Assessment of Financial Burden as a Standard of Care in Pediatric Oncology

Abstract

Family financial hardship has emerged as a burden of pediatric cancer treatment with negative implications for family well‐being. As part of an extensive project to create evidence‐based standards for the psychosocial care of children with cancer, we performed a literature review of pediatric cancer‐associated financial hardship utilizing six databases, and identified 24 publications for incorporation into this review. Financial hardship during childhood cancer was found to affect a significant proportion of the population and to negatively impact family well‐being. Existing literature supports a strong recommendation for assessment of financial hardship as a component of comprehensive psychosocial care in pediatric oncology. Pediatr Blood Cancer © 2015 Wiley Periodicals, Inc.

Impact of a child’s cancer disease on parents’ everyday life: a longitudinal study from Sweden

“…Even after the end of successful treatment, some parents need to reduce working hours [4]. The literature, still scarce, indicates that family income decreases and expenses increase in the wake of childhood cancer [5]. In a previous study, we concluded that childhood cancer affects parents', particularly mothers', possibility to maintain working hours up to one year after completion of treatment [6], however, only minor adverse effects were found five years after end of treatment [7].…”

Perceptions of support among Swedish parents of children after end of successful cancer treatment: a prospective, longitudinal study

“…To summarize, psychosocial support for families with a history of childhood cancer has positive effects for parents [9,10] and is recommended by international guidelines [4,6]. Such support not only help parents, but also their family members.…”

“…Recently published guidelines for how children diagnosed with cancer and their family members should be cared for, recommend standardized psychosocial and financial risk assessments and referrals across the disease trajectory into long-term survivorship [4,6]. A substantial group of Swedish parents of children on cancer treatment reports a need to talk to psychologists, but few get the opportunity to do so [7].…”

“…Five years after end of treatment a subgroup (27%) reports a clinically relevant level of general psychological distress [3] and 19% of mothers and 8% of fathers report symptoms of posttraumatic stress (PTSS) [2]. Families with a history of childhood cancer are at high risk for financial burden potentially having a negative impact on family members' emotional health [4]. Negative consequences of parenting a child diagnosed with cancer are pronounced among mothers who report a higher level of PTSS and tend to be more disadvantaged in their professional life than fathers [2,5].…”

Should Clinicians Intervene If They Suspect That a Caregiver Whose Child Has Cancer Is at Risk of Psychological Harm?

“…Clinicians can work with other members of the health care team, such as social workers, to ensure that all families are assessed for financial hardship at the time of diagnosis, are reassessed regularly throughout treatment, and are referred appropriately. Referrals might be made to the hospital's financial counseling office, community organizations, and governmental programs [25]. Families may also require assistance navigating state and federal safety-net programs.…”