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Al-Abdulla O, Sonsuz AA, Alaref M, Albakor B, Kauhanen J. The impact of humanitarian aid on financial toxicity among cancer patients in Northwest Syria. BMC Health Serv Res 2024; 24:641. [PMID: 38762456 PMCID: PMC11102167 DOI: 10.1186/s12913-024-11077-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 05/03/2024] [Indexed: 05/20/2024] Open
Abstract
INTRODUCTION The ongoing crisis in Syria has divided the country, leading to significant deterioration of the healthcare infrastructure and leaving millions of people struggling with poor socioeconomic conditions. Consequently, the affordability of healthcare services for the population has been compromised. Cancer patients in Northwest Syria have faced difficulties in accessing healthcare services, which increased their financial distress despite the existence of humanitarian health and aid programs. This study aimed to provide insights into how humanitarian assistance can alleviate the financial burdens associated with cancer treatment in conflict-affected regions. MATERIALS AND METHODS This research employed a quantitative, quasi-experimental design with a pre-test-post-test approach, focusing on evaluating the financial toxicity among cancer patients in Northwest Syria before and after receiving humanitarian aid. The study used purposeful sampling to select participants and included comprehensive demographic data collection. The primary tool for measuring financial toxicity was the Comprehensive Score for Financial Toxicity (FACIT-COST) tool, administered in Arabic. Data analysis was conducted using SPSS v25, employing various statistical tests to explore relationships and impacts. RESULTS A total of 99 cancer patients were recruited in the first round of data collection, out of whom 28 patients affirmed consistent receipt of humanitarian aid throughout the follow-up period. The results of the study revealed that humanitarian aid has no significant relationship with reducing the financial toxicity experienced by cancer patients in Northwest Syria. Despite the aid efforts, many patients continued to face significant financial distress. CONCLUSION The research findings indicate that current humanitarian assistance models might not sufficiently address the complex financial challenges faced by cancer patients in conflict zones. The research emphasizes the need for a more comprehensive and integrated approach in humanitarian aid programs. The study highlights the importance of addressing the economic burdens associated with cancer care in conflict settings and calls for a re-evaluation of aid delivery models to better serve the needs of chronic disease patients. The findings suggest a need for multi-sectoral collaboration and a systemic approach to improve the overall effectiveness of humanitarian assistance in such contexts.
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Affiliation(s)
- Orwa Al-Abdulla
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, The University of Eastern Finland, P.O. Box 1627, Kuopio, 70211, Finland.
- Strategic Research Center (Öz SRC), Incili Pinar MAH, Gazi Muhtar Paşa BUL, Doktorlar Sitesi, 38E, 104. Sehitkamil, 27090, Gaziantep, Türkiye.
| | - Aliye Aslı Sonsuz
- Health Science Institute, Istanbul Medipol University, Beykoz, İstanbul, Türkiye
| | - Maher Alaref
- Strategic Research Center (Öz SRC), Incili Pinar MAH, Gazi Muhtar Paşa BUL, Doktorlar Sitesi, 38E, 104. Sehitkamil, 27090, Gaziantep, Türkiye
| | - Bakor Albakor
- Health Science Institute, Istanbul Medipol University, Beykoz, İstanbul, Türkiye
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, The University of Eastern Finland, P.O. Box 1627, Kuopio, 70211, Finland
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Cho D, Roth M, Peterson SK, Jennings K, Kim S, Weathers SP, Ahmed S, Livingston JA, Barcenas C, You YN, Milbury K. Associations Between Stress, Health Behaviors, and Quality of Life in Young Couples During the Transition to Survivorship: Protocol for a Measurement Burst Study. JMIR Res Protoc 2024; 13:e53307. [PMID: 38652520 PMCID: PMC11077407 DOI: 10.2196/53307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Cancer is a life-threatening, stressful event, particularly for young adults due to delays and disruptions in their developmental transitions. Cancer treatment can also cause adverse long-term effects, chronic conditions, psychological issues, and decreased quality of life (QoL) among young adults. Despite numerous health benefits of health behaviors (eg, physical activity, healthy eating, no smoking, no alcohol use, and quality sleep), young adult cancer survivors report poor health behavior profiles. Determining the associations of stress (either cancer-specific or day-to-day stress), health behaviors, and QoL as young adult survivors transition to survivorship is key to understanding and enhancing these survivors' health. It is also crucial to note that the effects of stress on health behaviors and QoL may manifest on a shorter time scale (eg, daily within-person level). Moreover, given that stress spills over into romantic relationships, it is important to identify the role of spouses or partners (hereafter partners) in these survivors' health behaviors and QoL. OBJECTIVE This study aims to investigate associations between stress, health behaviors, and QoL at both within- and between-person levels during the transition to survivorship in young adult cancer survivors and their partners, to identify the extent to which young adult survivors' and their partners' stress facilitates or hinders their own and each other's health behaviors and QoL. METHODS We aim to enroll 150 young adults (aged 25-39 years at the time of cancer diagnosis) who have recently completed cancer treatment, along with their partners. We will conduct a prospective longitudinal study using a measurement burst design. Participants (ie, survivors and their partners) will complete a daily web-based survey for 7 consecutive days (a "burst") 9 times over 2 years, with the bursts spaced 3 months apart. Participants will self-report their stress, health behaviors, and QoL. Additionally, participants will be asked to wear an accelerometer to assess their physical activity and sleep during the burst period. Finally, dietary intake (24-hour diet recalls) will be assessed during each burst via telephone by research staff. RESULTS Participant enrollment began in January 2022. Recruitment and data collection are expected to conclude by December 2024 and December 2026, respectively. CONCLUSIONS To the best of our knowledge, this will be the first study that determines the interdependence of health behaviors and QoL of young adult cancer survivors and their partners at both within- and between-person levels. This study is unique in its focus on the transition to cancer survivorship and its use of a measurement burst design. Results will guide the creation of a developmentally appropriate dyadic psychosocial or behavioral intervention that improves both young adult survivors' and their partners' health behaviors and QoL and potentially their physical health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53307.
