ASPO Abstracts
Financial Distress and its Associated Burden in Couples Coping with an Incurable Cancer
Category: Financial Hardship Associated with Cancer
Conference Year: 2020
Abstract Body:
Although financial toxicity has been linked to poor disease outcomes in cancer patients, the associations between subjective financial distress (FD) and symptom burden and quality of life (QOL) are rarely examined from a patient-partner dyadic perspective. Thus, this cross-sectional study seeks to examine dyadic associations in couples coping with an incurable cancer.
Method: Patients undergoing systemic and/or radiotherapy for advanced lung cancer (n=50) or high grade glioma (n=50) and their spouses/romantic partners completed measures of psychological distress (BSI-18), symptom severity including FD (ESAS, 0-10 scale), QOL (PROMIS-10), relationship wellbeing (SRI), and avoidance (AAQ-2).
Results: Patients were mainly female (60%), and patients and partners were all in a heterosexual relationship (mean length: 30.12 +/- 15.1 yrs), mainly non-Hispanic White (80%), married to each other (93%) and well educated with a mean age of 57.9 years (range: 28.5-79.0 years). FD was interrelated in couples (ICC=.53, P<.0001), and mean score did not significantly differ by role (patient=2.32 vs partner=2.81). Controlling for medical and demographic factors, based on dyadic level analyses, FD was significantly associated with physical QOL (P=.01) so that those with higher FD reported lower QOL. Interestingly, FD was significantly associated with psychological distress (P=.001), mental QOL (P<.001), avoidance (P=.01), and relationship wellbeing (P=.03) for partners but not for patients so that partners reporting higher FD had worse health and wellbeing. Moreover, in terms of relative burden, FD was the 7th (out of 12) most severe symptom for patients, and the 2nd most severe symptom for partners (after sleep disturbances). Based on concordance analyses, patients significantly underestimated their partners' FD (P=.007), which was further associated with increased partner psychological distress (P=.04).
Conclusion: Although FD is interdependent in couples coping with an incurable cancer, FD appears to be a greater relative burden for partners than patients. In the palliative care setting, reducing FD may be an important target for caregiver interventions seeking to improve their health and wellbeing and reduce the overall cancer burden.
Keywords: Couples, financial distress, psychological distress, quality of life