Financial hardship among siblings of long-term survivors of childhood cancer: A Childhood Cancer Survivor Study report.

BACKGROUND: Siblings of children with cancer may experience adverse household economic consequences, but their financial outcomes in adulthood are unknown. METHODS: A total of 880 siblings (aged 18-64 years) of adult-aged childhood cancer survivors were surveyed to estimate the prevalence of financial hardship by three established domains (behavioral, material, and psychological). For individual financial hardship items matching the contemporaneous National Health Interview Survey or Behavioral Risk Factor Surveillance System, siblings were compared with the general population by calculating adjusted prevalence odds ratios (ORs) to sample-weighted responses. Multivariable logistic regression models examined associations between sibling characteristics and each hardship domain and between sibling hardship and survivors' cancer/treatment characteristics. RESULTS: Behavioral, material, and psychological hardship was reported by 24%, 35%, and 28%, respectively. Compared with national survey respondents, siblings were more likely to report worries about medical bills (OR, 1.14; 95% confidence interval [CI], 1.06-1.22), difficulty affording nutritious foods (OR, 1.79; 95% CI, 1.54-2.07), and forgoing needed medical care (OR, 1.38; 95% CI, 1.10-1.73), prescription medications (OR, 2.52; 95% CI, 1.99-3.20), and dental care (OR, 1.34; 95% CI, 1.15-1.57) because of cost. Sibling characteristics associated with reporting financial hardship in one or more domains included female sex, older age, chronic health conditions, lower income, not having health insurance, high out-of-pocket medical expenditures, and nonmedical/nonhome debt. No survivor cancer/treatment characteristics were associated with sibling financial hardship. CONCLUSIONS: Adult siblings of childhood cancer survivors were more likely to experience financial hardship compared with the general population. Childhood cancer may adversely affect entire households, with potentially lasting implications.

How individuals perceive their partner's relationship behaviors when worrying about finances.

What role do financial worries play in close relationship functioning? In this research, we examine how financial worry - negative thoughts and feelings about finances - is associated with perceived relationship behaviors. Participants recalled how their partner acted during a recent disagreement (Study 1, N = 97 couples) or recalled the frequency of positive and negative behaviors enacted by their partner during the previous week (Study 2, N = 99 couples). Feeling more worried about finances was associated with recalling less supportive behavior from one's partner at the disagreement (Study 1) and with perceiving more negative behaviors from one's partner in the last week (Study 2). Truth and Bias Model analyses suggest that part of this link may be attributed to biased perceptions, as the link between financial worry and perceiving more negative behaviors persisted even after controlling for participants' own reported behaviors (i.e., accounting for similarity) and for their partner's own reported behaviors (i.e., accounting for accurate perceptions). In sum, financial worry is linked to how partners notice and interpret a loved one's actions within their relationship.

Financial worry and psychological distress among cancer survivors in the United States, 2013-2018.

BACKGROUND: A growing proportion of cancer survivors experience financial toxicity. However, the psychological burden of cancer costs and associated mental health outcomes require further investigation. We assessed prevalence and predictors of self-reported financial worry and mental health outcomes among cancer survivors. PATIENTS AND METHODS: Data from the 2013-2018 National Health Interview Survey (NHIS) for adults reporting a cancer diagnosis were used. Multivariable ordinal logistic regressions defined adjusted odds ratios (AORs) of reporting financial worry by relevant sociodemographic variables, and sample weight-adjusted prevalence of financial worry was estimated. The association between financial worry and psychological distress, as defined by the six-item Kessler Psychological Distress Scale was also assessed. RESULTS: Among 13,361 survey participants (median age 67; 60.0% female), 9567 (71.6%) self-reported financial worry, including worries regarding costs of paying for children's college education (62.7%), maintaining one's standard of living (59.7%), and medical costs due to illness or accident (58.3%). Female sex, younger age, and Asian American race were associated with increased odds of financial worry (P < 0.05 for all). Of 13,218 participants with complete responses to K6 questions, 701 (5.3%) met the threshold for severe psychological distress. Participants endorsing financial worry were more likely to have psychological distress (6.6 vs. 1.2%, AOR 2.89, 95% CI 2.03-4.13, P< 0.001) with each additional worry conferring 23.9% increased likelihood of psychological distress. CONCLUSIONS: A majority of cancer survivors reported financial worry, which was associated with greater odds of reporting psychological distress. Policies and guidelines are needed to identify and mitigate financial worries and psychologic distress among patients with cancer, with the goal of improving psychological well-being and overall cancer survivorship care.

