Financial burden and physical and emotional quality of life in COPD, heart failure, and kidney failure.

Patients with chronic and serious illnesses experience significant quality of life concerns. More research is needed to understand the impact of financial burden on patients with COPD, heart failure, and kidney failure. Patients with COPD, heart failure, or kidney failure completed a cross-sectional online survey using validated measures of financial burden (general financial strain as well as financial toxicity attributable to treatment), physical quality of life (symptom burden and perceived health), and emotional quality of life (anxiety, depression, and suicidal ideation). ANCOVA was used to examine whether financial strain and financial toxicity were associated with physical and emotional quality of life, while accounting for key covariates. Among 225 participants with COPD (n = 137), heart failure (n = 48), or kidney failure (n = 40), 62.2% reported general financial strain, with 34.7% experiencing financial toxicity attributable to treatments. Additionally, 68.9% rated their health as fair or poor, experiencing significant symptom burden including fatigue, dyspnea, and chest pain. Participants also reported clinically relevant levels of anxiety (55.1%), depression (52.0%), and suicidal ideation (21.8%). In the total sample, financial strain was associated with worse physical and emotional quality of life on all measures (all Ps < .001). Financial toxicity attributable to treatment was not associated with quality of life in the total sample or subsamples. Patients with COPD, heart failure, and kidney failure face significant financial, physical, and emotional burdens. Financial strain appears to undermine physical and emotional quality of life. Our study highlights the demand for interventions aimed at mitigating financial strain and toxicity experienced by individuals with chronic illnesses.

Personality and Self-efficacy for Illness Management in Cancer.

Objectives: Self-efficacy for illness management is increasingly recognized as important for outcomes in cancer. We examined whether The Big Five personality dimensions were associated with self-efficacy for illness management and hypothesized that patients who were less neurotic and more conscientious would have better self-efficacy. Methods: Adults with cancer completed a cross-sectional survey that included the Mini-International Personality Item Pool (IPIP) and three subscales of the Patient-Reported Outcomes Measurement Information System (PROMIS) Self-Efficacy for Chronic Conditions: managing emotions, managing symptoms, and managing treatment and medication. Linear regressions were used to test the hypotheses, while controlling for covariates. Results: The personality and PROMIS self-efficacy measures demonstrated good evidence of reliability (median Cronbach's alpha = .78, range of .69-.92) and validity (intercorrelations). As hypothesized, patients who were less neurotic or more conscientious had higher levels of illness self-efficacy overall and on each of the three subscales (all ps < .001). Openness was associated with better self-management of symptoms (p = .013) and emotions (p = .040). Extraversion was associated with better self-management of emotions (p = .024). Conclusions: Personality plays a vital role in illness self-efficacy for patients with cancer. Practice Implications: As a part of multidisciplinary care teams, psychosocial experts can use these findings to help patients better manage their illness.