Financial Toxicity and Quality of Life in Hospitalized Cancer Patients: A Multicenter Study

NCT ID: NCT07083271

Last Updated: 2025-11-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

130 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-08-01

Study Completion Date

2026-01-15

Brief Summary

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This multicenter, cross-sectional observational study aims to evaluate the impact of financial toxicity on caregiver burden, quality of life, and emotional distress among hospitalized adult cancer patients. Participants will complete validated Turkish versions of the Zarit Caregiver Burden Scale, the EORTC QLQ-C30, and the Hospital Anxiety and Depression Scale (HADS). Financial toxicity will be assessed through indicators such as household income, treatment-related costs, and insurance coverage. Informed consent will be obtained from all participants. The study will not impose any financial burden on the participants or the hospital.

Data collection is planned between August 1, 2025 and January 15, 2026 at three tertiary centers: Etlik City Hospital, Gazi University Faculty of Medicine, and Kocaeli University Faculty of Medicine in Turkey. The findings are expected to contribute to the development of targeted support strategies for patients and caregivers in oncology settings.

Detailed Description

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This is a cross-sectional, multicenter observational study designed to assess the relationship between financial toxicity and caregiver burden, quality of life, and emotional well-being in hospitalized adult patients with cancer. The study population will include patients aged 18 years or older who are hospitalized in oncology wards and mentally capable of completing self-report questionnaires. Exclusion criteria include patients in intensive care units, those with impaired consciousness, severe psychiatric disorders, or those who are pregnant or lactating.

All participants will be asked to complete a battery of validated, Turkish-translated assessment tools covering multiple psychosocial domains:

The Comprehensive Score for Financial Toxicity (COST) will be used to assess perceived financial burden related to cancer care. The Turkish version consists of 11 items, each rated on a 5-point Likert scale. Total scores range from 0 to 44, with lower scores indicating greater financial toxicity. Financial toxicity will be further evaluated using self-reported data on household income, treatment-related out-of-pocket expenses, and insurance coverage.

The Zarit Caregiver Burden Scale (ZCBS) will be administered to evaluate caregiver burden, especially for informal caregivers such as family members. This 22-item instrument is rated on a 5-point Likert scale, generating a total score between 0 and 88. Higher scores reflect greater levels of burden. The Turkish version has demonstrated strong psychometric validity and reliability in oncology and geriatric care settings.

The Hospital Anxiety and Depression Scale (HADS) will be used to evaluate emotional well-being. It comprises 14 items divided into two subscales: anxiety and depression (each 7 items). Each subscale yields a score between 0 and 21; higher scores denote more severe emotional symptoms. The Turkish version has been validated for use in cancer patient populations.

The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) will be applied to assess quality of life across several domains. This 30-item questionnaire includes a global health status scale, five functional scales (physical, role, emotional, cognitive, and social functioning), and nine symptom scales. Each scale is transformed linearly to a 0-100 score, where higher functioning scores indicate better quality of life, and higher symptom scores reflect greater symptom burden. The Turkish version has been culturally and linguistically validated.

All participants will provide written informed consent prior to enrollment. No medical intervention will be applied, and the study will not impose any financial or logistical burden on the patients or the participating institutions. Participation is voluntary, and withdrawal from the study is permitted at any point without consequences. The study protocol has been reviewed and approved by the Scientific Research and Evaluation Board of Etlik City Hospital (BADEK). The study complies with the ethical principles outlined in the Declaration of Helsinki. Data will be anonymized, securely stored, and only used for academic purposes.

Data collection is scheduled to be conducted between August 1, 2025, and January 15, 2026, across three tertiary oncology centers in Turkey: Etlik City Hospital, Gazi University Faculty of Medicine, and Kocaeli University Faculty of Medicine. Data will be analyzed using descriptive statistics, group comparisons (e.g., independent samples t-test, ANOVA), correlation analyses, and multivariable regression modeling to explore the predictors of financial toxicity and associated psychosocial outcomes.

Conditions

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Financial Toxicity Cancer Patients

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Hospitalized Adult Cancer Patients

Adult cancer patients (≥18 years) who are hospitalized in medical oncology wards and are cognitively capable of completing self-administered questionnaires. Participants will complete validated Turkish versions of the Zarit Caregiver Burden Scale (ZCBS), EORTC QLQ-C30, and Hospital Anxiety and Depression Scale (HADS). Financial toxicity will be evaluated using self-reported data on household income, out-of-pocket treatment expenses, and insurance status. No intervention will be administered.

Administration of validated questionnaires with established Turkish versions

Intervention Type OTHER

Participants will complete validated Turkish versions of three self-administered instruments: the Zarit Caregiver Burden Scale (ZCBS), the EORTC QLQ-C30, and the Hospital Anxiety and Depression Scale (HADS). Financial toxicity will be assessed via self-reported socioeconomic data. No clinical, behavioral, or pharmaceutical intervention will be applied.

Interventions

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Administration of validated questionnaires with established Turkish versions

Participants will complete validated Turkish versions of three self-administered instruments: the Zarit Caregiver Burden Scale (ZCBS), the EORTC QLQ-C30, and the Hospital Anxiety and Depression Scale (HADS). Financial toxicity will be assessed via self-reported socioeconomic data. No clinical, behavioral, or pharmaceutical intervention will be applied.

Intervention Type OTHER

Other Intervention Names

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Psychosocial assessment tools Self-reported questionnaires

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years
* Histologically confirmed solid organ malignancy
* Currently receiving inpatient care in the medical oncology service
* Receiving active oncologic treatment and/or supportive care
* Fluent in Turkish (reading and speaking)
* Capable of understanding and answering the administered surveys
* Signed informed consent form

Exclusion Criteria

* ICU admission at the time of enrollment
* ECOG Performance Status ≥3 or cognitive/clinical condition preventing completion of questionnaires
* Severe cognitive impairment or psychiatric condition interfering with survey participation
* Failure to provide informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gazi University

OTHER

Sponsor Role collaborator

Kocaeli University

OTHER

Sponsor Role collaborator

Ankara Etlik City Hospital

OTHER_GOV

Sponsor Role lead

Responsible Party

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Galip Can Uyar

Principal Investigator, Medical Oncology Specialist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Galip Can Uyar, MD

Role: PRINCIPAL_INVESTIGATOR

Etlik City Hospital, Department of Medical Oncology

Locations

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Kocaeli University, Medical Oncology Department

Kocaeli, İzmit, Turkey (Türkiye)

Site Status NOT_YET_RECRUITING

Etlik City Hospital, Medical Oncology Department

Ankara, Yenimahalle, Turkey (Türkiye)

Site Status RECRUITING

Gazi University, Medical Oncology Department

Ankara, Çankaya, Turkey (Türkiye)

Site Status NOT_YET_RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Galip Can Uyar, MD

Role: CONTACT

+90506 596 38 12

Mustafa Altınbaş, MD

Role: CONTACT

+90 532 465 79 32

Facility Contacts

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Erdem Köleman, MD

Role: primary

+90539 654 89 36

Galip Can Uyar, MD

Role: primary

+90506 596 38 12

Mustafa Altınbaş, MD

Role: backup

+90532 465 79 32

Orhun Akdoğan, MD

Role: primary

+90537 583 15 94

Other Identifiers

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AEŞH-BADEK-2024-1249

Identifier Type: -

Identifier Source: org_study_id

AEŞH-BADEK-2024-1249

Identifier Type: OTHER

Identifier Source: secondary_id

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