Influence of Financial Toxicity on the Quality of Life in Lung Cancer Patients Undergoing Immunotherapy: The Mediating Effect of Self-Perceived Burden.
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引用次数: 0
Abstract
Purpose: The purpose of this study is to understand the level of quality of life (QOL) of lung cancer patients receiving immunotherapy and to clarify the potential mediating role of self-perceived burden (SPB) in the relationship between financial toxicity (FT) and QOL.
Patients and methods: A convenience sample of 342 lung cancer patients receiving immunotherapy was recruited from a cancer hospital from October 2022 to April 2023 for this cross-sectional study. The participants were requested to complete the following structured questionnaires: a sociodemographic and clinical questionnaire, the Functional Assessment of Cancer Therapy-Lung (FACT-L), the Self-Perceived Burden Scale (SPBS) and the COmprehensive Score for Financial Toxicity (COST). The data were subjected to Pearson correlation analysis and bootstrapping analysis in structural equation modelling.
Results: The total FACT-L score was 79.90±15.84 points in 322 lung cancer patients receiving immunotherapy. FT (β = 0.37, P < 0.01) and SPB (β = -0.27, P < 0.01) had a direct effect on QOL. In addition, SPB partly mediated the association between FT and QOL, and the standardized indirect effect was 0.19, accounting for 33.9% of the total effect.
Conclusion: The present study revealed that there is still much room for improvement in the QOL of lung cancer patients during immunotherapy. A greater financial burden resulted in a greater self-perceived burden and was thus associated with inferior QOL. It is imperative for oncology nurses to routinely assess QOL, FT or risk and SPB for lung cancer patients undergoing immunotherapy as well as to assist those patients in understanding the potential financial risk of each choice and help them take more active roles in their routine clinical care.
目的：本研究旨在了解接受免疫治疗的肺癌患者的生活质量（QOL）水平，并阐明自我感觉负担（SPB）在经济毒性（FT）与QOL之间的潜在中介作用：2022年10月至2023年4月期间，我们从一家肿瘤医院招募了342名接受免疫治疗的肺癌患者，作为这项横断面研究的方便样本。参与者需填写以下结构化问卷：社会人口学和临床问卷、肺癌治疗功能评估（FACT-L）、自我感觉负担量表（SPBS）和经济毒性综合评分（COST）。对数据进行了皮尔逊相关分析和结构方程模型的引导分析：322名接受免疫治疗的肺癌患者的FACT-L总分为（79.90±15.84）分。FT（β=0.37，P＜0.01）和SPB（β=-0.27，P＜0.01）对QOL有直接影响。此外，SPB在一定程度上介导了FT与QOL之间的关系，标准化间接效应为0.19，占总效应的33.9%：本研究显示，肺癌患者在免疫治疗期间的 QOL 仍有很大的改善空间。经济负担越重，自我感觉的负担越重，因此与QOL较差有关。肿瘤科护士有必要对接受免疫治疗的肺癌患者的QOL、FT或风险和SPB进行常规评估，并协助患者了解每种选择的潜在经济风险，帮助他们在日常临床护理中发挥更积极的作用。
期刊介绍：
Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include:
◦Epidemiology, detection and screening
◦Cellular research and biomarkers
◦Identification of biotargets and agents with novel mechanisms of action
◦Optimal clinical use of existing anticancer agents, including combination therapies
◦Radiation and surgery
◦Palliative care
◦Patient adherence, quality of life, satisfaction
The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.
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