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Impact of objective financial burden and subjective financial distress on spiritual well-being and quality of life among working-age cancer survivors

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Abstract

Purpose

To assess objective financial burden (OFB) and subjective financial distress (SFD) amikong working-age cancer survivors and evaluate their association with spiritual well-being and health-related quality of life (HRQoL).

Methods

This is a multicenter cross-sectional survey of cancer survivors working at diagnosis between 2017 and 2018. OFB was defined as patients with high medical payments for individuals/households, debt due to cancer care costs, or bankruptcy. SFD was measured using a questionnaire. Fear of cancer recurrence (FCR), spiritual well-being, and HRQoL were also assessed.

Results

Among 727 participants, 31% reported that they experienced financial toxicity, and 12% and 26% had OFB and SFD, respectively. The No-OFB-SFD, OFB-No-SFD, and OFB-SFD groups were 4.90, 1.82, and 7.81 times more likely to experience uncertainty than the No-OFB-No-SFD group. Furthermore, the No-OFB-SFD, OFB-No-SFD, and OFB-SFD groups were 1.92, 1.35, and 2.53 times more likely to report lost purpose of life, respectively. Overall QoL and health status in the No-OFB-No-SFD, No-OFB-SFD, OFB-No-SFD, and OFB-SFD groups were 63.1, 42.9, 57.0, and 41.2, respectively. Survivors who had SFD regardless of OFB had lower HRQoL and functioning, and higher symptoms than those of the survivors without SFD.

Conclusion

Financial toxicity was associated with FCR, uncertainty, loss of purpose, and loss of hope among working-age cancer survivors, even in a universal care setting. It is associated with FCR, uncertainty, loss of purpose, and loss of hope. It is necessary to inform survivors of the financial implications of cancer care to allow them to prepare financially as needed.

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Data availability

The data that support the findings of this study are available from the corresponding author (JC) reasonable request.

Code availability

The code that supports the findings of this study is available from the corresponding author (JC) reasonable request.

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Acknowledgements

Additionally, we would like to thank Editage (www.editage.co.kr) for English language editing.

Funding

This study was supported by a grant from the National R&D Program for Cancer Control of the Ministry of Health and Welfare of the Republic of Korea (no. 1720220).

Author information

Authors and Affiliations

  1. Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, 06355, Korea

    Danbee Kang, Nayeon Kim & Juhee Cho

  2. Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, South Korea

    Danbee Kang, Jihyun Lim, Sungkeun Shim & Juhee Cho

  3. National Cancer Control Institute, National Cancer Center, Goyang, 10408, South Korea

    Ka Ryeong Bae

  4. Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea

    Nayeon Kim & Juhee Cho

  5. Department of Digital Health, Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, 06355, South Korea

    Sungkeun Shim & Juhee Cho

  6. Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, 34134, Korea

    Sun Seog Kweon

  7. Medical Informatics and Health Technology (MIT), Department of Health Care Management, College of Social Science, Gachon University, Seongnam-si, Gyeonggi-do, 13120, South Korea

    Hwa Jeong Seo

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  1. Danbee Kang
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Contributions

Conception and design: Ka Ryeong Bae, Danbee Kang, Sungkeun Shim, Nayeon Kim, Juhee Cho

Financial support: Juhee Cho

Collection and assembly of data: Ka Ryeong Bae, Sungkeun Shim, Sun-Seog Kweon

Data analysis and interpretation: Danbee Kang, Jihyun Im, Juhee Cho

Manuscript writing: Danbee Kang, Hwa Jeong Seo, Juhee Cho

Final approval of manuscript: Hwa Jeong Seo, Juhee Cho

Corresponding authors

Correspondence to Hwa Jeong Seo or Juhee Cho.

Ethics declarations

Ethics approval

The study was approved by the Institutional Review Board of Samsung Medical Center (IRB 2017–05-166) and Chonnam National University Hospital (IRB TMP-2017–118).

Consent to participate

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

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Patients signed informed consent regarding publishing their data.

Conflict of interest

The authors declare no competing interests.

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Kang, D., Bae, K., Lim, J. et al. Impact of objective financial burden and subjective financial distress on spiritual well-being and quality of life among working-age cancer survivors. Support Care Cancer 30, 4917–4926 (2022). https://doi.org/10.1007/s00520-022-06906-w

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  • DOI: https://doi.org/10.1007/s00520-022-06906-w

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