衡量德国癌症患者的财务困境：癌症财务困境评估工具（FIAT）的开发和验证

IF 7.1 2区医学 Q1 ONCOLOGY

ESMO Open Pub Date : 2024-12-01 DOI:10.1016/j.esmoop.2024.103992

L. Richter , S. Pauge , K. Mehlis , A. Zueger , B. Surmann , V. Mathies , W. Greiner , T. Ernst , E.C. Winkler , N. Menold

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引用次数: 0

摘要

癌症的诊断和治疗可能给患者带来巨大的经济困难，即使在全民卫生保健系统中也是如此。我们提出的发展和验证的病人报告的结果衡量经济困境在德国癌症患者。方法采用两步法对新开发的仪器进行验证，包括两次定量纸笔调查（N1 = 111, N2 = 267），对德国两所大学医院的所有类型癌症患者和治疗状况进行调查。用探索性和验证性因子分析、相关和线性回归分析评估因子效度、信度、结构和标准效度。结果：癌症财务困境评估工具（FIAT）包括主观财务困境三个领域的19个项目：(i)财务担忧；（二）对各个生活领域的不满；（三）与主管部门和福利提供者（如职业介绍所、健康保险）打交道的困难经历。验证性因子分析证实了仪器的因子结构。复合信度（Raykov 's rho）范围为0.88 ~ 0.96，重测信度范围为0.64 ~ 0.75。相关分析显示，FIAT分数与相关结构之间存在显著关联[例如，与EORTC-QLQ-C30财务困境子量表（Q28）的相关性在0.47至0.60之间]，支持其结构效度。此外，较高的FIAT分数与EORTC-QLQ-C30的Q29和Q30测量的较低的健康相关生活质量显著相关，相关性范围为- 0.21至- 0.28。与抑郁（PHQ-4）和焦虑（PHQ-4）呈正相关，相关性在0.33 ~ 0.45之间，相关性在0.25 ~ 0.36之间，证实了其标准效度。新开发的患者报告的结果测量是第一个报道的测量工具来评估德国癌症患者的经济困境。该工具可用于研究目的，并能够提供协调的支助服务。

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Measuring financial distress in German cancer patients: development and validation of the Financial Distress of Cancer Assessment Tool (FIAT)

Background

Cancer diagnosis and therapy can lead to significant financial distress for those affected, even in universal health care systems. We present the development and validation of a patient-reported outcome measure for financial distress in German cancer patients.

Methods

Validation of the newly developed instrument followed a two-step approach, including two quantitative paper–pencil surveys (N1 = 111, N2 = 267) with patients of all types of cancer and treatment status at two German university hospitals. Factorial validity, reliability, construct, and criterion validity were assessed using exploratory and confirmatory factor analysis, correlative and linear regression analysis.

Results

The Financial Distress of Cancer Assessment Tool (FIAT) comprises 19 items across three domains of subjective financial distress: (i) financial worries; (ii) dissatisfaction across various life domains, and (iii) challenging experiences with authorities and benefit providers (e.g. employment agency, health insurance). Confirmatory factor analysis confirmed the instrument’s factorial structure. Composite reliability (Raykov’s rho) ranges from 0.88 to 0.96, and retest reliability ranges from 0.64 to 0.75. Correlational analyses showed significant associations between FIAT scores and related constructs [e.g. correlations with the EORTC-QLQ-C30 financial distress subscale (Q28) ranging from 0.47 to 0.60], supporting its construct validity. Additionally, higher FIAT scores were significantly associated with lower health-related quality of life measured by Q29 and Q30 of the EORTC-QLQ-C30, with correlations ranging from −0.21 to −0.28. They were also positively correlated with depression (PHQ-4), with correlations ranging from 0.33 to 0.45, and anxiety (PHQ-4) with correlations ranging from 0.25 to 0.36, confirming its criterion validity.

Conclusions

The newly developed patient-reported outcome measure is the first reported measurement tool to assess financial distress in German cancer patients. The instrument can be used for research purposes and to enable the provision of coordinated support services.

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来源期刊

ESMO Open Medicine-Oncology

CiteScore

11.70

自引率

2.70%

发文量

255

审稿时长

10 weeks

期刊介绍： ESMO Open is the online-only, open access journal of the European Society for Medical Oncology (ESMO). It is a peer-reviewed publication dedicated to sharing high-quality medical research and educational materials from various fields of oncology. The journal specifically focuses on showcasing innovative clinical and translational cancer research. ESMO Open aims to publish a wide range of research articles covering all aspects of oncology, including experimental studies, translational research, diagnostic advancements, and therapeutic approaches. The content of the journal includes original research articles, insightful reviews, thought-provoking editorials, and correspondence. Moreover, the journal warmly welcomes the submission of phase I trials and meta-analyses. It also showcases reviews from significant ESMO conferences and meetings, as well as publishes important position statements on behalf of ESMO. Overall, ESMO Open offers a platform for scientists, clinicians, and researchers in the field of oncology to share their valuable insights and contribute to advancing the understanding and treatment of cancer. The journal serves as a source of up-to-date information and fosters collaboration within the oncology community.