A Conceptual Model of Financial Toxicity in Pediatric Oncology

Sheila Judge Santacroce · Shawn M. Kneipp

69 citations0/0 files storedJournal of Pediatric Oncology Nursing

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Economic and Financial Impacts of Cancer Childhood Cancer Survivors' Quality of Life Family Support in Illness

Abstract

The purpose of this article is to explicate a conceptual framework for financial toxicity in pediatric oncology to guide nursing practice and research. The framework is based on one for financial outcomes of severe illness attributed to Scott Ramsey and adapted by the National Cancer Institute to describe relationships between preexisting factors, a cancer diagnosis, financial distress, and health outcomes for adult cancer patients and survivors. The adaption for pediatric oncology was informed by the results of a systematic scoping review to identify advances and gaps in the recent literature about the personal costs of illness to parents in the pediatric oncology context. The conceptual model for pediatric oncology indicates that existing and dynamic parent and family factors, other risk and protective factors, the child's diagnosis and treatment, and treatment-related financial costs can affect parent financial coping behaviors and parent health and family financial outcomes, all of which may affect child outcomes. Additionally, nursing's historic emphasis on holistic care, quality of life, and health determinants justify attention to financial toxicity as a nursing role. Therefore, pediatric oncology nurses must be sensitive to financial toxicity and related risk factors, become comfortable communicating about treatment-related financial costs and financial distress with parents and other health professionals, and collaborate in efforts that draw on the expertise of multiple stakeholders to identify potential or actual financial toxicity in parents and mitigate its impact on childhood cancer health outcomes through direct care, referral, research, quality improvement, and health advocacy.

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References

2016Measuring financial toxicity as a clinically relevant patient‐reported outcome: The validation of the COmprehensive Score for financial Toxicity (COST)2016Financial Insolvency as a Risk Factor for Early Mortality Among Patients With Cancer 1860Notes on nursing. What it is, and what it is not 2014The development of a financial toxicity patient‐reported outcome in cancer: The COST measure 2016United States Health Care Reform 1982Cost-of-Illness Methodology: A Guide to Current Practices and Procedures 2013Financial toxicity, Part I: a new name for a growing problem.2015Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity

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2019Influence of pediatric cancer–related financial burden on parent distress and other stress‐related symptoms

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