识别因治疗相关的经济困境而改变治疗或生活方式的癌症患者。

Identifying cancer patients who alter care or lifestyle due to treatment-related financial distress.

作者信息

Nipp Ryan D, Zullig Leah L, Samsa Gregory, Peppercorn Jeffrey M, Schrag Deborah, Taylor Donald H, Abernethy Amy P, Zafar S Yousuf

机构信息

Dana-Farber Cancer Institute, Boston, MA, USA.

Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA.

出版信息

Psychooncology. 2016 Jun;25(6):719-25. doi: 10.1002/pon.3911. Epub 2015 Jul 7.

DOI:10.1002/pon.3911

PMID:26149817

Abstract

BACKGROUND

Cancer patients may experience financial distress as a side effect of their care. Little is known about which patients are at greatest risk for altering their care or lifestyle due to treatment-related financial distress.

METHODS

We conducted a cross-sectional survey study to determine which patients are at greatest risk for altering their care or lifestyle due to treatment-related financial distress. Eligible patients were adults receiving cancer treatment enrolled between June 2010 and May 2011. We grouped coping strategies as lifestyle altering or care altering. We assessed coping strategies and relationships between covariates using descriptive statistics and analysis of variance.

RESULTS

Among 174 participants, 89% used at least one lifestyle-altering coping strategy, while 39% used a care-altering strategy. Care-altering coping strategies adopted by patients included the following: not filling a prescription (28%) and taking less medication than prescribed (23%). Lifestyle-altering strategies included the following: spending less on leisure activities (77%), spending less on basics like food and clothing (57%), borrowing money (54%), and spending savings (50%). Younger patients were more likely than older patients to use coping strategies (p < 0.001). Lower-income patients adopted care-altering strategies more than higher-income patients (p = 0.03). Participants with more education and shorter duration of chemotherapy used lifestyle-altering strategies more than their counterparts (both p < 0.05).

CONCLUSIONS

As a means of coping with treatment-related financial distress, patients were more likely to use lifestyle-altering approaches, but more than one-third adopted potentially harmful care-altering strategies. Younger age, lower income, higher education, and shorter duration of chemotherapy were characteristics associated with greater use of coping strategies. Copyright © 2015 John Wiley & Sons, Ltd.

摘要

背景

癌症患者可能会经历经济困境，这是其治疗的一种副作用。对于哪些患者因与治疗相关的经济困境而最有可能改变其治疗方案或生活方式，我们知之甚少。

方法

我们进行了一项横断面调查研究，以确定哪些患者因与治疗相关的经济困境而最有可能改变其治疗方案或生活方式。符合条件的患者为2010年6月至2011年5月期间登记接受癌症治疗的成年人。我们将应对策略分为改变生活方式或改变治疗方案两类。我们使用描述性统计和方差分析评估应对策略以及协变量之间的关系。

结果

在174名参与者中，89%至少采用了一种改变生活方式的应对策略，而39%采用了改变治疗方案的策略。患者采用的改变治疗方案的应对策略包括：不按处方取药（28%）和减少用药剂量（23%）。改变生活方式的策略包括：减少休闲活动支出（77%）、减少食品和衣物等基本生活支出（57%）、借钱（54%）和动用储蓄（50%）。年轻患者比老年患者更有可能采用应对策略（p < 0.001）。低收入患者比高收入患者更多地采用改变治疗方案的策略（p = 0.03）。受教育程度较高且化疗疗程较短的参与者比其他参与者更多地采用改变生活方式的策略（p均< 0.05）。