Household material hardship in families of children post‐chemotherapy

Bilodeau, Madeline; Ma, Clement; Al‐Sayegh, Hasan; Wolfe, Joanne; Bona, Kira

doi:10.1002/pbc.26743

Cited by 47 publications

(61 citation statements)

References 16 publications

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“…We identified 3359 articles through literature searches and included 35 articles, reporting on 29 individual studies (Figure ). Thirteen (37%) studies were conducted in Europe, 16 (46%) in North America/Australia, and six (17%) in Asia/Africa (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies on income reported substantial income loss after the child's diagnosis . The proportion of parents reporting income loss and the extent of these losses varied largely.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies on income reported substantial income loss after the child's diagnosis. 26,28,31,36,[38][39][40]44,47,[49][50][51][52][53][54][55]58 The proportion of parents reporting income loss and the extent of these losses varied largely. Two studies from Norway 25 and Finland 24 found no effects on income, and one study from New Zealand 52 found more parents reporting income gain than loss.…”

Section: Incomementioning

confidence: 99%

“…A population-based study from Sweden 26,28 indicated that maternal income reductions persisted until 6 years after diagnosis compared with 3 years among fathers. Findings from longitudinal studies suggest that income losses are most pronounced in the first months after diagnosis, 24,31,39,40 but may persist into early survivorship. 26,28 Lower income at diagnosis, 28,40,44,47 younger age of child at diagnosis, 25,28,38 and diagnosis of leukaemia 25,50 were consistently associated with income loss.…”

Section: Incomementioning

confidence: 99%

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The impact of childhood cancer on parents' socio‐economic situation—A systematic review

et al. 2019

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Objective Taking care of children diagnosed with cancer may have considerable consequences on parents' socio‐economic situation. Our systematic review aimed to evaluate and synthesise the evidence on the impact of childhood cancer on parents' socio‐economic situation. Methods Systematic literature searches for articles published between January 2000 and January 2019 were performed in PubMed, Scopus, and PsycINFO. Findings of eligible articles were narratively synthesised and quality appraised. Results Our systematic review included 35 eligible articles. Childhood cancer had a substantial impact on parents' socio‐economic situation across all studies. This impact varied largely by geographical region. We observed a high prevalence of disruptions in parental employment such as job quitting or job loss, particularly among mothers. The associated income losses further contributed to families' perceived financial burden in addition to increased cancer‐related expenses. Adverse socio‐economic consequences were most pronounced shortly after diagnosis, however, persisted into early survivorship for certain groups of parents. We identified families of children diagnosed with haematological cancers, younger age at diagnosis, and lower parental socio‐economic position to be at particular risk for adverse socio‐economic consequences. Conclusions Following the child's cancer diagnosis, parents experience a broad range of adverse socio‐economic consequences. Further effort is needed to systematically implement an assessment of financial hardship in paediatric oncology together with appropriate support services along the cancer trajectory.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Incomementioning

confidence: 99%

Section: Incomementioning

confidence: 99%

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The impact of childhood cancer on parents' socio‐economic situation—A systematic review

et al. 2019

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“…Using a cross-sectional survey, we found that the large majority of PCPs had provided acute medical care to on-therapy patients with childhood cancer (70% of PCPs) and health maintenance care to childhood cancer survivors (91% of PCPs) in their practices within the past year. Additional barriers to accessing specialty care for minor illnesses during cancer treatment or health maintenance during survivorship may include household material hardship 36,37 and the absence of infrastructure such as mass transit in rural areas. In addition, these findings also likely point to the complexities of patient access to specialized pediatric oncology care in states such as Alabama that have broad geographic areas that encompass large rural populations.…”

Section: Discussionmentioning

confidence: 99%

Providing health care for patients with childhood cancer and survivors: A survey of pediatric primary care providers

