Coping strategies adopted by caregivers of pediatric oncology patients navigating the economic burden of treatment in a tertiary cancer care center: A qualitative thematic analysis.

e22004 Background: Economic distress due to cost of cancer treatment is a significant challenge for patients and caregivers. It impacts treatment adherence, quality of life, and emotional well-being, often leading to need for coping strategies that differ across sociocultural contexts, especially in pediatric cancers. Research on coping strategies used to navigate treatment costs is especially important in LMICS like India to plan healthcare delivery and policy. Methods: We conducted a qualitative study using semi-structured interviews with 10 parents/caregivers of pediatric cancer patients (< 18 years) to understand coping strategies used to navigate through their financial burdens during treatment. Interviews were recorded and transcribed verbatim and thematic analysis was performed using manual coding to identify common codes and themes on unique strategies used to address financial burdens. Results: All participants reported significant financial strain on their families due to the cancer treatment of their ward, which led to various coping strategies that cane grouped under the following 4 themes: (1) financial coping (selling of personal assets, taking loans and mortgages, relying on family and friends, support from charities, NGOs and government schemes, change of jobs and home, reduce/cut non-medical expenses),(2) emotional and social isolation, (3) discontinuation of education and (4) effect on siblings of the patient. Conclusions: The families of pediatric oncology patients in India face acute financial toxicity that extends beyond the medical bills which includes loss of income, educational disruption, and social isolation. The coping strategy themes identified from this study can help guide pediatric cancer care implementation and policies in India and similar LMIC countries.