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Affiliation(s)
- Dalnim Cho
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Michael Roth
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kristofer Jennings
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Seokhun Kim
- The Center for Clinical Research and Evidence-Based Medicine, The University of Texas McGovern Medical School, Houston, TX, United States
| | - Shiao-Pei Weathers
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sairah Ahmed
- Department of Lymphoma-Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - J Andrew Livingston
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Carlos Barcenas
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Y Nancy You
- Department of Colon & Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kathrin Milbury
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Ruan J, Liu C, Yang Z, Kuang Y, Yuan X, Qiu J, Tang L, Xing W. Suffering and adjustment: a grounded theory of the process of coping with financial toxicity among young women with breast cancer. Support Care Cancer 2024; 32:96. [PMID: 38197967 DOI: 10.1007/s00520-024-08305-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/02/2024] [Indexed: 01/11/2024]
Abstract
PURPOSE To explore the process of coping with financial toxicity among young women with breast cancer and formulate a grounded theory that serves as a foundation for creating intervention strategies aimed at supporting cancer survivors. METHODS A qualitative study using the Corbin and Strauss variant of grounded theory. A series of in-depth interviews were carried out with young women with breast cancer (n = 29) using the theoretical sampling method. We analyzed data by coding core categories in the patients' coping processes and developing theory around these categories. Data collection and analysis were performed simultaneously. RESULTS A substantial theory of the process of coping with financial toxicity among young female breast cancer survivors was constructed. Two core concepts, suffering and adjustment, were identified. Young women with breast cancer suffered from financial toxicity, which was related to risk factors, coping resources, and unmet needs. To overcome financial toxicity, young women with breast cancer adjusted by reshaping consumption concept, re-dividing of family functions, re-planning of occupation career, and rebuilding life confidence. CONCLUSION This qualitative study constructed a theory delineating the coping strategies employed by young women with breast cancer in response to financial toxicity, offering profound insights into the intricacies of cancer-related financial toxicity. Identifying risk factors, enhancing coping resources, and meeting unmet needs would be helpful to patients' adjustment to financial stress.
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Affiliation(s)
- Junyi Ruan
- School of Nursing, Fudan University, 305 Fenglin Rd, Shanghai, 200032, China
| | - Cheng Liu
- School of Nursing, Fudan University, 305 Fenglin Rd, Shanghai, 200032, China
| | - Zhongfang Yang
- School of Nursing, Fudan University, 305 Fenglin Rd, Shanghai, 200032, China
| | - Yi Kuang
- School of Nursing, Fudan University, 305 Fenglin Rd, Shanghai, 200032, China
| | - Xiaoyi Yuan
- School of Nursing, Fudan University, 305 Fenglin Rd, Shanghai, 200032, China
| | - Jiajia Qiu
- Department of Nursing Administration, Shanghai Cancer Center, Fudan University, 270 Dongan Rd, Shanghai, 200032, China
| | - Lichen Tang
- Department of Breast Surgery, Shanghai Cancer Center, Fudan University, 270 Dongan Rd, Shanghai, 200032, China.
| | - Weijie Xing
- School of Nursing, Fudan University, 305 Fenglin Rd, Shanghai, 200032, China.
