Xu Binbin, So Winnie K W, Choi Kai Chow
School of Nursing, Hunan University of Chinese Medicine, Changsha, Hunan, China; The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
Eur J Oncol Nurs. 2025 Feb;74:102782. doi: 10.1016/j.ejon.2025.102782. Epub 2025 Jan 8.
To explore how regional economic levels moderate the relationships between cancer-related financial toxicity (FT) and its associated risk factors.
A secondary analysis was conducted using data from a cross-sectional survey of 1208 adult patients with cancer, conducted in six tertiary and six secondary hospitals across three Chinese provinces from February to October 2022. The interactions between the regional economic level-categorised as high- or low-/middle-income based on the gross domestic product per capita- and 13 previously identified risk factors for FT were examined via moderation analysis using the PROCESS macro for SPSS software.
Regional economic level moderated the impacts of both patients' and family carers' negative work changes due to cancer and the hospital level on FT (all p-values for interaction effect <0.05). Job changes had more severe effects on FT in high-income regions (patients: B = -2.07, standard error [SE] = 0.67, p = 0.002; carers: B = -1.58, SE = 0.66, p = 0.017), while treatment in tertiary hospitals had a stronger negative impact on FT in low-/middle-income regions (B = 1.81, SE = 0.87, p = 0.037).
These findings highlight the need for region-specific FT mitigation strategies. In high-income regions, more attention could be paid to managing the adverse work-related effects of cancer on patients and their families. In low-/middle-income regions, increased awareness and management of cancer-related FT in tertiary hospitals is needed. Future research should explore other risk factors associated with FT that may be moderated by regional economic levels.
探讨区域经济水平如何调节癌症相关经济毒性（FT）与其相关风险因素之间的关系。
利用2022年2月至10月在中国三个省份的六家三级医院和六家二级医院对1208名成年癌症患者进行的横断面调查数据进行二次分析。基于人均国内生产总值将区域经济水平分为高收入或低/中等收入，并通过使用SPSS软件的PROCESS宏进行调节分析，检验其与13个先前确定的FT风险因素之间的相互作用。
区域经济水平调节了患者及其家庭照顾者因癌症导致的负面工作变化以及医院级别对FT的影响（所有交互效应的p值<0.05）。工作变化在高收入地区对FT的影响更为严重（患者：B = -2.07，标准误[SE]=0.67，p = 0.002；照顾者：B = -1.58，SE = 0.66，p = 0.017），而在低/中等收入地区，三级医院的治疗对FT有更强的负面影响（B = 1.81，SE = 0.87，p = 0.037）。
这些发现凸显了针对特定区域的FT缓解策略的必要性。在高收入地区，可更多关注管理癌症对患者及其家庭与工作相关的不利影响。在低/中等收入地区，需要提高三级医院对癌症相关FT的认识并加强管理。未来的研究应探索其他可能受区域经济水平调节的与FT相关的风险因素。
