Cross-lagged analysis of financial toxicity and psychological distress between breast cancer patients and spouses during chemotherapy: an actor-partner interdependence model.

AIM: To explore the longitudinal interaction between financial toxicity and psychological distress in breast cancer patients and their spouses based on the actor-partner interdependence model.

METHODS

Convenience sampling method was used to select 258 breast cancer patients and their spouses as the research partners. The financial toxicity scale and distress thermometer were used to investigate the patients in the early stage (T1), the middle stage (T2) and the end of chemotherapy (T3).

RESULTS

The actor effects of financial toxicity on psychological distress were significant for both breast cancer patients and their spouses. Specifically, the level of financial toxicity in patients significantly predicted their own psychological distress at the next time point (T1 → T2: β = -0.19, T2 → T3: β = -0.18, both p < 0.001), and the level of financial toxicity in spouses significantly predicted their own psychological distress at the next time point (T1 → T2: β = -0.15, T2 → T3: β = -0.14, both p < 0.01). The actor effects of psychological distress on financial toxicity were also significant. That is, the level of psychological distress in patients significantly predicted their own financial toxicity at the next time point (T1 → T2: β = -0.18, T2 → T3: β = -0.17, both p < 0.01), and the level of psychological distress in spouses significantly predicted their own financial toxicity at the next time point (T1 → T2: β = -0.16, T2 → T3: β = -0.15, p < 0.01). The partner effects of psychological distress were significant. Specifically, patients' psychological distress significantly and positively predicted their spouses' psychological distress at the next time point (T1 → T2: β = 0.18, T2 → T3: β = 0.17, both p < 0.01), and spouses' psychological distress significantly and positively predicted patients' psychological distress at the next time point (T1 → T2: β = 0.20, p < 0.001; T2 → T3: β = 0.20, p < 0.01).

CONCLUSION

The financial toxicity and psychological distress of breast cancer patients and their spouses have a two-way actor prediction effect.