Self-reported determinants for subjective financial distress: a qualitative interview study with German cancer patients
Objectives Patient-reported financial effects of a tumour disease in a universal healthcare setting are a multidimensional phenomenon. Actual and anticipated objective financial burden caused by direct medical and non-medical costs as well as indirect costs such as loss of income can lead to subject...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/1/e081432.full |
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| author | Eva Winkler Katja Mehlis Bastian Surmann Wolfgang Greiner Andrea Züger Viktoria Mathies Sophie Pauge Luise Richter Thomas Ernst Natalja Menold |
| author_facet | Eva Winkler Katja Mehlis Bastian Surmann Wolfgang Greiner Andrea Züger Viktoria Mathies Sophie Pauge Luise Richter Thomas Ernst Natalja Menold |
| author_sort | Eva Winkler |
| collection | DOAJ |
| description | Objectives Patient-reported financial effects of a tumour disease in a universal healthcare setting are a multidimensional phenomenon. Actual and anticipated objective financial burden caused by direct medical and non-medical costs as well as indirect costs such as loss of income can lead to subjective financial distress. To better understand subjective financial distress, the presented study explores self-reported determinants for subjective financial distress in German patients with cancer, aiming to inform a new German-language patient-reported outcome measure for determining the financial effects of a tumour disease.Design Semistructured interviews with n=18 patients with cancer were conducted between May 2021 and December 2021. Patients were recruited based on a purposive sampling strategy in outpatient and inpatient settings. The interviews were audiorecorded, transcribed verbatim and analysed using qualitative content analysis.Setting Participants were recruited from two German academic cancer centres, that is, the National Center for Tumor Diseases Heidelberg and Jena University Hospital.Participants 18 patients who had undergone cancer-related therapy for at least 2 months were interviewed (10 females).Results Based on the results of the qualitative content analysis, we developed a multicomponent construct of determinants that could influence subjective financial distress. The self-reported determinants can be classified into material (savings, good salary, shared rent through shared living, employed partner, paid-off house, potential financial support from family and friends, work-related specifics, consumer restrictions, out-of-pocket-costs and anticipated financial changes), social (social support from friends and family), systemic (administrative hurdlers and insurance cover) and inner personal determinants (coping strategies, change of attitude, character traits).Conclusion Subjective financial distress depends not only on material but also on social, systemic and inner personal determinants. Knowledge of these determinants can inform a new comprehensive German-language instrument for measuring self-reported financial effects of a tumour disease.Trial registration number NCT05319925. |
| format | Article |
| id | doaj-art-f05800fc01e741d9905a03ca67d7c01d |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-f05800fc01e741d9905a03ca67d7c01d2025-01-31T20:30:10ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2023-081432Self-reported determinants for subjective financial distress: a qualitative interview study with German cancer patientsEva Winkler0Katja Mehlis1Bastian Surmann2Wolfgang Greiner3Andrea Züger4Viktoria Mathies5Sophie Pauge6Luise Richter7Thomas Ernst8Natalja Menold9Department of Medical Oncology, Section Translational Medical Ethics, National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, GermanyDepartment of Medical Oncology, Section Translational Medical Ethics, National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, GermanyDepartment of Health Economics and Health Care Management, Faculty of Health Science, Bielefeld University, Bielefeld, GermanyDepartment for Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, GermanyDepartment of Medical Oncology, Section Translational Medical Ethics, National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, GermanyDepartment of Hematology/Oncology, Jena University Hospital, Jena, GermanyDepartment for Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, GermanyMethods in Empirical Social Research, Institute of Sociology, Faculty of Arts, Humanities and Social Science, Dresden University of Technology, Dresden, GermanyDepartment of Hematology/Oncology, Jena University Hospital, Jena, GermanyMethods in Empirical Social Research, Institute of Sociology, Faculty of Arts, Humanities and Social Science, Dresden University of Technology, Dresden, GermanyObjectives Patient-reported financial effects of a tumour disease in a universal healthcare setting are a multidimensional phenomenon. Actual and anticipated objective financial burden caused by direct medical and non-medical costs as well as indirect costs such as loss of income can lead to subjective financial distress. To better understand subjective financial distress, the presented study explores self-reported determinants for subjective financial distress in German patients with cancer, aiming to inform a new German-language patient-reported outcome measure for determining the financial effects of a tumour disease.Design Semistructured interviews with n=18 patients with cancer were conducted between May 2021 and December 2021. Patients were recruited based on a purposive sampling strategy in outpatient and inpatient settings. The interviews were audiorecorded, transcribed verbatim and analysed using qualitative content analysis.Setting Participants were recruited from two German academic cancer centres, that is, the National Center for Tumor Diseases Heidelberg and Jena University Hospital.Participants 18 patients who had undergone cancer-related therapy for at least 2 months were interviewed (10 females).Results Based on the results of the qualitative content analysis, we developed a multicomponent construct of determinants that could influence subjective financial distress. The self-reported determinants can be classified into material (savings, good salary, shared rent through shared living, employed partner, paid-off house, potential financial support from family and friends, work-related specifics, consumer restrictions, out-of-pocket-costs and anticipated financial changes), social (social support from friends and family), systemic (administrative hurdlers and insurance cover) and inner personal determinants (coping strategies, change of attitude, character traits).Conclusion Subjective financial distress depends not only on material but also on social, systemic and inner personal determinants. Knowledge of these determinants can inform a new comprehensive German-language instrument for measuring self-reported financial effects of a tumour disease.Trial registration number NCT05319925.https://bmjopen.bmj.com/content/15/1/e081432.full |
| spellingShingle | Eva Winkler Katja Mehlis Bastian Surmann Wolfgang Greiner Andrea Züger Viktoria Mathies Sophie Pauge Luise Richter Thomas Ernst Natalja Menold Self-reported determinants for subjective financial distress: a qualitative interview study with German cancer patients BMJ Open |
| title | Self-reported determinants for subjective financial distress: a qualitative interview study with German cancer patients |
| title_full | Self-reported determinants for subjective financial distress: a qualitative interview study with German cancer patients |
| title_fullStr | Self-reported determinants for subjective financial distress: a qualitative interview study with German cancer patients |
| title_full_unstemmed | Self-reported determinants for subjective financial distress: a qualitative interview study with German cancer patients |
| title_short | Self-reported determinants for subjective financial distress: a qualitative interview study with German cancer patients |
| title_sort | self reported determinants for subjective financial distress a qualitative interview study with german cancer patients |
| url | https://bmjopen.bmj.com/content/15/1/e081432.full |
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