Richard Huan Xu1,2, Ling-Ling Wang3, Ling-Ming Zhou4, Eliza Lai-Yi Wong5, Dong Wang6. 1. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China. richard.xu@polyu.edu.hk. 2. JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China. richard.xu@polyu.edu.hk. 3. Department of Blood Transfusion Medicine, School of Medicine, Jinling Hospital, Nanjing University, Nanjing, China. 4. Department of Human Resource, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. 5. JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China. 6. School of Health Management, Southern Medical University, Guangzhou, China. dongw96@smu.edu.cn.
Abstract
OBJECTIVE: This study aimed to investigate the urban-rural differences in associations between financial toxicity (FT), physical health-related quality of life (HRQoL), negative emotional status, and the effect of patients' socioeconomic status and clinical and cost-related characteristics on the levels of FT in a sample of Chinese cancer survivors. METHODS: Data were obtained from a cross-sectional survey conducted by the oncology department at two tertiary level hospitals in China. The COmprehensive Score for financial Toxicity, Euroqol five-level instrument (EQ-5D), and Depression Anxiety Stress Scale - 21 (DASS-21) were used to measure patients' FT, physical HRQoL, and negative emotional status. A latent class analysis was used to identify patient subgroups with distinct symptom experiences based on self-reported data on symptom occurrence using the EQ-5D and DASS-21. RESULTS: Four distinct latent classes were identified: all low (47.6%); high physical and low psych (18.6%); low physical and high psych (17.1%); and all high (17.1%). Rural patients younger than 50 years showed a statistically significantly higher FT than urban patients. Rural patients who were male, highly educated, insured, first hospitalization, new cases, received surgery or immunotherapy, and had low cancer-related costs in all low classes showed a higher FT than urban patients. CONCLUSIONS: Rural patients with cancer suffered from higher FT than their urban counterparts, and the negative impact of psychological distress on FT was higher than that of physical HRQoL.
OBJECTIVE: This study aimed to investigate the urban-rural differences in associations between financial toxicity (FT), physical health-related quality of life (HRQoL), negative emotional status, and the effect of patients' socioeconomic status and clinical and cost-related characteristics on the levels of FT in a sample of Chinese cancer survivors. METHODS: Data were obtained from a cross-sectional survey conducted by the oncology department at two tertiary level hospitals in China. The COmprehensive Score for financial Toxicity, Euroqol five-level instrument (EQ-5D), and Depression Anxiety Stress Scale - 21 (DASS-21) were used to measure patients' FT, physical HRQoL, and negative emotional status. A latent class analysis was used to identify patient subgroups with distinct symptom experiences based on self-reported data on symptom occurrence using the EQ-5D and DASS-21. RESULTS: Four distinct latent classes were identified: all low (47.6%); high physical and low psych (18.6%); low physical and high psych (17.1%); and all high (17.1%). Rural patients younger than 50 years showed a statistically significantly higher FT than urban patients. Rural patients who were male, highly educated, insured, first hospitalization, new cases, received surgery or immunotherapy, and had low cancer-related costs in all low classes showed a higher FT than urban patients. CONCLUSIONS: Rural patients with cancer suffered from higher FT than their urban counterparts, and the negative impact of psychological distress on FT was higher than that of physical HRQoL.
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