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Caregiver perceived financial strain during pediatric cancer treatment: Longitudinal predictors and outcomes
Liana R Galtieri1, Kaitlyn M Fladeboe2, Kevin King1
1Department of Psychology.
Insights
Caregiver financial strain decreases over the first year of pediatric cancer treatment, but unmarried caregivers and those with lower incomes face higher strain. This financial stress can negatively impact caregiver mental health.
Area of Science:
- Pediatric Oncology
- Psychological Oncology
- Health Economics
Background:
- Previous research explored family income and material hardship in pediatric cancer.
- Fewer studies have investigated perceived financial strain (PFS) in caregivers of children with cancer.
Purpose of the Study:
- To describe the trajectory of PFS during the first year of pediatric cancer treatment.
- To identify sociodemographic predictors of PFS.
- To examine the association between PFS and caregiver/child psychological adjustment.
Main Methods:
- Primary caregivers of children recently diagnosed with cancer completed 12 monthly reports.
- Data included caregiver PFS, depression, anxiety, PTSD symptoms, and child internalizing/externalizing symptoms.
- Multilevel models were used for data analysis.
Main Results:
- Caregiver PFS generally decreased over the first year of treatment.
- Nonmarried caregivers and those with lower incomes reported higher PFS.
- Higher PFS was associated with caregiver psychological maladjustment but not child adjustment.
Conclusions:
- While PFS may decrease over time, certain caregiver groups remain at risk.
- PFS is linked to caregiver psychological distress, highlighting the need for support.
- Psychosocial interventions targeting financial strain management may benefit caregivers.
Objective:
Previous work has examined family income and material hardship in pediatric cancer. However, few studies have focused on perceived financial strain (PFS), or the extent to which caregivers perceive financial stress and worry related to their child's cancer. The current study addresses this gap by a) describing the trajectory of perceived financial strain over the first year of pediatric cancer treatment; b) examining sociodemographic predictors of that trajectory; and c) examining associations between PFS and caregiver and child psychological adjustment.
Method:
Primary caregivers of children (Mage = 6.31) recently diagnosed with cancer provided 12 monthly reports of their own perceived financial strain and depression, anxiety, and posttraumatic stress symptoms, as well as their child's internalizing and externalizing symptoms. Data were analyzed using multilevel models.
Results:
Caregiver PFS decreased over the first year of treatment. Nonmarried caregivers and those with lower income reported higher levels of PFS over time. Caregivers with higher PFS relative to other caregivers and relative to their own average PFS in a given month experienced psychological maladjustment. PFS was not associated with child adjustment.
Conclusions:
On average caregivers perceive less financial strain over the first year of treatment; however, nonmarried caregivers and those with lower income are at risk for higher PFS over time, and PFS may contribute to psychological maladjustment in caregivers. Caregivers may benefit from psychosocial support focused on managing financial strain. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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