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Thom B, Friedman DN, Aviki EM, Benedict C, Watson SE, Zeitler MS, Chino F. The long-term financial experiences of adolescent and young adult cancer survivors. J Cancer Surviv 2023; 17:1813-1823. [PMID: 36472761 PMCID: PMC9734817 DOI: 10.1007/s11764-022-01280-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/17/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cancer-related financial hardship can negatively impact financial well-being and may prevent adolescent and young adult (AYA) cancer survivors (ages 15-39) from gaining financial independence. This analysis explored the financial experiences following diagnosis with cancer among AYA survivors. METHODS We conducted a cross-sectional, anonymous survey of a national sample of AYAs recruited online. The Comprehensive Score for Financial Toxicity (COST) and InCharge Financial Distress/Financial Well-Being Scale (IFDFW) assessed financial hardship (cancer-related and general, respectively), and respondents reported related financial consequences and financial coping behaviors (both medical and non-medical). RESULTS Two hundred sixty-seven AYA survivors completed the survey (mean 8.3 years from diagnosis). Financial hardship was high: mean COST score was 13.7 (moderate-to-severe financial toxicity); mean IFDFW score was 4.3 (high financial stress). Financial consequences included post-cancer credit score decrease (44%), debt collection contact (39%), spending more than 10% of income on medical expenses (39%), and lacking money for basic necessities (23%). Financial coping behaviors included taking money from savings (55%), taking on credit card debt (45%), putting off major purchases (45%), and borrowing money (42%). In logistic regression models, general financial distress was associated with increased odds of experiencing financial consequences and engaging in both medical- and non-medical-related financial coping behaviors. DISCUSSION AYA survivors face long-term financial hardship after cancer treatment, which impacts multiple domains, including their use of healthcare and their personal finances. Interventions are needed to provide AYAs with tools to navigate financial aspects of the healthcare system; connect them with resources; and create systems-level solutions to address healthcare affordability. IMPLICATIONS FOR CANCER SURVIVORS Survivorship care providers, particularly those who interact with AYA survivors, must be attuned to the unique risk for financial hardships facing this population and make efforts to increase access available interventions.
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Affiliation(s)
- Bridgette Thom
- Affordability Working Group, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Danielle N Friedman
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Emeline M Aviki
- Affordability Working Group, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Catherine Benedict
- Stanford University School of Medicine, Stanford Cancer Institute, Palo Alto, CA, USA
| | | | | | - Fumiko Chino
- Affordability Working Group, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Thom B, Arora N, Benedict C, Aviki EM, Chino F, Friedman DN, Watson SE, Zeitler MS. Using Real-World Data to Explore the Impact of One-Time Financial Grants Among Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2023; 12:912-917. [PMID: 37852000 PMCID: PMC10739788 DOI: 10.1089/jayao.2022.0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
Young adult (YA) cancer survivors experience worse financial outcomes than older survivors. This analysis used data from Expect Miracles Foundation to explore the impact of one-time financial grants on financial well-being and access to health care. Among 300 respondents, the average grant was $1526 (standard deviation = $587; range $300-$3000). Respondents reported improved ability to pay expenses (t = 4.45, p < 0.001), increased financial decision-making power (t = 2.79, p = 0.06), decreased medical debt impact (t = 2.1, p = 0.04), improved transportation access (t = 2.38, p = 0.02), and fewer challenges in accessing care (t = 3.0, p = 0.005) 6 months after receiving a financial grant. Financial assistance offers YAs an opportunity to meet medical and nonmedical expenses.
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Affiliation(s)
- Bridgette Thom
- Thom, Aviki, Friedman, Chino: Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Neha Arora
- Texas A&M School of Medicine, College Station, Texas, USA
| | - Catherine Benedict
- Stanford University School of Medicine, Stanford Cancer Institute, Palo Alto, California, USA
| | - Emeline M. Aviki
- Thom, Aviki, Friedman, Chino: Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Fumiko Chino
- Thom, Aviki, Friedman, Chino: Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Danielle N. Friedman
- Thom, Aviki, Friedman, Chino: Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Waters AR, Kaddas HK, van Thiel Berghuijs KM, Vaca Lopez PL, Warner EL, Ou JY, Ramsay JM, Palmer A, Ray N, Tsukamoto T, Fair DB, Lewis MA, Linder L, Gill D, Kirchhoff AC. COVID-19-Related Employment Disruptions and Increased Financial Burden Among Survivors of Adolescent and Young Adult Cancer. J Adolesc Young Adult Oncol 2023; 12:744-751. [PMID: 36951664 PMCID: PMC10623459 DOI: 10.1089/jayao.2022.0099] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
Background: Financial burden is a major concern for survivors of adolescent and young adult (AYA) cancers. We identified if employment disruptions during the COVID-19 pandemic affected AYA survivors' financial burden. Methods: AYAs who were enrolled in a cancer patient navigation program were e-mailed a survey in fall 2020. Survey items included sociodemographics, employment disruption, and two measures of financial burden: COmprehensive Score for Financial Toxicity (COST) and material and behavioral financial hardship items (for any reason, COVID-19 induced, cancer induced). Financial burden outcomes were dichotomized at the median (COST = 21; financial hardship = 3). The association of employment disruptions and sociodemographics with financial burden was assessed using multivariable logistic regression models. Results: Reduced hours/job loss was reported by 24.0% of 341 participants. Survivors with a high school education or less (odds ratio [OR]: 2.70; 95% confidence interval [CI]: 1.21-6.03) or who had decreased hours or job loss (OR: 3.97; 95% CI: 2.01-7.84) had greater odds for high financial toxicity. Reduced hours/job loss was the only factor associated with high material and behavioral financial hardship for both any reason (OR: 2.75; 95% CI: 1.41-5.33) and owing to COVID-19 (OR: 4.98; 95% CI: 2.28-10.92). Cancer treatment since March 2020 was associated with cancer-induced high material and behavioral financial hardship (OR: 3.31; 95% CI: 1.96-5.58). Conclusion: Employment disruptions owing to the COVID-19 pandemic, lower education levels, and cancer treatment were associated with high financial burden among AYA cancer survivors. Our findings suggest the need for multilevel interventions to identify and address financial burden among vulnerable cancer survivors.
