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Characteristics associated with inter-individual variability in financial distress in patients with breast cancer prior to and for 12 months following surgery

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Abstract

Purpose

To evaluate for inter-individual differences in financial distress and identify demographic, clinical, and symptom characteristics associated with higher levels of financial distress.

Methods

Patients (n = 387) were enrolled prior to breast cancer surgery and followed for 12 months. Financial distress was measured using a 0 (no problem) to 10 (severe problem) numeric rating scale. Hierarchical linear modeling was used to evaluate for inter-individual differences in trajectories of financial distress and characteristics associated with financial distress at enrollment and over 12 months.

Results

Patients’ mean age was 55.0 (± 11.7) years and the majority underwent breast conservation surgery (80.6%). Mean financial distress score prior to surgery was 3.3 (± 3.4; range 0 to 10). Unconditional model for financial distress demonstrated no significant changes over time (-0.006/month). Younger age, lower income, receipt of an axillary lymph node dissection and adjuvant chemotherapy, and lower attentional function were associated with higher preoperative levels of financial distress.

Conclusion

Risk factors identified in this study can be used to inform clinicians regarding the need to initiate financial discussions and social work referrals for some patients. Additional clinical or system level interventions should be considered for vulnerable groups with these risk factors.

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Data availability

Not applicable.

Code availability

Analyses were conducted using SPSS 27.0 (IBM Corporation, Armonk, NY).

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Acknowledgements

The Oncology Nursing Foundation provided funding for this project. The original study was funded by grants from the National Cancer Institute (NCI, CA107091 and CA118658). Dr. Miaskowski is an American Cancer Society Clinical Research Professor and has a K05 award from the NCI (CA168960). This project was supported by NIH/NCRR UCSF-CTSI Grant Number UL1 RR024131. The Australian National Health and Medical Research Council provides salary for Dr. Chan (APP1194051). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health, the Oncology Nursing Foundation, or the National Health and Medical Research Council.

Funding

This study was funded by Oncology Nursing Foundation. The original study was funded by grants from the National Cancer Institute (NCI, CA107091 and CA118658). Dr. Miaskowski is an American Cancer Society Clinical Research Professor. This project was supported by NIH/NCRR UCSF-CTSI Grant Number UL1 RR024131. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health or the Oncology Nursing Foundation.

Author information

Authors and Affiliations

  1. Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA5042, Australia

    Raymond Javan Chan

  2. School of Nursing, Queensland University of Technology, Kelvin Grove, Australia

    Raymond Javan Chan & Louisa Gordon

  3. Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, QLD, Australia

    Raymond Javan Chan

  4. School of Nursing, University of California, San Francisco, San Francisco, CA, USA

    Bruce Cooper, Steven M. Paul, Kord M. Kober & Christine Miaskowski

  5. Flinders Centre for Innovation in Cancer, Flinders Medical Centre, Flinders University, Bedford Park, Australia

    Bogda Koczwara

  6. Department of Clinical Pharmacy Practice, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, CA, USA

    Alexandre Chan

  7. Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore

    Chia Jie Tan

  8. Department of Pharmacy, National Cancer Centre, Singapore, Singapore

    Chia Jie Tan

  9. QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia

    Louisa Gordon

  10. School of Medicine, Stanford University, Stanford, CA, USA

    Laura B. Dunn

  11. School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA

    Yvette P. Conley

  12. School of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Gary Abrams & Jon D. Levine

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  1. Raymond Javan Chan
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Contributions

All authors contributed to the study conception, design, and manuscript writing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Raymond Javan Chan.

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Ethics approval

Approval was attained by the Committee on Human Research at the University of California, San Francisco and by the Institutional Review Board at each of the study sites. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Chan, R.J., Cooper, B., Koczwara, B. et al. Characteristics associated with inter-individual variability in financial distress in patients with breast cancer prior to and for 12 months following surgery. Support Care Cancer 30, 1293–1302 (2022). https://doi.org/10.1007/s00520-021-06524-y

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