The relationship between household income and patient‐reported symptom distress and quality of life in children with advanced cancer: A report from the PediQUEST study

Ilowite, Maya; Al‐Sayegh, Hasan; Ma, Clement; Dussel, Verónica; Rosenberg, Abby R.; Feudtner, Chris; Kang, Tammy I.; Wolfe, Joanne; Bona, Kira

doi:10.1002/cncr.31668

Cited by 55 publications

(77 citation statements)

References 37 publications

(81 reference statements)

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“…The null hypothesis for the t-tests was that there are no differences in the mean sociodemographic characteristics and natural environmental conditions (neighborhood greenery) between low and high-income neighborhoods. Block groups were categorized into low income and high-income neighborhoods based on whether the median income of a block group was greater than $50,000 [57]. The block groups with a median income less than $50,000 were coded as zero, representing low-income neighborhoods, and the rest were coded as one, representing high-income neighborhoods.…”

Section: Discussionmentioning

confidence: 99%

Neighborhood Greenery as a Predictor of Outdoor Crimes between Low and High Income Neighborhoods

Kim

2020

IJERPH

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Neighborhood greenery contributes to improving mental, emotional, and physical health and may help to promote neighborhood safety. Several studies have reported positive effects of neighborhood greenery on the improvement of outdoor safety, but little is known about whether the relationship between green vegetation and outdoor safety varies with the income status of neighborhoods. The purpose of this study is to examine neighborhood greenery as a predictor of outdoor crime rates between low and high-income neighborhoods while controlling for the sociodemographic conditions of the neighborhoods. This study used 2010 census block group data and objectively measured natural environment data derived from GIS in Austin, Texas. Comparison t-tests and ordinal least square regressions were conducted as statistical analyses. The t-tests showed that low-income neighborhoods were more socioeconomically disadvantaged and had less greenery than high-income neighborhoods. The final regression models showed that neighborhood greenery had a negative relationship with outdoor crimes for low-income neighborhoods but a positive relationship with crimes for high-income neighborhoods. The results suggest that different strategies may be needed in dealing with neighborhood safety according to neighborhood-level income.

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Section: Discussionmentioning

confidence: 99%

Neighborhood Greenery as a Predictor of Outdoor Crimes between Low and High Income Neighborhoods

Kim

2020

IJERPH

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“…Physical symptoms were highly prevalent and distressful during the EOL period compared with psychosocial symptoms (Bell et al, 2010;Beretta et al, 2010;Birtar et al, 2015;Friedrichsdorf et al, 2014;Heath et al, 2010;Hechler et al, 2008;Ilowite et al, 2018;Rosenberg et al, 2016;Schindera et al, 2014;Theunissen et al, 2007;Tomlinson et al, 2011;Ullrich et al, 2010a;Ullrich et al, 2010b;Van Cleve et al, 2012;Wolfe et al, 2015). The most prevalent physical symptoms were fatigue, pain, poor appetite, and dyspnea followed by nausea, vomiting, constipation, and diarrhea.…”

Section: Symptom Prevalencementioning

confidence: 99%

“…Symptom Reporting. Parent proxy report (n = 13, 48%) was the most common method used to obtain information related to symptom experiences during the EOL period for children with cancer (Friedrichsdorf et al, 2014;Heath et al, 2010;Ilowite et al, 2018;Latha et al, 2016;Pritchard et al, 2008;Schindera et al, 2014;Theunissen et al, 2007;Tomlinson et al, 2011;Ullrich et al, 2010a;Ullrich et al, 2010b;von Lutzau et al, 2012;Wolfe et al, 2015;Zelcer et al, 2010) followed by medical chart review (n = 11, 41%; Bell et al, 2010;Beretta et al, 2010;Birtar et al, 2015;Hassan et al, 2018;Hechler et al, 2008;Hoell et al, 2017;Jagt-van Kampen et al, 2015;Kuhlen et al, 2016;Snaman et al, 2018;Veldhuijzen van Zanten et al, 2015;Ye et al, 2019). Of the studies that used parent proxy-report, 4 (31%) used a combination of parents', providers' and patients' reports (Ullrich et al, 2010a;Van Cleve et al, 2012;Wolfe et al, 2015;Zhukovsky et al, 2015).…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

“…Psychological symptoms such as irritability, sleep disturbances, anxiety, sadness, fear of being alone, and fear of dying were also prevalent at the EOL period (Friedrichsdorf et al, 2014;Heath et al, 2010;Hassan et al, 2018;Ilowite et al, 2018;Latha et al, 2016;Pritchard et al, 2008;Rosenberg et al, 2016;Theunissen et al, 2007;Tomlinson et al, 2011;Ullrich et al, 2010a;Van Cleve et al, 2012;Wolfe et al, 2015;Ye et al, 2019). For example, Ye et al (2019) found that sleep disturbances persisted 65.4% of the time in children with cancer at EOL.…”