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Affiliation(s)
- Austin R. Waters
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Heydon K. Kaddas
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | | | - Perla L. Vaca Lopez
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Echo L. Warner
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Judy Y. Ou
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
- Cancer Biostatistics Shared Resource, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Joemy M. Ramsay
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Alexandra Palmer
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Nicole Ray
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | | | - Douglas B. Fair
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
- Primary Children's Hospital, Salt Lake City, Utah, USA
- Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | | | - Lauri Linder
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
- Primary Children's Hospital, Salt Lake City, Utah, USA
| | - David Gill
- Intermountain Health, Salt Lake City, Utah, USA
| | - Anne C. Kirchhoff
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
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Ghazal LV, Wentzell K, Blanchette JE. Mobilizing Research to Understand the Impact of Financial Toxicity Among Adolescents and Young Adults Diagnosed With Chronic Diseases. J Adolesc Health 2023; 73:403-405. [PMID: 37389528 PMCID: PMC10697307 DOI: 10.1016/j.jadohealth.2023.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 07/01/2023]
Affiliation(s)
- Lauren V Ghazal
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, Ann Arbor, Michigan; Rogel Cancer Center, Ann Arbor, Michigan.
| | - Katherine Wentzell
- Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, Massachusetts
| | - Julia E Blanchette
- Center for Diabetes and Metabolic Care, Department of Medicine, University Hospitals, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio
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Wu VS, Benedict C, Friedman DN, Watson SE, Anglade E, Zeitler MS, Chino F, Thom B. Do discussions of financial burdens decrease long-term financial toxicity in adolescent and young adult cancer survivors? Support Care Cancer 2023; 31:434. [PMID: 37395811 DOI: 10.1007/s00520-023-07822-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/16/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE This study aims to evaluate the associations between patient-provider cost discussions with patient-reported out-of-pocket (OOP) spending and long-term financial toxicity (FT) among adolescent and young adult (AYA; 15-39 years old) cancer survivors. METHODS Using a cross-sectional survey, we assessed the themes and quality of patient discussions with providers about financial needs and general survivorship preparation, quantified patients' levels of FT, and evaluated patient-reported OOP spending. We determined the association between cancer treatment cost discussion and FT using multivariable analysis. In a subset of survivors (n = 18), we conducted qualitative interviews and used thematic analysis to characterize responses. RESULTS Two hundred forty-seven AYA survivors completed the survey at a mean of 7 years post treatment and with a median COST score of 13. 70% of AYA survivors did not recall having any cost discussion about their cancer treatment with a provider. Having any cost discussion with a provider was associated with decreased FT (β = 3.00; p = 0.02) but not associated with reduced OOP spending (χ2 = 3.77; p = 0.44). In a second adjusted model, with OOP spending included as a covariate, OOP spending was a significant predictor of FT (β = - 1.40; p = 0.002). Key qualitative themes included survivors' frustration about the lack of communication related to financial issues throughout treatment and in survivorship, feeling unprepared, and reluctance to seek help. CONCLUSION AYA patients are not fully informed about the costs of cancer care and FT; the dearth of cost discussions between patients and providers may represent a missed opportunity to reduce costs.
