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Our goal was to derive a model for the German healthcare system to shed light on the complex process of financial effects of cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The model was developed through systematic literature review and qualitative studies, including interviews with 18 cancer patients and a focus group with 4 social services representatives. The iterative process of model development was accompanied by an ongoing exchange in the interdisciplinary research team.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The developed model of financial effects of cancer experienced by patients consists of three dimensions: (1)\n                      <jats:italic>actual and anticipated financial disadvantages<\/jats:italic>\n                      , (2)\n                      <jats:italic>behavioural<\/jats:italic>\n                      <jats:italic>and cognitive coping strategies<\/jats:italic>\n                      , and (3)\n                      <jats:italic>subjective financial distress<\/jats:italic>\n                      conceptualised as negative effects in different aspects of daily living:\n                      <jats:italic>employment<\/jats:italic>\n                      ,\n                      <jats:italic>living situation<\/jats:italic>\n                      ,\n                      <jats:italic>family<\/jats:italic>\n                      ,\n                      <jats:italic>social participation<\/jats:italic>\n                      ,\n                      <jats:italic>health promoting lifestyle<\/jats:italic>\n                      ,\n                      <jats:italic>additional personally preferred treatments<\/jats:italic>\n                      ,\n                      <jats:italic>navigating the health system<\/jats:italic>\n                      , and a further area so-called\n                      <jats:italic>unspecific.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Subjective financial distress is driven by different financial effects of cancer experienced by patients and is perceived as negative in various aspects of daily living. While the identified categories of daily living can be observed in countries with universal healthcare coverage, the content and degree of each subcategory depend on country-specific characteristics. The introduced model can be used to inform the development of a new patient-reported outcome measure (PROM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>NCT05319925 (registration date, 2022-06-01)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-026-10395-6","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T05:22:43Z","timestamp":1770873763000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Towards the assessment of financial distress among cancer patients: a conceptual model of the financial effects of a tumour disease"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6032-0239","authenticated-orcid":false,"given":"Sophie","family":"Pauge","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5540-780X","authenticated-orcid":false,"given":"Andrea","family":"Z\u00fcger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luise","family":"Richter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viktoria","family":"Mathies","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1655-0907","authenticated-orcid":false,"given":"Bastian","family":"Surmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2147-489X","authenticated-orcid":false,"given":"Thomas","family":"Ernst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1106-474X","authenticated-orcid":false,"given":"Natalja","family":"Menold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9552-6969","authenticated-orcid":false,"given":"Wolfgang","family":"Greiner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7460-0154","authenticated-orcid":false,"given":"Eva C.","family":"Winkler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6532-9876","authenticated-orcid":false,"given":"Katja","family":"Mehlis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"issue":"15","key":"10395_CR1","doi-asserted-by":"publisher","first-page":"1732","DOI":"10.1200\/JCO.2015.63.2232","volume":"34","author":"CS Lathan","year":"2016","unstructured":"Lathan CS, Cronin A, Tucker-Seeley R, Zafar SY, Ayanian JZ, Schrag D (2016) Association of financial strain with symptom burden and quality of life for patients with lung or colorectal cancer. 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