满足观察到的需求。相当一部分受访者报告说,由于缺乏资源,他们感到道德上的困扰。
FOSP 已经具备了讨论患者财务需求的必要知识和舒适度,是减轻癌症相关经济负担的关键资源。干预措施应利用这一资源,但要优先考虑透明度和效率,以减轻 FOSP 工作人员的行政和情感负担,并降低职业倦怠的风险。