Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

Financial Hardship Factors affecting the Cancer Patient's Quality of Life

암 환자의 삶의 질에 영향을 미치는 재정 관련 어려움 요인

  • Rhee, Young-Sun (Division of Administration & Social Welfare, Chosun University) ;
  • Kim, Su-Yeon (Department of Social Welfare, Graduate School of Chosun University) ;
  • Park, Jeong-Hwan (Department of Nursing, Chosun University)
  • 이영선 (조선대학교 행정복지학부) ;
  • 김수연 (조선대학교 대학원 사회복지학과) ;
  • 박정환 (조선대학교 간호학과)
  • Received : 2020.08.19
  • Accepted : 2020.10.05
  • Published : 2020.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to investigate the financial hardships affecting the quality of life of cancer survivors. Method: Data were collected from five convalescent hospitals using self-administered questionnaires, and 422 questionnaires were used for the final analysis. We used a 5-step hierarchical multiple-regression analysis by entering each sociodemographic variable, medical variable, and three types of financial hardship (a material situation, the psychological response, and coping behavior coming from cancer treatment cost) into each step. Results: The results of statistical analysis indicate that the most influential factor in the quality of life was the financial difficulty, which was the frustration that they could not work as usual or support their family financially. In addition, the performance of physical activity, accompanying diseases, women patients, psychological burden on cancer treatment cost, the satisfaction of communication with medical staff for medical expenses, and the feeling unsuccessful financial coping strategy were predictors for the quality of life of cancer survivors. Conclusion: This study provides a blueprint for the development of intervention programs in practice to improve the quality of life of cancer patients, clinical intervention plans, and health policies.

연구목적: 본 연구는 암 환자의 삶의 질에 영향을 미치는 재정 관련 어려움 요인을 찾고자 수행하였다. 방법: 연구대상은 항암, 방사선 치료 경험이 있는 암 환자이며, 종속변수는 삶의 질, 독립변인은 인구사회학적 요소, 의료적 상황, 재정관련 어려움(암 치료비로 인한 물질적 상황, 심리적 반응, 대처행동)을 변인으로 하여 모형을 구성하였다. 자료수집은 자기기입식 설문지를 활용, 5개 요양병원에서 수집하였으며, 422부의 설문지를 분석에 사용하였다. 분석방법은 인구사회학적, 의료적 변인과 함께, 세 유형으로 분류한 재정관련 어려움 변인을 각각 단계적으로 투입하여 5단계로 위계적 다중 회귀분석 하였다. 결과: 삶의 질에 가장 영향력이 큰 요인은 평소처럼 일할 수 없거나, 가계에 도움이 될 수 없다는 좌절감이었으며, 신체활동수행정도가 나쁠수록, 동반질환이 있는 경우, 여자인 경우, 암 치료비에 대한 심리적 부담감이 클 경우, 치료비용에 대한 의료진과 의사소통 만족도가 낮을 경우, 경제적 상황에 대해 잘 관리되고 있다고 느끼지 못하는 경우, 삶의 질이 나쁜 것으로 나타났다. 결론: 본 연구결과가 암 환자 삶의 질 향상을 위한 실천 현장의 중재 프로그램 개발, 임상적 개입방안 및 관련 정책 방안 마련을 위한 근거로 활용되길 기대한다.