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Affiliation(s)
- Victoria S Wu
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Catherine Benedict
- Stanford University School of Medicine, Stanford Cancer Institute, Palo Alto, CA, USA
| | - Danielle N Friedman
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | | | - Fumiko Chino
- Affordability Working Group, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bridgette Thom
- Affordability Working Group, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
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Hassan AM, Chu CK, Liu J, Angove R, Rocque G, Gallagher KD, Momoh AO, Caston NE, Williams CP, Wheeler S, Offodile Ii AC. A nationwide cross-sectional study on the association of patient-level factors with financial anxiety in the context of chronic medical conditions. Sci Rep 2023; 13:10363. [PMID: 37365187 DOI: 10.1038/s41598-023-36282-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/31/2023] [Indexed: 06/28/2023] Open
Abstract
Patient-level characteristics associated with the prevalence and severity of financial anxiety have yet to be described. We conducted a cross-sectional analysis of survey data assessing financial anxiety in patients with chronic medical conditions in December 2020. 1771 patients (42.6% response rate) participated in the survey. Younger age (19-35 age compared to ≥ 75 age) (β, 5.86; 95% CI 2.10-9.63), male sex (β, - 1.9; 95% CI - 3.1 to - 0.73), Hispanic/Latino race/ethnicity (compared with White patients) (β, 2.55; 95% CI 0.39-4.71), household size ≥ 4 (compare with single household) (β, 4.54; 95% CI 2.44-6.64), household income of ≥ $96,000-$119,999 (compared with ≤ $23,999) (β, - 3.2; 95% CI - 6.3 to 0.04), single marital status (compared with married) (β, 2.18; 95% CI 0.65-3.71), unemployment (β, 2.07; 95% CI 0.39-3.74), high-school education (compared with advanced degrees) (β, 3.10; 95% CI 1.32-4.89), lack of insurance coverage (compared with private insurance) (β, 6.05; 95% CI 2.66-9.45), more comorbidities (≥ 3 comorbidities compared to none) (β, 2.95; 95% CI 1.00-4.90) were all independently associated with financial anxiety. Patients who are young, female, unmarried, and representing vulnerable sub-populations are at elevated risk for financial anxiety.
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Affiliation(s)
- Abbas M Hassan
- Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA
| | - Carrie K Chu
- Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA
| | - Jun Liu
- Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA
| | | | - Gabrielle Rocque
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Adeyiza O Momoh
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Nicole E Caston
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Courtney P Williams
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stephanie Wheeler
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anaeze C Offodile Ii
- Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA.
- Department of Health Policy Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Baker Institute for Public Policy, Rice University, Houston, TX, USA.
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Beauchemin MP, Roth ME, Parsons SK. Reducing Adolescent and Young Adult Cancer Outcome Disparities Through Optimized Care Delivery: A Blueprint from the Children's Oncology Group. J Adolesc Young Adult Oncol 2023; 12:314-323. [PMID: 36716260 PMCID: PMC10282820 DOI: 10.1089/jayao.2022.0136] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Achieving equitable, high-quality cancer care delivery across socioeconomically and biologically diverse populations requires multilevel interventions, including those at the patient, provider, institution, and policy levels that influence cost, quality, and access to care. For adolescent and young adults (AYAs), who experience suboptimal health outcomes compared with younger and older people with cancer, cancer care delivery is influenced by additional contextual factors unique to the patients' developmental stage, psychosocial and economic status, and cancer subtype. In this review, we highlight the most pressing research needs in AYA cancer care delivery and opportunities to improve outcomes for this population.
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Affiliation(s)
- Melissa P. Beauchemin
- School of Nursing, Columbia University Irving Medical Center, New York, New York, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York, USA
| | - Michael E. Roth
- Division of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Susan K. Parsons
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA
- Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
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Ghazal LV, Watson SE, Gentry B, Santacroce SJ. "Both a life saver and totally shameful": young adult cancer survivors' perceptions of medical crowdfunding. J Cancer Surviv 2023; 17:332-341. [PMID: 35169983 PMCID: PMC9378759 DOI: 10.1007/s11764-022-01188-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/10/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Young adults (YAs) diagnosed with cancer face high financial burden at a time in their lives when they are financially vulnerable. Some turn to medical crowdfunding, that is, using social media and other means to raise funds or resources to offset medical and usual life expenses. Major research gaps exist regarding the experiences of those who pursued crowdfunding. Thus, the study purpose was to describe the perceptions of, and experiences with, medical crowdfunding among a sample of YA cancer survivors. METHODS In February 2021, we distributed an online survey to YAs with a history of a cancer diagnosis, who had received grants from an organization that offers financial assistance. We calculated descriptive statistics on the crowdfunding sample and employed thematic analysis to analyze the open-ended questions. RESULTS In this sample (N = 113), 46 YA cancer survivors had engaged in medical crowdfunding and shared their perceptions and experiences. Our central theme, "The Crowdfunding Compromise" captures the trade-offs participants faced, which included subthemes of "crowdfunding as useful/helpful," "factors associated with crowdfunding success," and "questioning the why?". CONCLUSIONS Among YA cancer survivors, medical crowdfunding brings shame and stigma in addition to financial support. YA cancer survivors demonstrate resilience in their attempts to find individual solutions to financial problems created by unchecked health care costs, the US health insurance infrastructure, and lack of legislation. IMPLICATIONS FOR CANCER SURVIVORS This study fills an important gap in understanding individual-level crowdfunding experiences. Implications include system-level approaches to addressing cancer-related financial burden and potential worsening of existing disparities through medical crowdfunding.
