title: Determining the costs of families' support networks following a child's cancer diagnosis.
abstract: BACKGROUND
  Cancer in children may place considerable economic burden on more than individual family members. The costs incurred to families' support networks (FSNs) have not been previously studied.
  
  
  OBJECTIVE
  The study objectives were to (a) identify and determine independent predictors of the direct and time costs incurred by the FSN and (b) explore the impact of these cancer-related costs on the FSN.
  
  
  METHODS
  A prospective mixed-methods study was conducted. Representing the FSN, parents recorded the resources consumed and costs incurred during 1 week per month for 3 consecutive months, beginning 1 month following their child's diagnosis. Descriptive statistics, multiple regression modeling, and descriptive qualitative analytical methods were used to analyze the data.
  
  
  RESULTS
  In total, 28 fathers and 71 mothers participated. The median total direct and time costs for the 3 months were CAN$154 and $2776, respectively, per FSN. The largest component of direct and time costs was travel and foregone leisure. Direct and time costs were greatest among those parents who identified a support network at baseline. Parents relied on their FSN to "hold the fort," which entailed providing financial support, assuming household chores, maintaining the siblings' routines, and providing cancer-related care.
  
  
  CONCLUSIONS
  Families' support networks are confronted with a wide range of direct and time costs, the largest being travel and foregone leisure.
  
  
  CONCLUSIONS
  Families' support networks play an important role in mitigating the effects of families' costs. Careful screening of families without an FSN is needed.
authors.affiliation: School of Nursing, Columbia University, New York, NY 10032, USA. at2704@columbia.edu
authors.forename: Argerie
authors.initials: A
authors.lastname: Tsimicalis
authors.forename: Bonnie
authors.initials: B
authors.lastname: Stevens
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Ungar
authors.forename: Mark
authors.initials: M
authors.lastname: Greenberg
authors.forename: Patricia
authors.initials: P
authors.lastname: McKeever
authors.forename: Mohammad
authors.initials: M
authors.lastname: Agha
authors.forename: Denise
authors.initials: D
authors.lastname: Guerriere
authors.forename: Ronald
authors.initials: R
authors.lastname: Barr
authors.forename: Ahmed
authors.initials: A
authors.lastname: Naqvi
authors.forename: Rahim
authors.initials: R
authors.lastname: Moineddin
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D017281:Cost of Illness; D005260:Female; D005102:Health Expenditures; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000191:economics / Q000451:nursing*; D010290:Parents; D011446:Prospective Studies; D013315:Stress, Psychological / Q000191:economics / Q000451:nursing; D011795:Surveys and Questionnaires