Financial burdens and challenges experienced by geographically remote families during pediatric cancer treatment: A qualitative analysis

Abstract

Introduction: Children with cancer and their families often experience financial toxicity, defined as the adverse financial effects resulting from cancer care. Limited research has explored the financial experiences of families from geographically remote locations, who may be at increased risk for disproportionate negative effects. Materials and Methods: Using a phenomenological approach, we conducted 13 semi-structured interviews with caregivers of children with cancer with a permanent residence located greater than 60 minutes of travel time from their treating center. We performed a thematic analysis of interview transcripts focused on elucidating how elements of financial toxicity manifested and subsequently impacted patients and families. Results: We identified five general themes; four related to separate constructs of financial toxicity and one related to coping behaviors in response to financial challenges. We identified several exacerbating and ameliorating factors salient to the development of financial toxicity. Specifically, geographic distance to care often provoked or exacerbated financial toxicity. Conclusion: Geographically distant families of pediatric patients with cancer experience a wide range of financial toxicity and caregiving challenges throughout treatment, and families perceive distance to care as an important provoking factor. Interventions are needed to mitigate the development and effects of financial toxicity for families of children with cancer, and greater attention should be given to examining financial toxicity specifically among geographically distant families.