# Financial Hardship among Patients with Acute Respiratory Failure and their Family Member Caregivers: Understanding the Impact on Patient- and Family- Centered Outcomes

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2024 · $673,491

## Abstract

PROJECT SUMMARY/ABSTRACT: For many seriously ill patients, such as those with underlying life-limiting
chronic conditions, deterioration in health often results in acute respiratory failure (ARF), a common critical
illness that is associated with prolonged disability and high risk of death. Critical illness hospitalizations are
resource intensive and expensive, and associated with significant family caregiver burden. As a result, these
patients and their family caregivers are particularly vulnerable to significant financial hardship. We have
previously shown that financial hardship is a major source of stress for patients with ARF and their family
members. Importantly, it is persistent, worsens after hospital discharge, and is likely to be an important
mediator of psychological distress and poorer quality of life in this population, yet few studies have sought to
address the role of financial hardship in the context of patient- and family-centered outcomes over time.
 Financial hardship encompasses material (e.g. out-of-pocket expenses, unemployment), psychological
(e.g. feelings of distress), and behavioral aspects (e.g. coping mechanisms). Although financial hardship has
been established as an important and modifiable problem among outpatients with cancer, little work has been
done with patients with ARF and their families. In order to develop context-specific interventions that are likely
to be effective in meeting the unique needs of these patients and their family caregivers, we need to
understand who is at highest risk for developing financial hardship during and after critical illness, which of
these risk factors are modifiable, and the effect of financial hardship on patient- and family-centered outcomes.
 We will address this knowledge gap by using a multiple methods approach to advance our understanding
of financial hardship for seriously ill adults with ARF and their family caregivers. In Aim 1, we will identify
patients with ARF and family caregivers who are at highest risk for subsequent financial hardship by examining
both non-modifiable baseline characteristics that identify those at risk, and modifiable factors that may be the
focus for context-specific interventions. In Aim 2, we will make the important connection between financial
hardship and patient- and family-centered outcomes (psychological distress, health-related quality of life and
goal-concordant care) over time, something which has not been done for patients with ARF and their family but
is a necessary next step for the development of interventions that will successfully disrupt the long-term
consequences of financial hardship following critical illness. In Aim 3, using qualitative methods, we will explore
drivers of material hardship and factors that influence psychological responses and coping behaviors from the
perspective of key stakeholders. Our multi-disciplinary team has significant experience assessing patient- and
family-centered outcomes, performing electroni...

## Key facts

- **NIH application ID:** 10908556
- **Project number:** 5R01HL162831-03
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Nita Khandelwal
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $673,491
- **Award type:** 5
- **Project period:** 2022-08-01 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10908556

## Citation

> US National Institutes of Health, RePORTER application 10908556, Financial Hardship among Patients with Acute Respiratory Failure and their Family Member Caregivers: Understanding the Impact on Patient- and Family- Centered Outcomes (5R01HL162831-03). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/10908556. Licensed CC0.

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