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Affiliation(s)
- Lauren V Ghazal
- Center for Improving Patient and Population Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA.
- Rogel Cancer Center, University of Michigan Ann, Arbor, MI, USA.
| | | | | | - Sheila J Santacroce
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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12
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Di Giuseppe G, Pagalan L, Jetha A, Pechlivanoglou P, Pole JD. Financial toxicity among adolescent and young adult cancer survivors: A systematic review of educational attainment, employment, and income. Crit Rev Oncol Hematol 2023; 183:103914. [PMID: 36706969 DOI: 10.1016/j.critrevonc.2023.103914] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/17/2022] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To identify, evaluate and summarize the evidence on educational attainment, employment status and income of AYAs surviving cancer. METHODS A search of six databases for articles published between 01/01/2010 and 03/31/2022 was performed. Articles with an AYA survivorship population, quantitative design and a cancer-free comparator group were included. Data extraction was conducted, and quality appraisal was completed using ROBINS-I. Results were summarized using a narrative synthesis. RESULTS A total of 2801 articles were identified, of which 12 were included. Among the limited evidence, educational attainment did not differ from cancer-free peers. Survivors were more likely to be unemployed, have lower incomes and require social security for income supplementation. Evidence suggested that females, diagnosis of brain cancer and the presence of late-effects were among the risk factors for severe outcomes. CONCLUSIONS Limited socioeconomic evidence exists for AYAs surviving cancer. Long-lasting financial toxicities occur and highlights a need for further investigation.
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Affiliation(s)
- Giancarlo Di Giuseppe
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - Lief Pagalan
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Arif Jetha
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Work & Health, Toronto, Ontario, Canada
| | | | - Jason D Pole
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Centre for Health Sciences Research, University of Queensland, Brisbane, Australia
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Abstract
PURPOSE OF REVIEW There is a growing population of adolescent and young adult (AYA, ages 15-39 years) cancer patients and survivors, and the field of AYA oncology is rapidly evolving. Despite an increased focus on survival and quality of life for AYAs, gaps in knowledge remain. The current review focuses on what is known across several domains unique to AYA cancer care as well as areas of improvement and future directions in research and intervention. RECENT FINDINGS Due to the developmental stages included in the AYA age range, a cancer diagnosis and treatment can affect relationships, education and employment, finances, and long-term health differently than diagnoses in younger or older populations. Recent studies that have focused on these unique aspects of AYA cancer care, including health-related quality of life (HRQoL), fertility, financial toxicity, barriers to clinical trial enrollment, genetic predisposition, and survivorship care are included in the current review. SUMMARY Although studies have described many of the challenges faced by AYAs across the cancer continuum from diagnosis to survivorship, more work is needed, particularly in systematically measuring HRQoL, eliminating barriers to clinical trial enrollment, addressing financial toxicity, and increasing access to fertility preservation and high-quality survivorship care.
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Ragavan MV, Mora RV, Winder K, Incudine A, Cunningham R, Stivers T, Borno HT. Impact of a Comprehensive Financial Resource on Financial Toxicity in a National, Multiethnic Sample of Adult, Adolescent/Young Adult, and Pediatric Patients With Cancer. JCO Oncol Pract 2023; 19:e286-e297. [PMID: 36378994 DOI: 10.1200/op.22.00350] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Financial toxicity is a well-recognized problem for patients with cancer. However, a crucial gap remains in describing and implementing mitigation strategies. We conducted a national survey of a multiethnic adolescent/pediatric and adult patient population served by Family Reach, a nonprofit organization focused on removing financial barriers to cancer care, to evaluate the impact of a comprehensive financial resource on patient-reported financial toxicity. METHODS An electronic survey was administered to characterize patients' current financial health and the impact of Family Reach's resources on financial toxicity. The survey was e-mailed to all patients or caregivers who received resources from Family Reach between January 1, 2020, and June 30, 2020. Factors associated with higher financial stress and higher potential impact of resources on financial burden were evaluated through separate multivariate regression models. Qualitative responses were analyzed using manual coding and thematic analysis. RESULTS Three hundred thirty socioeconomically and racially diverse respondents (overall response rate 40%; 46% non-Hispanic White; 48% with incomes below the federal poverty line) completed the survey and were included in the analysis. More than half of respondents reported high financial stress in the previous week. Hispanic ethnicity, Black race, and low annual household income were associated with higher financial toxicity. A greater amount of financial assistance was associated with a higher confidence rating that resources provided would decrease financial stress. In open-ended comments, respondents highlighted the impact of the COVID-19 pandemic and resulting job loss on financial toxicity, the importance of financial navigation, the benefits of financial assistance, and anxiety about long-term financial health. CONCLUSION A comprehensive financial resource, particularly financial assistance, alleviated financial toxicity in a multiethnic national sample of patients with cancer. Ongoing work is critical to address sustainable funding sources and financial navigation to support patients during treatment and survivorship.