Keywords

References

  1. World Health Organization and World Health Organization. Reproductive Health. "Medical eligibility criteria for contraceptive use", World Health Organization, 2010.
  2. J. H. Kim, M. I. Hahm, E. C. Park, J. H. Park, S. E. Kim, "Economic burden of cancer in South Korea for the year 2005", J Prev Med Public Health, Vol.42, No.3, pp.190-198, 2009. DOI: https://doi.org/10.3961/jpmph.2009.42.3.190
  3. G. P. Guy Jr, D. U. Ekwueme, K. R. Yabroff, E. C. Dowling, C. Li, "Economic burden of cancer survivorship among adults in the United States", Journal of Clinical Oncology, Vol.31, No.30, pp.3749-3757, 2013. DOI: https://ascopubs.org/doi/10.1200/JCO.2013.49.1241
  4. D. U. Ekwueme, K. R. Yabroff, J. R. Guy, "Medical costs and productivity losses of cancer survivors- United States, 2008-2011". MMWR Morb Mortal Wkly Rep, Vol.63, No.23, pp.505-510, 2014.
  5. Y. S. Rhee, I. Y. Han, J. W. Lim, B. G. Gang, "Diagnostic and Therapeutic Delays of Breast Cancer for Korean Women", Health and Social Research, Vol.32, No.4, pp.577-604, 2012. DOI: http://doi.org/10.15709/hswr.2012.32.4.577
  6. S. Y. Zafar, J. M. Peppercorn, D. Schrag, "The financial toxicity of cancer treatment: A pilot study assessing out-of-pocket expenses and the insured cancer patients experience", The Oncologist, Vol.18, No.4, pp.381-390, 2013. DOI: https://doi.org/10.1634/theoncologist.2012-0279
  7. S. Y. Zafar, R. B. McNeil, C. M. Tomas, C. S. Lathan, J. Z. Ayanian, "Population-based assessment of cancer survivors' fnancial burden and quality of life: a prospective cohort study", Journal of Oncology Practice, Vol.11, No.2, pp.145-150, 2015. DOI: https://ascopubs.org/doi/10.1200/JOP.2014.001542
  8. S. J. KANG, "Factors influencing quality of life among cancer survivors: Using KNHANES 2010-2014", The Journal of the Korea Contents Association, Vol.16, No.9, pp.628-637, 2016. DOI: https://doi.org/10.5392/JKCA.2016.16.09.628
  9. S. Ramsey, D. Blough, A. Kirchhoff, K. Kreizenbeck, C. Fedorenko, "Washington State cancer patients found to be at greater risk for bankruptcy than people without a cancer diagnosis", Health affairs, Vol.32, No.6, pp.1143-1152, 2013. DOI: https://doi.org/10.1377/hlthaff.2012.1263
  10. K. Yabroff, "Financial hardship associated with cancer in the United States: findings from a population-based sample of adult cancer survivors" Journal of clinical oncology, Vol.34, No.3, pp.259-267, 2016. DOI: https://doi.org/10.1200/jco.2015.62.0468
  11. C. K. Altice, M. P. Banegas, R. D. Tucker-Seeley, K. R. Yabroff, "Financial hardships experienced by cancer survivors: a systematic review", JNCI Vol.109, No.2, pp. 2017. DOI: https://doi.org/10.1093/jnci/djw205
  12. M. Y. Martin, M. N. Fouad, R. A. Oster, "What do cancer patients worry about when making decisions about treatment? Variation across racial/ethnic groups", Support Care Cancer, Vol.22, No.1, pp.233-244, 2014. DOI: https://doi.org/10.1007/s00520-013-1958-5
  13. N. J. Meropol, K. A. Schulman, "Cost of cancer care: Issues and implications", J Clin Oncol, Vol.25, No.2, pp.180-186, 2007. DOI: https://doi.org/10.1200/jco.2006.09.6081
  14. S. G. Kim, W. S. Park, "Out-of-pocket health expenditures among adult Koreans with cancer", The Korean Journal of Medicine, Vol.70, No.1, pp.61-68, 2006.
  15. Y. H. Yun, Y. S. Rhee, S. Y. Nam, S. M. Park, J. S. Lee, "The Socioeconomic Impact of Terminal Cancer on Patients' Families and Its Associated Factors", Journal of the Korean Academy of Family Medicine, Vol.26, No.1, pp.31-39, 2005.
  16. D. H. Kim, "Study on Improving the Fairness of Health Insurance in the Burden of Expenses by Diseases", Insurance Finance Research, Vol.26, No.2, pp.85-107, 2015.
  17. I. J. Lee, "Factors affecting on Health-Related Quality Of Life Among Cancer Survivors: Focusing on Gender Difference", Journal of the Korea Academia-Industrial cooperation Society, Vol.19, No.2, pp.497-507, 2018. DOI: https://doi.org/10.5762/KAIS.2018.19.2.497
  18. J. W. Lim, I. Y. Han, "Comparison of Quality of Life on the Stage of Cancer Survivorship for Breast and Gynecological Cancer Survivors", Korean journal of social welfare, Vol.60, No.1, pp.5-27, 2008. DOI: http://doi.org/10.20970/kasw.2008.60.1.001
  19. A. Montazeri, M. Vahdaninia, I. Harirchi, M. Ebrahimi, F. Khaleghi, "Quality of life in patients with breast cancer before and after diagnosis: An eighteen months follow-up study", BMC Cancer, Vol.8, pp.330-336, 2008. https://doi.org/10.1186/1471-2407-8-330
  20. H. Kim, H. J. Yoo, Y. J. Kim, O. S. Han, K. H. Lee, "Development and Validation of Korean Functional Assessment Cancer Therapy-General (FACT-G)", Korean Journal of Clinical Psychology, Vol.22, No.1, pp.215-229, 2003.
  21. J. A. de Souza, B. J. Yap, F. J. Hlubocky, K. Wroblewski, M. J. Ratain, "The development of a financial toxicity patient‐reported outcome in cancer: the COST measure", Cancer, Vol.120, No.20, pp.3245-3253, 2014. DOI: https://doi.org/10.1002/cncr.28814
  22. M. H. Kim, J. S. Kim, H. N. Kim, "Return-to-work experiences among nurses after receiving cancer treatment", Journal of the Korea Academia-Industrial cooperation Society, Vol.17, No.6, pp.215-225, 2016. DOI: http://doi.org/10.5762/KAIS.2016.17.6.215
  23. M. de Jong, S. J. Tamminga, M. H. Frings-Dresen, A. G. de Boer, "Quality of working life of cancer survivors: associations with health-and work-related variables", Supportive Care in Cancer, Vol.25, No.5, pp.1475-1484, 2017. DOI: https://doi.org/10.1007/s00520-016-3549-8
  24. J. J. Hyun, E. J. Lee, "Factors Influencing Quality of Working Life of Cancer Survivors after Return to the Workplace", Korean Journal of Occupational Health Nursing, Vol.27, No.4, pp. 203-214, 2018. DOI: http://doi.org/10.5807/kjohn.2018.27.4.203
  25. A. C. Sasser, M. D. Rousculp, H. G. Birnbaum, "Economic burden of osteoporosis, breast cancer, and cardiovascular disease among postmenopausal women in an employed population", Womens Health Issues, Vol.15, No.3, pp.97-108, 2005. DOI: https://doi.org/10.1016/j.whi.2004.11.006
  26. Y. S. Choi, "The Lived Experience of Suffering of Family with Cancer Patients: Parse's Human Becoming Research Method", The Korean Journal of Hospice and Palliative Care, Vol.19, No.2, pp.127-135, 2016. DOI: http://dx.doi.org/10.14475/kjhpc.2016.19.2.127
  27. E. E. Suh, "The processes of coping with breast cancer among Korean women", The Korean Journal of Stress Research, Vol.16, No.4, pp.305-315, 2008.
  28. C. M. Bestvina, L. L. Zullig, C. Rushing, "Patient-oncologist cost communication, financial distress, and medication adherence", J Oncol Pract, Vol.10, No.3, pp.162-167, 2014. DOI: https://doi.org/10.1200/jop.2014.001406