Current Status And Influencing Factors Of Financial Toxicity In Patients With Hematologic Malignancies

Objective:1.Investigate the current situation of financial toxicity(FT)in patients with hematological malignancies.2.Analyze the relevant factors that affect the level of financial toxicity in patients with hematological malignancies.Methods:In this study,153 patients with hematologic malignancies admitted to a Grade-III hospital in Jinan,Shandong Province from July 2022 to January 2023 were selected by convenience sampling method.A cross-sectional survey was conducted using the general data questionnaire,the Financial Toxicity Composite Score Scale for reported outcomes of cancer patients,the Medical Coping Style Scale and the simplified Fear of Disease Progression Scale.General demographic data,disease-related data,family economic status,medical response and progression of disease fear were collected.SPSS 26.0 software was used for descriptive analysis of the data,and univariate analysis,Spearman correlation analysis and multiple linear regression analysis were used to explore the influencing factors of FT of hematologic malignancies.Results:1.In 153 patients with hematologic malignancies,the total score of FT was(15.44±6.38),9.2%(14 cases)had no FT,50.3%(77 cases)had mild FT,39.2%(60 cases)had moderate FT,and 1.3%(2 cases)had severe FT.The score of medical coping style was(42.98±5.49),and the score of face dimension was(19.39±3.18).The lowest yield score was(7.23±2.70),and the avoidance score was(16.46±2.64).The score of fear of disease progression was 36(31,42),and 58.8%of patients with hematologic malignancies had fear of disease progression.2.The results of univariate analysis show that The FT scores of hematologic malignancies patients were statistically significant in age,education,residence,marital status,course of disease,payment method of medical expenses,payment method of medical insurance type,treatment method,complications,family monthly income,disposable family savings,total out-of-pocket expenses for treatment,and proportion of out-of-pocket expenses during hospitalization(p<0.05).3.Spearman correlation analysis showed that the total score of FT in patients with hematologic malignancies was negatively correlated with the progression of fear disease(r=-0.480,p<0.01),and the total score of FT was negatively correlated with the yield dimension score of medical coping style(r=-0.176,p<0.05).It was negatively correlated with the score of avoidance dimension of medical coping style(r=-0.163,p<0.05).4.Multiple linear regression analysis showed that payment method of medical expenses,disposable family savings,total out-of-pocket expenses for treatment,complications of GVHD in hematopoietic stem cell transplantation patients,degree of fear of disease progression,and medical coping style were factors influencing FT in hematologic malignancies patients.Conclusions:1.Financial toxicity is common in patients with hematologic malignancies investigated in this study.2.Financial toxicity in patients with hematologic malignancies was negatively correlated with the progression of fear disease,and FT was negatively correlated with the avoidance dimension and yield dimension of medical coping style.3.In clinical work,special attention should be paid to the family economic level of patients with hematologic malignancies,payment methods of medical expenses,GVHD complications of patients with hematopoietic stem cell transplantation,and the degree of fear of disease progression.Comprehensively evaluate the economic status of the patient’s family,guide them to take active coping methods,reduce the fear of·disease,improve the level of FT of the patient,improve the quality of life of the patient.