Stakeholder-informed conceptual framework for financial burden among adolescents and young adults with cancer
Suzanne C Danhauer, Mollie Canzona, Reginald D Tucker-Seeley, Bryce B Reeve, Chandylen L Nightingale, Dianna S Howard, Nicole Puccinelli-Ortega, Denisha Little-Greene, John M Salsman, Suzanne C Danhauer, Mollie Canzona, Reginald D Tucker-Seeley, Bryce B Reeve, Chandylen L Nightingale, Dianna S Howard, Nicole Puccinelli-Ortega, Denisha Little-Greene, John M Salsman
Abstract
Background: Cancer and its treatments can result in substantial financial burden that may be especially distressing for adolescents and young adults (AYAs) since they are at a developmental stage focused on completing one's education and establishing independence. The purpose of this study was to develop a conceptual model of financial burden among AYA cancer patients to inform development of a financial burden measure.
Methods: In-depth concept elicitation interviews were conducted with a purposive-selected stakeholder sample (36 AYAs and 36 AYA oncology health care providers). The constant comparative method was used to identify themes that illustrate AYAs' experience of financial burden by stakeholder groups.
Results: Eleven financial burden themes emerged: (1) impact of socioeconomic status and age; (2) significant cancer costs; (3) indirect cost "ripple effects"; (4) limited awareness of costs (adolescents); (5) emotional impact; (6) feeling overwhelmed navigating the health care system; (7) treatment decision modifications; (8) reducing spending; (9) coping strategies; (10) financial support; and (11) long-lasting impact. The conceptual model highlights the importance of material, psychosocial, and behavioral domains of financial burden with an emphasis on phase along the cancer continuum and developmental stage in the experience of financial burden for AYAs.
Conclusions: Issues presented in the voice of AYA patients and providers highlight the profound impact of financial burden in this survivor group. The next step in this work will be to develop and test a patient-reported measure of financial burden among AYA cancer survivors.
Keywords: adolescent; adolescent and young adult oncology; cancer; financial burden; financial distress; financial toxicity; oncology; psycho-oncology; stakeholder input; young adult.
Conflict of interest statement
CONFLICTS OF INTEREST
The authors have no conflicts of interest, financial or otherwise, related to the content of this manuscript.
© 2021 John Wiley & Sons Ltd.
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Source: PubMed