Financial difficulties are associated with greater total pain and suffering among patients with advanced cancer : results from the COMPASS study
BACKGROUND: The Universal Health Coverage goals call for access to affordable palliative care to reduce inequities in "total pain" and suffering. To achieve this, a patient-centred understanding of these inequities is required.
AIM: To assess association of total pain and suffering (i.e. physical, psychological, social, and spiritual health outcomes) and perceived health care quality with financial difficulties among stage IV solid malignancy patients.
DESIGN: Using baseline data from the COMPASS cohort study, we assessed total pain and suffering including physical (physical and functional well-being, pain, symptom burden), psychological (anxiety, depression, emotional well-being), social (social well-being), and spiritual (spiritual well-being, hope) outcomes and perceived health care quality (physician communication, nursing care, and coordination/responsiveness). Financial difficulties were scored by assessing patient perception of the extent to which their resources were meeting expenses for their treatments, daily living, and other obligations. We used multivariable linear/logistic regression to test association between financial difficulties and each patient-reported outcome.
SETTING/PARTICIPANTS: Six hundred stage IV solid malignancy patients in Singapore.
RESULTS: Thirty-five percent reported difficulty in meeting expenses. A higher financial difficulties score was associated with worse physical, psychological, social, spiritual outcomes, and lower perceived quality of health care coordination and responsiveness (i.e. greater total pain and suffering) (all p < 0.05). These associations persisted after adjustment for socio-economic indicators.
CONCLUSION: Results identify advanced cancer patients with financial difficulties to be a vulnerable group with greater reported total pain and suffering. A holistic patient-centred approach to care at end-of-life may help meet goals for Universal Health Coverage.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
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| Enthalten in: |
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer - 28(2020), 8 vom: 12. Aug., Seite 3781-3789 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Malhotra, Chetna [VerfasserIn] |
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| Links: |
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| Themen: |
Cancer |
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| Anmerkungen: |
Date Completed 06.08.2020 Date Revised 06.08.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00520-019-05208-y |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM304339776 |
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| 100 | 1 | |a Malhotra, Chetna |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Financial difficulties are associated with greater total pain and suffering among patients with advanced cancer |b results from the COMPASS study |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Revised 06.08.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The Universal Health Coverage goals call for access to affordable palliative care to reduce inequities in "total pain" and suffering. To achieve this, a patient-centred understanding of these inequities is required | ||
| 520 | |a AIM: To assess association of total pain and suffering (i.e. physical, psychological, social, and spiritual health outcomes) and perceived health care quality with financial difficulties among stage IV solid malignancy patients | ||
| 520 | |a DESIGN: Using baseline data from the COMPASS cohort study, we assessed total pain and suffering including physical (physical and functional well-being, pain, symptom burden), psychological (anxiety, depression, emotional well-being), social (social well-being), and spiritual (spiritual well-being, hope) outcomes and perceived health care quality (physician communication, nursing care, and coordination/responsiveness). Financial difficulties were scored by assessing patient perception of the extent to which their resources were meeting expenses for their treatments, daily living, and other obligations. We used multivariable linear/logistic regression to test association between financial difficulties and each patient-reported outcome | ||
| 520 | |a SETTING/PARTICIPANTS: Six hundred stage IV solid malignancy patients in Singapore | ||
| 520 | |a RESULTS: Thirty-five percent reported difficulty in meeting expenses. A higher financial difficulties score was associated with worse physical, psychological, social, spiritual outcomes, and lower perceived quality of health care coordination and responsiveness (i.e. greater total pain and suffering) (all p < 0.05). These associations persisted after adjustment for socio-economic indicators | ||
| 520 | |a CONCLUSION: Results identify advanced cancer patients with financial difficulties to be a vulnerable group with greater reported total pain and suffering. A holistic patient-centred approach to care at end-of-life may help meet goals for Universal Health Coverage | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cancer | |
| 650 | 4 | |a Cancer pain | |
| 650 | 4 | |a Health status disparities | |
| 650 | 4 | |a Palliative care | |
| 650 | 4 | |a Patient-centred care | |
| 650 | 4 | |a Patient-reported outcomes | |
| 650 | 4 | |a Social class | |
| 650 | 4 | |a Survey | |
| 700 | 1 | |a Harding, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Teo, Irene |e verfasserin |4 aut | |
| 700 | 1 | |a Ozdemir, Semra |e verfasserin |4 aut | |
| 700 | 1 | |a Koh, Gerald C H |e verfasserin |4 aut | |
| 700 | 1 | |a Neo, Patricia |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Lai Heng |e verfasserin |4 aut | |
| 700 | 1 | |a Kanesvaran, Ravindran |e verfasserin |4 aut | |
| 700 | 1 | |a Finkelstein, Eric |e verfasserin |4 aut | |
| 700 | 0 | |a COMPASS Study team |e verfasserin |4 aut | |
| 700 | 1 | |a Dent, R A |e investigator |4 oth | |
| 700 | 1 | |a Kumarakulasinghe, N B |e investigator |4 oth | |
| 700 | 1 | |a Malhotra, R |e investigator |4 oth | |
| 700 | 1 | |a Cheung, Y B |e investigator |4 oth | |
| 700 | 1 | |a Nadkarni, N |e investigator |4 oth | |
| 700 | 1 | |a Yee, A C P |e investigator |4 oth | |
| 700 | 1 | |a Yang, G M |e investigator |4 oth | |
| 700 | 1 | |a Chan, N |e investigator |4 oth | |
| 700 | 1 | |a Yeo, W L |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer |d 1994 |g 28(2020), 8 vom: 12. Aug., Seite 3781-3789 |w (DE-627)NLM07487618X |x 1433-7339 |7 nnns |
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