A prospective study of financial worry, mental health changes and the moderating effect of social support among Canadian adolescents during the COVID-19 pandemic. / Étude prospective des préoccupations financières, des changements de l'état de santé mentale et de l'effet modérateur du soutien social chez les adolescents canadiens pendant la pandémie de COVID-19.

INTRODUCTION: The COVID-19 pandemic intensified the impact of risk factors for adolescent mental health, including financial worry. Social support has shown to protect from negative mental health during times of stress. We examined the effect of financial worry on changes in anxiety and depression symptoms among Canadian adolescents prior to and during the pandemic, and assessed whether social support from family and friends moderated any changes. METHODS: We analyzed 2-year linked data from the 2018/19 (pre-pandemic) and 2020/21 (during-pandemic) waves of the COMPASS study, with reports from 12 995 Canadian secondary school students. A series of multilevel linear regressions were conducted to examine the main hypotheses under study. RESULTS: Students scored an average (SD) of 7.2 (5.8) on the anxiety (GAD-7) and 10.0 (6.5) on the depression (CESD-10) scales; 16.1% reported they experienced financial worry during the pandemic. Financial worry was a strong and significant predictor of increased anxiety scores (+1.7 score between those reporting "true/mostly true" versus "false/mostly false") during the pandemic, but not for depression scores. Low family and friend support were associated with anxiety, and low family support was associated with depression. No significant interactions were detected between social support and financial worry. CONCLUSIONS: Pandemic-related financial worry was significantly associated with anxiety in our large sample of Canadian adolescents. Clinical and public health initiatives should be aware of adolescents' financial worry and its associations with anxiety during times of crisis.

The personal financial burden associated with idiopathic inflammatory myopathies.

The economic burden of idiopathic inflammatory myopathies (IIMs) within the US is underexplored. We hypothesized that IIMs patients experience considerable personal financial burden due to risks of multi-specialist visits, chronic long-term care, costs associated with disability, medical treatment, and overall high spending costs within the US healthcare system. We surveyed members of Myositis Support and Understanding (MSU) (response rate 4.7 %), and of the 470 survey participants that self-reported with diagnoses of IIMs, we assessed financial burden using two validated measures: (1) Financial Worry Score, and (2) Financial Burden Composite Score (FBCS). We determined factors associated with increased FBCS using logistic and Poisson regression respectively. High financial worry was endorsed by 202 participants (43 %) and the average FBCS ± SD was 1.8 ± 1.9. The odds of financial worry among participants with Medicaid is 3.016 times the odds of financial worry among participants without Medicaid (p = 0.011), and the odds of financial worry among participants with private high-deductible insurance is 3.216 times the odds of financial worry among participants who do not have private high-deductible insurance (p =< 0.001). Given the link between personal financial burden and potential effects on patient outcomes, it is essential for physicians to consider patient financial health when determining management or treatment courses. Identifying specific risk factors that can further exacerbate personal financial burden can help physicians identify vulnerable patients to reduce financial hardship.

Nationally Representative Sample Shows an Increase in Domestic Conflict Early in the COVID-19 Pandemic.

OBJECTIVE: The coronavirus disease (COVID-19) pandemic and associated social distancing increased stressors related to risk for domestic conflict, but increases in domestic conflict early in the pandemic have yet to be studied in community samples. METHODS: Increase in domestic conflict (verbal or physical fights) since the beginning of the pandemic was assessed in 1196 partnered and cohabitating respondents, drawn from a nationally representative sample, in May 2020. Chi-square tests and logistic regression analyses were used to estimate associations of demographic characteristics and financial worry with domestic conflict. RESULTS: An increase in domestic conflict was reported by 10.6% (95% CI: 7.7-13.4) of the sample. Domestic conflict increase was significantly associated with younger age, lower education, and financial worry. CONCLUSION: Increases in domestic conflict were seen in certain vulnerable groups and in those who report financial worry. Policies ensuring financial stability, particularly early in the disaster conditions, could reduce domestic conflict during continued COVID-19 conditions or other disasters.

Emotional and financial health during COVID-19: The role of housework, employment and childcare in Australia and the United States.

