International journal of nursing studies · 2026
"Between love and bills"- tailored personas of families coping with financial toxicity from caring for people with dementia and comorbidities: A qualitative study.
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Liu Tong, Ma Yingzhuo, Yang Yang, Cheng Oumei, Feng Min, Zhao Qinghua, Wang Jun, Xiao Mingzhao
Аннотация
BACKGROUND: Financial toxicity is a critical factor impacting the well-being of families caring for people with dementia and comorbidities. However, the impact of individual differences in behavioral decision-making patterns when coping with financial toxicity is particularly significant, and standard financial support approaches often fail to meet the needs of this heterogeneous group.
OBJECTIVE: This study aimed to explore the heterogeneity of behavioral decision-making patterns in coping with financial toxicity among families managing dementia and comorbidities, and to construct family personas to address the unique challenges and needs of diverse family groups.
METHODS: A qualitative descriptive study was conducted at multiple medical institutions and community centers in Chongqing, China, from August to October 2025. Purposive sampling was used to select primary financial decision-makers for people with dementia and comorbidities. Semi-structured interviews were conducted to capture their financial coping strategies and the underlying decision-making mechanisms. Inductive content analysis was used to extract factual labels and construct dimensional models. Family personas were developed by categorizing participants based on these dimensions, and the behavioral decision-making patterns embodied by these personas were interpreted from a behavioral economics perspective and visualized using labeled personas.
RESULTS: A total of 26 eligible primary financial decision-makers participated in the study. Three key dimensions were identified to construct the personas: characteristics of financial coping, behavioral decision-making patterns, and primary unmet support needs. Four distinct personas were developed based on individual attributes, highlighting the varying behavioral decision-making patterns and needs of families managing dementia and comorbidities. The personas were categorized as follows: participants who are avoidant and overwhelmed, participants who are motivated by responsibility and guided by emotion, participants who are anxious and restricted by social image, and participants who are highly knowledgeable with planning capabilities.
CONCLUSION: Precise interventions based on family personas are essential for optimizing financial decision-making in dementia and comorbidities care. This study developed four family personas for coping with financial toxicity, providing a theoretical basis for precise interventions to address the heterogeneous needs of this family group.
OBJECTIVE: This study aimed to explore the heterogeneity of behavioral decision-making patterns in coping with financial toxicity among families managing dementia and comorbidities, and to construct family personas to address the unique challenges and needs of diverse family groups.
METHODS: A qualitative descriptive study was conducted at multiple medical institutions and community centers in Chongqing, China, from August to October 2025. Purposive sampling was used to select primary financial decision-makers for people with dementia and comorbidities. Semi-structured interviews were conducted to capture their financial coping strategies and the underlying decision-making mechanisms. Inductive content analysis was used to extract factual labels and construct dimensional models. Family personas were developed by categorizing participants based on these dimensions, and the behavioral decision-making patterns embodied by these personas were interpreted from a behavioral economics perspective and visualized using labeled personas.
RESULTS: A total of 26 eligible primary financial decision-makers participated in the study. Three key dimensions were identified to construct the personas: characteristics of financial coping, behavioral decision-making patterns, and primary unmet support needs. Four distinct personas were developed based on individual attributes, highlighting the varying behavioral decision-making patterns and needs of families managing dementia and comorbidities. The personas were categorized as follows: participants who are avoidant and overwhelmed, participants who are motivated by responsibility and guided by emotion, participants who are anxious and restricted by social image, and participants who are highly knowledgeable with planning capabilities.
CONCLUSION: Precise interventions based on family personas are essential for optimizing financial decision-making in dementia and comorbidities care. This study developed four family personas for coping with financial toxicity, providing a theoretical basis for precise interventions to address the heterogeneous needs of this family group.