Section: Symptom Prevalencementioning

confidence: 99%

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An Integrative Review of Factors Associated With Symptom Burden at the End of Life in Children With Cancer

Eche

Aronowitz

2020

J Pediatr Oncol Nurs

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Children with cancer experience multiple symptoms at end of life (EOL) that impair their health-related quality of life. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, this integrative literature review comprehensively summarized symptom experiences of children with cancer at EOL. The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Academic Premier were searched between January 2007 to September 2019 for articles published in English using the MeSH terms: symptom burden or distress AND children with cancer or pediatric cancer or cancer children or oncology and pediatrics AND EOL care or palliative care or death or dying or terminally ill. The inclusion criteria were the following: (a) study designs [randomized controlled trials, nonexperimental, secondary analysis (if aims were distinct from primary studies) and qualitative]; (b) participants <18 years old (died of cancer, had no realistic chance of cure, or had advanced cancer); and (c) focused on symptom experiences/burden at EOL. Exclusion criteria were nonresearch articles, systematic reviews, case studies, reports, and studies that focused on cancer survivors and/or those receiving curative therapies. Twenty-seven articles met inclusion criteria. The most prevalent symptoms—pain, fatigue, dyspnea, and loss of appetitewere associated with impairments in health-related quality of life. Children with brain tumors experienced higher symptom burden compared to those with hematologic/solid malignancies. Children who received cancer-directed therapies experienced disproportionate symptoms and were more likely to die in the intensive care unit compared with those who did not receive cancer-directed therapies. Most common location of death was home. This integrative review indicated that children with cancer were polysymptomatic at EOL. Strategies facilitating effective symptom management at EOL are needed.

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“…Although considerable evidence exists regarding the presence of SES differences in health status and health care utilization globally [ 7 ], the evidence regarding SES inequalities within the context of EOL suffering remains fragmentary. Previous studies have reported that low SES cancer patients are more likely to experience higher mortality [ 8 – 13 ], depression [ 14 ] and other comorbidities [ 12 , 13 ], and greater symptom burden [ 15 ] compared to higher SES patients. Low SES cancer patients are also less likely to receive palliative care [ 16 , 17 ], and to die at home [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Socio-economic inequalities in suffering at the end of life among advanced cancer patients: results from the APPROACH study in five Asian countries

Malhotra

Krishnan

Yong

et al. 2020

Int J Equity Health

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Background A systematic understanding of socio-economic inequalities in end-of-life (EOL) suffering among advanced cancer patients is required to inform efforts to reduce these inequalities as part of Universal Health Coverage goals. Aims To assess inequalities in multiple domains of EOL suffering among advanced cancer patients – physical, functional, psychological, social, and spiritual –, using two socio-economic status (SES) indicators, education and perceived economic status of the household. Methods We used cross-sectional data from surveys of stage IV cancer patients (n = 1378) from seven hospitals across five countries (China, Sri Lanka, India, Vietnam and Myanmar). We conducted separate multivariable linear regression models for each EOL suffering domain. We also tested interactions between the two SES indicators and between each SES indicator and patient age. Results Patients living in low economic status households /with fewer years of education reported greater suffering in several domains. We also found significant interaction effects between economic status of the household and years of education for all EOL suffering outcomes. Age significantly moderated the association between economic status of the household and social suffering and between years of education and psychological, social, and spiritual suffering (p < 0.05 for all). Conclusion Results highlight that SES inequalities in EOL suffering vary depending on the suffering domain, the SES indicator assessed, and by patient age. Greater palliative care resources for patients with low SES may help reduce these inequalities.

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The relationship between household income and patient‐reported symptom distress and quality of life in children with advanced cancer: A report from the PediQUEST study

Abstract: In this cohort of children with advanced cancer, children from low-income families were found to experience higher symptom burden and worse QOL.

Cited by 55 publications

References 37 publications

Neighborhood Greenery as a Predictor of Outdoor Crimes between Low and High Income Neighborhoods

Neighborhood Greenery as a Predictor of Outdoor Crimes between Low and High Income Neighborhoods

An Integrative Review of Factors Associated With Symptom Burden at the End of Life in Children With Cancer

Socio-economic inequalities in suffering at the end of life among advanced cancer patients: results from the APPROACH study in five Asian countries

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