During the first few months of the COVID-19 pandemic, the world witnessed major economic, school, and daycare closures. We sampled respondents in Australia and the US during the height of the first restrictions to understand how the first quarantine structured their emotional strain and financial worry (825 Australians and 835 Americans aged between 18 and 65; May 2-3, 2020; source YouGov). We apply structural equation modeling to demonstrate that the emotional well-being impacts of COVID-19 are not only gendered but also vary between childless people and parents. Specifically, we show that compared to Australians, Americans were more impacted by changes in their financial circumstances. Further, while the financial worry and emotional strain impacts were similar between childless people and parents in Australia, significant differences existed between the two groups in the United States. In particular, we identify American mothers as the most disadvantaged group-feeling the most anxious and financially worried about both employment and domestic changes under COVID-19. Policy wise, we argue that COVID-19 is exacerbating gender inequality in emotional health. To slow down this trend, more adequate mental health supports are needed, particularly for mothers.

The network of stress-related states and depression and anxiety symptoms during the COVID-19 lockdown.

BACKGROUND: The coronavirus (COVID-19) pandemic and the social distancing protocols used to impede the spread of the virus may have severe mental health consequences. The purpose of this study was to investigate the network of components of pandemic-related negative psychological states (i.e., fear of infection, financial worries, loneliness) and symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD). METHODS: Data from 10,061 Norwegian adults recruited through an online survey during a period of strict social distancing protocols were analyzed by cross-sectional network methods. RESULTS: Of the infection fears, fear of being infected, fear of dying from the coronavirus and fear of significant others dying from it had notable connections to the GAD symptoms anxiety and/or fear of awful events. The financial worry component worry about personal economy was connected to the MDD symptom sleep problems and to the GAD symptom generalized worry. Each of the loneliness components was connected to a specific MDD symptom. Depressed mood, low energy and worthlessness had the highest strength centrality among the MDD symptoms; generalized worry, uncontrollability of worry, and trouble relaxing among the GAD symptoms; fear of dying from the virus among the fear of infection components; and feeling isolated among the loneliness components. LIMITATIONS: Full random sampling was not conducted, although the sample turned out to be relatively representative of the Norwegian population. CONCLUSIONS: Some components of the pandemic-related distressing states of fear of infection, financial worry and loneliness seem to be associated with specific symptoms of MDD and GAD.

Psychosocial and Financial Impact of Disease among Patients of Dermatophytosis, a Questionnaire-Based Observational Study.

INTRODUCTION: In the present epidemic of chronic, recalcitrant, and widespread dermatophytosis, impact of disease on quality of life (QoL) can be severe. Similarly, financial impact due to treatment cost and loss of wages needs consideration too. AIMS AND OBJECTIVES: Our primary aim was to evaluate the impact of dermatophytosis on QoL and the financial burden on individual and family. MATERIALS AND METHODS: Adult patients having dermatophytosis were included in the study. Standard Dermatology Life Quality Index (DLQI) questionnaire was used to evaluate the psychosocial impact, and financial burden was evaluated by nine binary questions. RESULTS: A total of completed 299 DLQI surveys and 275 financial burden surveys were taken for final analysis. Mean DLQI was 12.25 (SD = 5.56, n = 299). Significant association between total body surface area (BSA) and DLQI score was observed (r s = 0.251, P < 0.001, n = 299). Presence of tinea corporis was found to be significantly affecting the choice of clothing (P = 0.018, χ2 = 5.127, CI 95%). More numbers of male respondents reported loss of work or study hours due to their illness (P = 0.015, χ2 = 5.196, CI 95%), which was significantly associated with the BSA involved (P < 0.05, t = 5.529, CI 95%). Some difficulties in sexual activity were reported by 35.6% patients, which has significant association with tinea cruris (P = 0.001, χ2 = 10.810, CI 95%). Median household income was 10,000 INR and interquartile range (IQR) being 8,000-19,000. Mean financial burden calculated at 3.458 (SD = 1.696, n = 275), whereas mean financial worry reported by patient stood at 3.661 (SD = 1.216, n = 275). Financial burden showed significant correlation with "previous treatment approximate cost," financial worry, and DLQI (P < 0.05, CI 95%). Financial worry (P = 0.016, r s = 0.145, CI 95%) and financial burden (P = 0.002, r s - = 0.145, CI 95%) both showed positive correlation with duration of disease. CONCLUSION: In present scenario of Dermatophytosis in India, the disease and its treatment causing impact on QOL as well as on personal financial burden and worry need consideration.