The impact of financial toxicity on psychological well-being, coping self-efficacy, and cost-coping behaviors in young adults with cancer Journal Article


Authors: Thom, B.; Benedict, C.
Article Title: The impact of financial toxicity on psychological well-being, coping self-efficacy, and cost-coping behaviors in young adults with cancer
Abstract: Purpose: The increase in cost-sharing between patients and payers has resulted in financial toxicity in cancer patients, particularly among young adult (YA) patients and survivors (<40 years of age). This study explored financial toxicity and its impact on psychological well-being, self-efficacy for coping with cancer, and cost-coping behaviors among a sample of YA cancer patients and survivors. Methods: One hundred forty YAs completed an anonymous online survey. The Comprehensive Score for Financial Toxicity measured financial toxicity and the Cancer Behavior Inventory-Brief measured coping self-efficacy. The Patient Health Questionnaire-4 and items from the Impact of Cancer-Young Adult and the Cancer Needs Questionnaire-Young People assessed psychological well-being. A single item assessed cost-coping behaviors (i.e., skipping or delaying treatment because of its cost). Analyses included Pearson and Spearman correlation matrices and multivariate regression modeling. Results: Worse financial toxicity was associated with lower insurance satisfaction (r = 0.52, p < 0.001), higher levels of depressive and anxiety symptoms (r = -0.42, p < 0.001), greater worry (p < 0.001), and lower self-efficacy in coping with cancer (i.e., maintaining independence and a positive attitude, r = 0.41, p < 0.001; coping and stress management, r = 0.43, p < 0.001; and managing negative effect, r = 0.20, p = 0.02). In multivariate modeling, financial toxicity related to skipping or delaying treatment and greater anxiety and depression symptomology, controlling for relevant covariates. Conclusion: The findings suggest financial toxicity negatively impacts many facets of the YA cancer experience. There is a need to address the cost of cancer care with patients to ensure they are informed about the financial implications of treatment decisions and to support financial planning as needed. © Copyright 2019, Mary Ann Liebert, Inc., publishers 2019.
Keywords: survivorship; mental health; financial toxicity; cost-coping behaviors
Journal Title: Journal of Adolescent and Young Adult Oncology
Volume: 8
Issue: 3
ISSN: 2156-5333
Publisher: Mary Ann Liebert, Inc  
Date Published: 2019-06-01
Start Page: 236
End Page: 242
Language: English
DOI: 10.1089/jayao.2018.0143
PUBMED: 30817217
PROVIDER: scopus
PMCID: PMC6588118
DOI/URL:
Notes: Source: Scopus
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  1. Bridgette Thom
    95 Thom