Self-reported determinants for subjective financial distress: a qualitative interview study with German cancer patients
Objectives Patient-reported financial effects of a tumour disease in a universal healthcare setting are a multidimensional phenomenon. Actual and anticipated objective financial burden caused by direct medical and non-medical costs as well as indirect costs such as loss of income can lead to subject...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
January 28, 2025
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| In: |
BMJ open
Year: 2025, Volume: 15, Pages: 1-9 |
| ISSN: | 2044-6055 |
| DOI: | 10.1136/bmjopen-2023-081432 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1136/bmjopen-2023-081432 Verlag, kostenfrei, Volltext: https://bmjopen.bmj.com/content/15/1/e081432 
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| Author Notes: | Andrea Züger, Viktoria Mathies, Katja Mehlis, Sophie Pauge, Luise Richter, Bastian Surmann, Thomas Ernst, Natalja Menold, Wolfgang Greiner, Eva Winkler |
| Summary: | Objectives Patient-reported financial effects of a tumour disease in a universal healthcare setting are a multidimensional phenomenon. Actual and anticipated objective financial burden caused by direct medical and non-medical costs as well as indirect costs such as loss of income can lead to subjective financial distress. To better understand subjective financial distress, the presented study explores self-reported determinants for subjective financial distress in German patients with cancer, aiming to inform a new German-language patient-reported outcome measure for determining the financial effects of a tumour disease. - Design Semistructured interviews with n=18 patients with cancer were conducted between May 2021 and December 2021. Patients were recruited based on a purposive sampling strategy in outpatient and inpatient settings. The interviews were audiorecorded, transcribed verbatim and analysed using qualitative content analysis. - Setting Participants were recruited from two German academic cancer centres, that is, the National Center for Tumor Diseases Heidelberg and Jena University Hospital. - Participants 18 patients who had undergone cancer-related therapy for at least 2 months were interviewed (10 females). - Results Based on the results of the qualitative content analysis, we developed a multicomponent construct of determinants that could influence subjective financial distress. The self-reported determinants can be classified into material (savings, good salary, shared rent through shared living, employed partner, paid-off house, potential financial support from family and friends, work-related specifics, consumer restrictions, out-of-pocket-costs and anticipated financial changes), social (social support from friends and family), systemic (administrative hurdlers and insurance cover) and inner personal determinants (coping strategies, change of attitude, character traits). - Conclusion Subjective financial distress depends not only on material but also on social, systemic and inner personal determinants. Knowledge of these determinants can inform a new comprehensive German-language instrument for measuring self-reported financial effects of a tumour disease. - Trial registration number NCT05319925. |
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| Item Description: | Gesehen am 01.08.2025 |
| Physical Description: | Online Resource |
| ISSN: | 2044-6055 |
| DOI: | 10.1136/bmjopen-2023-081432 |