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Affiliation(s)
- Meera V Ragavan
- University of California, San Francisco, Department of Medicine, Division of Hematology/Oncology, San Francisco, CA
| | - Rosa V Mora
- University of California San Francisco, School of Medicine, San Francisco, CA
| | | | | | | | | | - Hala T Borno
- University of California, San Francisco, Department of Medicine, Division of Hematology/Oncology, San Francisco, CA.,Trial Library Inc, San Francisco, CA
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15
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Greater financial toxicity correlates with increased psychological distress and lower quality of life among Turkish cancer patients. Support Care Cancer 2023; 31:137. [PMID: 36700998 DOI: 10.1007/s00520-023-07586-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE This study aims to investigate the factors that influence financial toxicity and its effects on both quality of life and psychological distress in Turkish cancer patients. METHODS Data from 400 cancer patients receiving chemotherapy at a public university in Turkey was analyzed. The Comprehensive Score for Financial Toxicity (COST), Patient Health Questionnaire for Depression and Anxiety (PHQ-4), and Functional Assessment of Cancer Therapy-General (FACT-G) were used to measure financial toxicity, psychological distress, and health quality of life, respectively. RESULTS Patients' median COST score was 22 (SD = 10.1; range: 1-44) and was consistent with mild financial toxicity. Financial toxicity was associated with lower education level (p < 0.001), lower monthly income (p < 0.001), being a woman (p = 0.021), living in another city (p = 0.012), and previous cancer surgery (p = 0.02). A negative and statistically significant correlation was found between financial toxicity and quality of life (r = - 0.139; p = 0.005) and psychological distress (r = - 0.398; p < 0.001). CONCLUSION This investigation demonstrated that financial toxicity was a significant determinant of quality of life and psychological distress.
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16
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Hassan AM, Chu CK, Liu J, Angove R, Rocque G, Gallagher KD, Momoh AO, Caston NE, Williams CP, Wheeler S, Butler CE, Offodile AC. Determinants of telemedicine adoption among financially distressed patients with cancer during the COVID-19 pandemic: insights from a nationwide study. Support Care Cancer 2022; 30:7665-7678. [PMID: 35689108 PMCID: PMC9187333 DOI: 10.1007/s00520-022-07204-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/03/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Telemedicine use during the COVID-19 pandemic among financially distressed patients with cancer, with respect to the determinants of adoption and patterns of utilization, has yet to be delineated. We sought to systematically characterize telemedicine utilization in financially distressed patients with cancer during the COVID-19 pandemic. METHODS We conducted a cross-sectional analysis of nationwide survey data assessing telemedicine use in patients with cancer during the COVID-19 pandemic collected by Patient Advocate Foundation (PAF) in December 2020. Patients were characterized as financially distressed by self-reporting limited financial resources to manage out-of-pocket costs, psychological distress, and/or adaptive coping behaviors. Primary study outcome was telemedicine utilization during the pandemic. Secondary outcomes were telemedicine utilization volume and modality preferences. Multivariable and Poisson regression analyses were used to identify factors associated with telemedicine use. RESULTS A convenience sample of 627 patients with cancer responded to the PAF survey. Telemedicine adoption during the pandemic was reported by 67% of patients, with most (63%) preferring video visits. Younger age (19-35 age compared to ≥ 75 age) (OR, 6.07; 95% CI, 1.47-25.1) and more comorbidities (≥ 3 comorbidities compared to cancer only) (OR, 1.79; 95% CI, 1.13-2.65) were factors associated with telemedicine adoption. Younger age (19-35 years) (incidence rate ratios [IRR], 1.78; 95% CI, 24-115%) and higher comorbidities (≥ 3) (IRR; 1.36; 95% CI, 20-55%) were factors associated with higher utilization volume. As area deprivation index increased by 10 units, the number of visits decreased by 3% (IRR 1.03, 95% CI, 1.03-1.05). CONCLUSIONS The rapid adoption of telemedicine may exacerbate existing inequities, particularly among vulnerable financially distressed patients with cancer. Policy-level interventions are needed for the equitable and efficient provision of this service.
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Affiliation(s)
- Abbas M Hassan
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA
| | - Carrie K Chu
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA
| | - Jun Liu
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA
| | | | - Gabrielle Rocque
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Adeyiza O Momoh
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Nicole E Caston
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Courtney P Williams
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stephanie Wheeler
- Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charles E Butler
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA
| | - Anaeze C Offodile
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1488, Houston, TX, 77030, USA.
- Institute for Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Baker Institute for Public Policy, Rice University, Houston, TX, USA.
