Experience of financial toxicity and coping strategies in young and middle-aged stroke patients: a qualitative study

Abstract

Background Financial toxicity（FT) has been prevalent in cancer patients, and some studies have reported that stroke patients are also affected by FT. FT can be physically and mentally detrimental to a patient's recovery. The experience of FT in cancer patients has been studied, however, stroke being a chronic disease, rehabilitation is also an important stage in the recovery of the disease. However, little is known about the experience of FT and coping in stroke patients. Therefore, the purpose of this study was to describe the experience of FT in young and middle-aged stroke patients and the coping measures they take. Methods From October 2022 to March 2023, Young and middle-aged stroke patients (18-59 years old) were recruited from a tertiary hospital in Shanghai, China, for semi-structured interviews. The research team used the Nvivo 12 software to analyze the interview data. Content analysis was used to analyze the data. Results A total of 21 young and middle-aged stroke patients were interviewed in this study. The results of the interviews are divided into two parts: one was the experience of FT among young and middle-aged stroke patients, and the other was their measures to cope with FT. A total of 8 sub-themes were constructed. The experience includes 4 sub-themes: (1) taking on a multifaceted economic pressure, (2) FT affecting treatment, (3) FT affecting living conditions (4) generating anxiety and depression emotions. Coping strategies include 4 sub-themes: (1) reducing expenses, (2) increasing economic income, (3) seeking social support, and (4) the need and expectation to address FT. Conclusions The presence of FT in young and middle-aged stroke patients, which affects their physical and mental health, has led them to take measures to cope with FT. It is recommended that the government should expand the scope of health insurance coverage and promote equity in health care policies. Healthcare professionals should actively focus on the FT of young and middle-aged stroke patients by supporting them with healthcare policy and employment information. Patients themselves need to improve their self-efficacy and actively cooperate with treatment. People at high risk of stroke can purchase commercial insurance in advance. Joint and combined efforts to reduce the impact of FT on young and middle-aged stroke patients.