{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:15:25Z","timestamp":1777943725459,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Financial distress, a term used to encompass the negative consequences of the cost of medical treatment, can lead to delay of care, psychological distress, or even bankruptcy for patients and\/or their families. Cancer is an expensive medical condition, and this distress is not routinely assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The primary objective of this study was to determine the frequency of high financial distress in patients with advanced cancer. Secondary objectives include determining the association between high financial distress with clinical and demographic characteristics. Primary outcome was based on the result of the InCharge Financial Distress\/Financial Well-Being Scale (IFDFW), an eight-question survey with each question rated from 1 (overwhelming stress) to 10 (no stress at all). High financial distress was defined as a mean score of \u22644.0. Quality of life was assessed with Edmonton Symptom Assessment Scale-Financial and Spiritual Distress (ESAS-FS), Comprehensive Score for Financial Toxicity\u2014Functional Assessment of Chronic Illness Therapy, and FACT-G surveys. Demographic data was collected from questionnaire and chart review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      One hundred and forty adult patients with advanced cancer were enrolled. The average patient age was in 50s, 67% were White, 12% Hispanic, 14% African American, and 4% Asian. Of the participants, 35\/140 patients (25%) reported high financial distress. Patients with high financial distress were younger (55.1 vs. 59.3 years old,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.04), less likely to be married (51.4% vs. 82.9%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002), less likely to be working full time (23% vs. 31%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.001), and had lower annual household income (49% making less than $40,000 a year vs. 13%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001). There was a significant association between financial distress, symptom burden, and decreased quality of life. There was a strong correlation between the IFDFW score and single item 0\u201310 financial distress ESAS (0.6,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>High financial distress is frequent among patients with advanced cancer. It was associated with younger age, nonmarried status, symptom severity, and decreased quality of life. Our findings suggest that financial distress should be monitored in supportive cancer care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218251401403","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T09:24:42Z","timestamp":1767173082000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Frequency and Correlates of Financial Distress in Patients with Advanced Cancer"],"prefix":"10.1177","author":[{"given":"Jacqueline","family":"Tschanz","sequence":"first","affiliation":[{"name":"Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rida","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxine","family":"De La Cruz","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minxing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Bruera","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-19-0460"},{"key":"e_1_3_2_3_2","unstructured":"Center for Disease Control. Fast facts: Health and economic costs of chronic conditions. Center for Disease Control; 2024. Available from: https:\/\/www.cdc.gov\/chronic-disease\/data-research\/facts-stats\/index.html"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djab192"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1586\/14737167.2014.963558"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2013-0374"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.4865"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2015-0026"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2017.0161"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(15)00151-9"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21443"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2013.001322"},{"key":"e_1_3_2_13_2","first-page":"34","article-title":"In charge financial distress\/financial well-being scale: Development, administration, and score interpretation","volume":"17","author":"Prawitz AD","year":"2006","unstructured":"Prawitz AD, , Garman ET, , Sorhaindo B, et al. In charge financial distress\/financial well-being scale: Development, administration, and score interpretation. J Financial Counseling Planning, 2006; 17:34\u201350.","journal-title":"J Financial Counseling Planning"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28814"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-1-79"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1017\/S147895151500108X"},{"key":"e_1_3_2_17_2","volume-title":"PDQ Cancer Information Summaries","author":"PDQ Adult Treatment Editorial Board","year":"2002","unstructured":"PDQ Adult Treatment Editorial Board. Financial Toxicity and Cancer Treatment (PDQ\u00ae): Health Professional Version. In: PDQ Cancer Information Summaries. National Cancer Institute (US): Bethesda, MD; 2002. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK384502\/"},{"key":"e_1_3_2_18_2","unstructured":"National Cancer Institute. Financial toxicity NCI Dictionary of Cancer Terms. National Cancer Institute; 2025. Available from: https:\/\/www.cancer.gov\/publications\/dictionaries\/cancer-terms\/def\/financial-toxicity"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0176470"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-020-05507-9"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/SPC.0b013e32835c7d88"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0000000000000463"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1159\/000502751"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/SPC.0b013e32832531ce"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.55388"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apjon.2022.04.008"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30369"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-020-05468-z"},{"key":"e_1_3_2_29_2","volume-title":"As Fewer Young Adults Wed, Married Couples\u2019 Wealth Surpasses Others\u2019","author":"Fenaba R","year":"2019","unstructured":"Fenaba R, , Addo LRR. As Fewer Young Adults Wed, Married Couples\u2019 Wealth Surpasses Others\u2019, Federal Reserve Bank of St. Louis, 2019."},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2306942"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.23.1183"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24333"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2015.007401"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1200\/OP.21.00042"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.09.2437"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2024.7030"},{"key":"e_1_3_2_37_2","volume-title":"Census Bureau Releases New Educational Attainment Data, For Immediate Release: Thursday, February 16, 2023","year":"2023","unstructured":"Census Bureau Releases New Educational Attainment Data, For Immediate Release: Thursday, February 16, 2023. 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