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Waters AR, Bybee S, Warner EL, Kaddas HK, Kent EE, Kirchhoff AC. Financial Burden and Mental Health Among LGBTQIA+ Adolescent and Young Adult Cancer Survivors During the COVID-19 Pandemic. Front Oncol 2022; 12:832635. [PMID: 35785163 PMCID: PMC9245943 DOI: 10.3389/fonc.2022.832635] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/25/2022] [Indexed: 11/20/2022] Open
Abstract
Background In the United States, the cost of cancer treatment can lead to severe financial burden for cancer survivors. The economic impacts of the COVID-19 pandemic compound cancer survivors' financial challenges. Financial burden may be particularly challenging for lesbian, gay, bisexual, transgender, queer, intersex, asexual and other sexual and gender minority (LGBTQIA+) survivors. LGBTQIA+ survivors who are adolescent and young adults (AYA) may face elevated financial burden due to multiple, intersecting identities. Methods An explanatory sequential mixed methods design was applied, beginning with a survey of AYA cancer survivors in the Mountain West region of the United States. Survey measures included demographics, COVID-19 impacts, the COmprehensive Score for financial Toxicity (COST), Perceived Stress Scale-4 (PSS-4), and PROMIS anxiety and depression scales. Two-way t-tests were used to analyze differences in outcomes between LGBTQIA+ and non-LGBTQIA+ AYAs. All LGBTQIA+ survey participants were invited to complete an interview, and those who agreed participated in descriptive interviews about financial burden due to cancer, COVID-19, and LGBTQIA+ identity. Interviews were audio recorded, transcribed, and analyzed using Dedoose. Results Survey participants (N=325) were LGBTQIA+ (n=29, 8.9%), primarily female (n= 197, 60.6%), non-Hispanic White (n= 267, 82.2%), and received treatment during COVID-19 (n= 174, 54.0%). LGBTQIA+ interview participants (n=9, 100%) identified as a sexual minority and (n=2, 22.2%) identified as a gender minority. Most were non-Hispanic White (n=6, 66.7%) and had received treatment during COVID-19 (n=7, 77.8%). Statistical analyses revealed that LGBTQIA+ AYAs reported significantly worse COST scores than non-LGBTQIA+ AYAs (p=0.002). LGBTQIA+ AYAs also reported significantly higher PSS-4 (p=0.001), PROMIS anxiety (p=0.002) and depression scores (p<0.001) than non-LGBTQIA+ AYAs, reflecting worse mental health outcomes. High costs of cancer treatment and employment disruptions due to COVID-19 contributed to substantial financial stress, which exacerbated existing mental health challenges and introduced new ones. Conclusions LGBTQIA+ AYA survivors reported substantial financial burden and psychological distress exacerbated by cancer, the COVID-19 pandemic, and LGBTQIA+ stigma. Given their multiple intersecting identities and potential for marginalization, LGBTQIA+ AYA survivors deserve prioritization in research to reduce financial burden and poor mental health.
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Affiliation(s)
- Austin R. Waters
- Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, UT, United States
- Department of Health Policy & Management, Gilling’s School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, United States
| | - Sara Bybee
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Echo L. Warner
- Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, UT, United States
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Heydon K. Kaddas
- Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Erin E. Kent
- Department of Health Policy & Management, Gilling’s School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, United States
| | - Anne C. Kirchhoff
- Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, UT, United States
- Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
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"Now everybody is thinking about things like that.": Young Adult Cancer Survivors Reimagining Work During the COVID-19 Pandemic. Nurs Res 2021; 71:153-157. [PMID: 34818265 DOI: 10.1097/nnr.0000000000000567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Diagnosed between ages 20-39, young adult (YA) cancer survivors have faced disruption to their lives well before the COVID-19 pandemic. Often seen as an at-risk population within cancer survivors, YAs experience the demands of a serious illness, such as cancer, alongside meeting the typical milestones of young adulthood and often have worse quality of life than their non-cancer peers. There is a need to further study the effect of the COVID-19 pandemic on specific populations, including YA cancer survivors (YACS), as it relates to work. OBJECTIVES Explore working YACS' experiences during the COVID-19 pandemic and identify facets of cancer survivorship that researchers can use to explore COVID-19 survivorship further. METHODS Secondary thematic analysis of 40 semistructured, qualitative interviews conducted through Zoom audio during the COVID-19 pandemic. YA hematologic cancer survivors were recruited through social media; they were eligible if they had completed active therapy, were within 5 years of their diagnosis, and working at the time of diagnosis. Interviews were transcribed verbatim and subjected to thematic content analysis. RESULTS Themes surrounded COVID's influence on working YACS' experiences, with the overarching theme: "From solo to shared experience: A change in awareness and understanding." A subtheme was "Lesson reaffirmed: Reimagining the work environment." DISCUSSION The consequences of COVID-19 on the overall quality of life for YACS are multilevel. Establishing the evidence for effective interventions to support YACS in the workplace, whether physical or virtual, is critically needed. Research is needed on YACS' risk and resilience factors that could ultimately impact future health and quality of life.
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