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Purpose <p>To optimize integration of appropriate referral pathways to adequate resources, a better understanding of the relationship between psychological distress and financial hardship for patients with cancer in Alabama is needed.</p> Methods <p>This cross-sectional study used standard-of-care collected, electronic, patient-reported outcome data from patients initiating medical oncology treatment. Psychological distress was measured using the NCCN Distress Thermometer. The FACIT-COmprehensive Score for financial Toxicity (COST) was used to measure cancer-related financial hardship. Associations between distress and financial hardship, domains of financial difficulty and distress, and factors associated with financial hardship and distress both alone and co-occurring were examined.</p> Results <p>Of 4637 patients with screening data, almost one-third (31%) reported both moderate/severe financial hardship and moderate/severe distress. Patients with financial hardship had nearly three times the odds of distress compared to those without financial hardship (aOR 2.99, 95% CI 2.61–3.44). Patients with co-occurring financial hardship and distress more often reported employment and disability issues and difficulty affording utilities and basic needs than those with financial hardship only. Factors associated with reporting both financial hardship and psychological distress included patients who were younger, less educated, unmarried, female, non-White, and resided in highly disadvantaged neighborhoods.</p> Conclusion <p>Both psychological distress and financial hardship were common and co-occurring for Alabama patients with cancer, with almost one-third of patients experiencing both financial hardship and distress.</p> Implications for Cancer Survivors <p>Integration of financial hardship and psychological distress screening, with referrals to interdisciplinary interventions such as psycho-oncology services, could address both financial and psychological needs of patients with cancer.</p>

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Associations between psychological distress and financial hardship for patients with cancer receiving care in Alabama

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月1日

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  • Courtney P. Williams,
  • Sandra Olisakwe,
  • Chloe J. Taub,
  • Margaret I. Liang,
  • Gabrielle B. Rocque,
  • Maria Pisu

摘要

Purpose

To optimize integration of appropriate referral pathways to adequate resources, a better understanding of the relationship between psychological distress and financial hardship for patients with cancer in Alabama is needed.

Methods

This cross-sectional study used standard-of-care collected, electronic, patient-reported outcome data from patients initiating medical oncology treatment. Psychological distress was measured using the NCCN Distress Thermometer. The FACIT-COmprehensive Score for financial Toxicity (COST) was used to measure cancer-related financial hardship. Associations between distress and financial hardship, domains of financial difficulty and distress, and factors associated with financial hardship and distress both alone and co-occurring were examined.

Results

Of 4637 patients with screening data, almost one-third (31%) reported both moderate/severe financial hardship and moderate/severe distress. Patients with financial hardship had nearly three times the odds of distress compared to those without financial hardship (aOR 2.99, 95% CI 2.61–3.44). Patients with co-occurring financial hardship and distress more often reported employment and disability issues and difficulty affording utilities and basic needs than those with financial hardship only. Factors associated with reporting both financial hardship and psychological distress included patients who were younger, less educated, unmarried, female, non-White, and resided in highly disadvantaged neighborhoods.

Conclusion

Both psychological distress and financial hardship were common and co-occurring for Alabama patients with cancer, with almost one-third of patients experiencing both financial hardship and distress.

Implications for Cancer Survivors

Integration of financial hardship and psychological distress screening, with referrals to interdisciplinary interventions such as psycho-oncology services, could address both financial and psychological needs of patients with cancer.