Work

Financial distress and its associated burden in couples coping with an advanced cancer

Year: 2022

Type: article

Abstract: Purpose As the economic burden and financial distress (FD) resulting from cancer care are increasingly recognized, FD remains inadequately understood from the perspective of patients and their spousal caregiver, the relational context where most financial and treatment decisions are navigated. Therefore, we assessed FD in both patients with advanced cancer and their spouses to identify symptom and QOL correlates. We additionally examined if illness communication moderated the association between FD and QOL. Methods Patients undergoing treatment for stage III/IV lung cancer or grade III/IV primary brain tumor and their spouses completed measures of their own FD, QOL, symptoms, perception of their spouse’s symptoms, and overall illness communication. Results Patients (62.7%) and spouses (64.7%) endorsed FD; however, spouses rated FD with greater relative severity. For both, FD was associated with greater anxiety, depression, and poorer physical QOL. For patients, FD was additionally associated with poorer mental QOL. Spousal caregivers accurately perceived patient FD, yet patients underreported spouse’s FD by a clinically meaningful difference. A 3-way interaction (FD X role X illness communication) revealed (b = .40, p = .041) that illness communication moderated the association between FD and physical QOL for spouses only. Conclusion In the advanced cancer setting, FD is prevalent in both patients and their caregivers and associated with psychological distress and poor physical QOL. Results suggest that optimal FD interventions should include patients and spouses. As illness communication appears to buffer the negative association of FD with physical QOL, studies targeting illness communication deficits in couples facing advanced disease are warranted.

Source: Supportive Care in Cancer

DOI: 10.1007/s00520-021-06758-w