Objectives/Purpose: Risk factors and consequences of financial distress are increasingly acknowledged in patients with cancer, particularly those who live longer with advanced disease. However, the specific impact on the patient-partner dyad, the relational context where financial decisions and coping are most intimately navigated for couples, is largely unexplored.
Methods: Women diagnosed with advanced breast cancer and their romantic partner separately completed self-report measures at three time points T1: within a year of patient’s diagnosis, T2: 3 months post T1, and T3: 6 months post T1. Measures included: financial distress (COST; ENRICH), psychological wellbeing (CESD, GAD-7) and relational support (SPS total) and relational attachment/intimacy (SPS-attachment scale). Spousal caregivers reported on caregiving burden (CRA). Patients and caregivers additionally provided open-ended response sharing what they would like their medical teams to know about financial stress.
Results: In the sample of 100 dyads (n=200) (51% female (n=2 same sex couples), Stage IV disease (53%), mean age=50 yrs, mean age married=19.5 yrs, 66% non-Hispanic white, 72% college educated, 65% >$100,000/yr income), financial distress captured by the COST (T1: M=24.8, SD=10.0, 23%≤17.5) and ENRICH (T1: M=3.38, SD=2.2) was stable over time (p=.57, p=.06); however, financial distress was consistently associated with poorer psychological wellbeing, less perceived relational support, and less relational attachment and intimacy across all three time points. For spousal caregivers, greater financial distress was associated with greater caregiving burden.
Conclusions: While financial stress was relatively stable over time, the associated sequelae of poorer psychological wellbeing of the patient and caregiver individually and the relational wellbeing of the couple continue to persist over time. Opportunities for potential intervention are highlighted to change the trajectory of these associations over time.