Wadhwa

Chen

Bhatia

et al. 2019

Cancer

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BACKGROUND:The current study was conducted to assess self-reported comfort levels of pediatric primary care providers (PCPs) in providing acute medical care to patients with childhood cancer who currently were receiving therapy (on-therapy patients) and health maintenance care to childhood cancer survivors, independently and in conjunction with pediatric oncologists, along with confidence levels regarding knowledge about immunizations for survivors. All levels were measured using 7-point Likert scales. METHODS: A cross-sectional, 23-item survey mailed to practicing PCPs affiliated with a tertiary children's hospital was analyzed. RESULTS: The response rate was 64.4% (259 of 402 eligible PCPs). The mean PCP comfort level was higher when collaborating with a pediatric oncologist to provide acute medical care for on-therapy patients and health maintenance care for childhood cancer survivors (mean ratings of 6.0 ± 1.5 and 6.4 ± 1.3, respectively) compared with independently providing such care (mean ratings of 4.6 ± 1.8 and 5.0 ± 1.7, respectively; P < .0001). Only approximately 30% of PCPs were confident in their knowledge regarding immunizations for survivors. Certain factors were found to be associated with PCP comfort in providing care in conjunction with a pediatric oncologist. For acute care, these factors were rural location compared with urban location (odds ratio [OR], 5.0; 95% CI, 1.9-13.1 [P = .03]) and having cared for ≥6 on-therapy patients within the past year versus none (OR, 3.8; 95% CI, 1.9-7.5 [P = .0001]). For survivor health maintenance care, practice location <50 miles from pediatric oncology specialty care versus ≥50 miles was the only factor found to be associated with PCP comfort (OR, 2.8; 95% CI, 1.3-6.1 [P = .009]). CONCLUSIONS: The findings of the current study underscore the need for collaboration between pediatric oncologists and PCPs when caring for children with cancer across the spectrum of care. Cancer 2019;125:3864-3872.

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Association Between Children With Life-Threatening Conditions and Their Parents’ and Siblings’ Mental and Physical Health

et al. 2021

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IMPORTANCE Despite concerns regarding the potential deleterious physical and mental health outcomes among family members of a child with a life-threatening condition (LTC), few studies have examined empirical measures of health outcomes among these family members.OBJECTIVES To examine whether mothers, fathers, sisters, and brothers of children with 1 of 4 types of pediatric LTCs have higher rates of health care encounters, diagnoses, and prescriptions compared with families of children without these conditions. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study included US families with commercial insurance coverage from a single carrier. Children who had 1 of 4 LTCs (substantial prematurity, critical congenital heart disease, cancer, or a condition resulting in severe neurologic impairment) were identified by a diagnosis in their insurance claim data between July 1, 2015, and June 30, 2016. Each case child and their family was matched with up to 4 control children and their families based on the age of the case and control children. Data were analyzed between August 2020 and March 2021. EXPOSURES Having a child or sibling with substantial prematurity, critical congenital heart disease, cancer, or a condition resulting in severe and progressive neurologic impairment.MAIN OUTCOMES Rates of occurrence of health care encounters, physical and mental health diagnoses, and physical and mental health medication prescriptions, identified from insurance claims data, were compared between case and control families using a multivariable negative binomial regression model. The statistical analysis adjusted for observed differences between case and control families and accounted for clustering at the family level. RESULTSThe study included 25 528 children (6909 case children [27.1%] and 18 619 control children [72.9%]; median age, 6.0 years [IQR, 1-13 years]; 13 294 [52.1%] male), 43 357 parents (11 586 case parents [26.7%] and 31 771 control parents [73.3%]; mean [SD] age, 40.4 [8.1] years; 22 318 [51.5%] female), and 25 706 siblings (7664 case siblings [29.8%] and 18 042 control siblings [70.2%]; mean [SD] age, 12.1 [6.5] years; 13 114 [51.0%] male). Overall, case mothers had higher rates of the composite outcome of health care encounters, diagnoses, and prescriptions compared with control mothers (incident rate ratio [IRR], 1.61; 95% CI, 1.54-1.68), as did case fathers compared with control fathers (IRR, 1.55; 95% CI, 1.46-1.64). Sisters of children with LTCs had higher rates of the composite outcome compared with sisters of children without LTCs (IRR, 1.68; 95% CI, 1.55-1.82), as did brothers of children with LTCs compared with brothers of children without LTCs (IRR, 1.70; 95% CI, 1.56-1.85).

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Household material hardship in families of children post‐chemotherapy

Cited by 47 publications

References 16 publications

The impact of childhood cancer on parents' socio‐economic situation—A systematic review

The impact of childhood cancer on parents' socio‐economic situation—A systematic review

Providing health care for patients with childhood cancer and survivors: A survey of pediatric primary care providers

Association Between Children With Life-Threatening Conditions and Their Parents’ and Siblings’ Mental and Physical Health

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