Financial toxicity and quality of life among hospitalized cervical cancer patients in Indonesia: A cross-sectional study

Vollständiger Abstract

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Cervical cancer significantly impairs patient well-being, particularly in low- and middle-income countries where financial toxicity exacerbates the disease burden. Evidence regarding income-related quality of life (QoL) disparities among Indonesian cervical cancer patients remains limited. This study examined the association between demographic characteristics, specifically income, and QoL among hospitalized cervical cancer patients. A quantitative cross-sectional study was conducted among 60 consecutive patients recruited at a tertiary referral hospital in Bandung, Indonesia. Researchers assessed QoL using the validated EORTC QLQ-C30 instrument. Data were analyzed using descriptive statistics, bivariable tests, and multiple linear regression to identify independent predictors of QoL. Participants demonstrated a moderately favorable mean global QoL score (68.4 ± 12.5) despite experiencing a moderate symptom burden. Bivariate analyses revealed that age, education level, and marital status were not significantly associated with QoL. Income emerged as the sole significant demographic predictor. Multiple regression analysis confirmed that the higher-income group reported significantly better QoL than the lower-income group, exhibiting a mean difference of 9.3 points (β = 0.38, p = 0.008). The analysis indicated a moderate-to-large effect size (Cohen's d = 0.72). Income substantially and independently influences QoL among cervical cancer patients, highlighting the critical impact of financial vulnerability on survivorship outcomes. Integrating routine socioeconomic assessments, financial navigation services, and targeted supportive oncology nursing interventions into clinical practice is essential for mitigating financial toxicity and improving patient-centered outcomes in resource-limited settings.