Association between Financial Hardship and Symptom Burden in Patients Receiving Maintenance Dialysis: A Systematic Review

Abstract

Background: Many patients on maintenance dialysis experience financial hardship. Existing studies are mainly cost analyses that quantify financial hardship in monetary terms, but an evaluation of its impact is also warranted. This review aims to explore the definition of financial hardship and its relationship with symptom burden among patients on dialysis. Methods: A literature search was conducted in November 2020, using six electronic databases. Studies published in English that examined the associations between financial hardship and symptom burden were selected. Two reviewers independently extracted data and appraised the studies by using the JBI Critical Appraisal Checklists. Results: Fifty cross-sectional and seven longitudinal studies were identified. Studies used income level, employment status, healthcare funding, and financial status to evaluate financial hardship. While relationships between decreased income, unemployment, and overall symptom burden were identified, evidence suggested that several symptoms, including depression, fatigue, pain, and sexual dysfunction, were more likely to be associated with changes in financial status. Conclusion: Our findings suggest that poor financial status may have a negative effect on physical and psychological well-being. However, a clear definition of financial hardship is warranted. Improving this assessment among patients on dialysis may prompt early interventions and minimize the negative impact of financial hardship.

The Heterogeneity of Symptom Burden and Fear of Progression Among Kidney Transplant Recipients: A Latent Class Analysis

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Hope, quality of life, and psychological distress in patients on peritoneal dialysis: A cross-sectional study

“…There is abundant evidence of the impact of low socioeconomic status on patients with ESRD (Billington et al, 2008;He, 2012;Zhang and Xue, 2011). While our previous systematic review (Ng et al, 2021) identified associations between financial difficulties and both physical and mental well-being, the present study showed that socioeconomic status may specifically affect hope. The finding related to the PD submodality is consistent with some previous reports (Bieber et al, 2014).…”

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