Financial toxicity in cancer: a concept analysis.

Details

• Personal Author:
  Ghazal L ; Gormley M ; Merriman J ; Santacroce S ; Ghazal L ; Gormley M ; Merriman J ; Santacroce S
• Description:
  Background: Cancer is one of the most expensive medical conditions to treat in the United States, and cancer patients and survivors experience more financial issues related to their treatment than those with any other illness. Financial toxicity is a concept that has been used in reference to the financial burden experienced by individuals with chronic illnesses and their caregivers. Across cancer types, financial toxicity is may result in sub-optimal coping and reduced quality of life. The term financial toxicity as applied to cancer populations was introduced in 2013, and, since its introduction, the number of articles using the term has increased considerably, suggesting both the significance of the problem and that we have not captured the breadth of the phenomenon and its consequences for cancer patients and survivors, and their caregivers. A key barrier to improving our understanding of how financial toxicity can affect care and quality of life outcomes for cancer patients and survivors and their caregivers is an unclear accepted definition of financial toxicity. Purpose: To analyze the concept of financial toxicity due to cancer and its treatment. Methods: Rodgers' evolutionary method guided the concept analysis. Searches of PubMed, CINAHL, EMBASE, and PsychINFO were conducted to identify papers that informed the concept analysis. Specific surrogate and related terms, antecedents, attributes and consequences were determined and categorized to display patterns and extract themes identified in the literature. Results: Across all age groups of cancer survivors, we identified cancer diagnosis and treatment as antecedents. No surrogate terms were identified but several related terms emerged, including financial or economic hardship, vulnerability, calamity, distress, and burden. Attributes are described as both objective financial burden and subjective financial distress. Consequences included poor treatment adherence, decreased retention in care, bankruptcy, poorer care outcomes, and decreased quality of life. Conclusions/Implications: Oncology nurse clinicians and researchers must recognize that the diagnosis and treatment of cancer create risk for financial toxicity. Health care providers should initiate conversations on treatment costs and identify resources to mitigate costs, such as financial navigators. Future research should include developing a financial toxicity screener to identify patients at high risk, and developing and testing interventions to address this harmful effect of cancer treatment. Further, researchers should investigate how organizations whose patients report lower levels of financial toxicity contribute to those outcomes with an eye towards developing policy proposals to reduce this burden. [Description provided by NIOSH]
• Subjects:
  Chronic Disease Delivery Of Health Care Economics Health Personnel Occupational Health Safety
• Keywords:
  Cancer survivors; Costs; Economic consequences; Chronic diseases; Medical care; Health care workers; Policy
• ISSN:
  0029-6562
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Abstract or Summary ; Abstract or Summary
• Place as Subject:
  New York ; North Carolina ; OSHA Region 2 ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH) ; National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health ; Workplace Safety & Health
• Location:
  North America ; North America
• Volume:
  69
• Issue:
  3
• NIOSHTIC Number:
  nn:20065828
• Citation:
  Nurs Res 2020 May/Jun; 69(3):E42
• Federal Fiscal Year:
  2020
• Performing Organization:
  Mount Sinai School of Medicine
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Nursing Research. Eastern Nursing Research Society 2020 Conference: 32nd ENRS Annual Scientific Sessions, April 2, 2020, virtual event
• End Date:
  20270630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a0d16e7a734f56e8fa25c47624fd3020d89b64dbf459ca47777de35b2a796c271517ee19acf0c38d1f82fdee081f1f5000280f4f1312d6b4d29b1192c28c7d8e
• Download URL:
  https://stacks.cdc.gov/view/cdc/248888/cdc_248888_DS1.pdf
• File Type:
  [PDF - 90.92 KB ]