Wu Yue, Wu Yihao, Zhou Botao, Sun Yongmou, Dai Rufei
Department of Neurosurgery, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Department of Neurosurgery, Xuzhou Central Hospital, Xuzhou, Jiangsu, China.
Front Public Health. 2025 Jul 18;13:1573000. doi: 10.3389/fpubh.2025.1573000. eCollection 2025.
OBJECTIVE: This study aims to investigate the longitudinal trajectories of family functioning and financial toxicity in glioma patients, while examining their predictive interrelationships, to establish evidence-based strategies for alleviating economic burden in neuro-oncology care. METHODS: This prospective longitudinal cohort study enrolled 266 glioma patients from the Second Affiliated Hospital of Xuzhou Medical University and Xuzhou Central Hospital (January 2022-June 2024). Family functioning and financial toxicity were serially assessed at three timepoints: baseline (T1, initial diagnosis), 3-month follow-up (T2), and 6-month follow-up (T3). Structural equation modeling (SEM) framework incorporated cross-lagged panel analysis and latent growth curve modeling to examine temporal relationships. RESULTS: A total of 242 valid consecutive questionnaires were collected. The cross-lagged panel analysis demonstrated that the average family functioning level significantly and positively predicted subsequent financial toxicity at follow-up time points ( = 0.478, = 0.01; β = 0.463, < 0.001), while financial toxicity exhibited no significant longitudinal predictive effect on family functioning across subsequent assessments. The latent growth curve modeling revealed parallel declining trajectories: family functioning (slope [S] = -0.410, < 0.001) and financial toxicity (slope [S] = -0.102, < 0.001) both decreased significantly from T1 to T3. At baseline, family functioning showed positive correlation with financial toxicity scores ( = 0.377, = 0.002). Initial family functioning level demonstrated dual regulatory effects: (1) negative auto-regulation ( = -0.352, = 0.007) and (2) inverse prediction of financial toxicity's developmental trajectory ( = -0.516, = 0.002). Crucially, the initial family functioning level exhibited compensatory effects on financial toxicity dynamics, showing negative coupling with its growth rate ( = -0.534, < 0.001). CONCLUSION: Family functioning and financial toxicity of glioma patients can predict each other. The initial level of family functioning can positively predict the initial level of financial toxicity, the initial level of family functioning can negatively predict the development speed of itself and financial toxicity, and the development speed of family functioning can positively predict the development speed of financial toxicity.
目的：本研究旨在调查胶质瘤患者家庭功能和经济毒性的纵向轨迹，同时检验它们之间的预测性相互关系，以制定基于证据的策略来减轻神经肿瘤护理中的经济负担。 方法：这项前瞻性纵向队列研究纳入了徐州医科大学第二附属医院和徐州市中心医院的266例胶质瘤患者（2022年1月至2024年6月）。在三个时间点对家庭功能和经济毒性进行连续评估：基线（T1，初次诊断）、3个月随访（T2）和6个月随访（T3）。结构方程模型（SEM）框架纳入交叉滞后面板分析和潜在增长曲线模型，以检验时间关系。 结果：共收集到242份有效连续问卷。交叉滞后面板分析表明，平均家庭功能水平在随访时间点对随后的经济毒性有显著正向预测作用（γ = 0.478，p = 0.01；β = 0.463，p < 0.001），而经济毒性在随后的评估中对家庭功能没有显著的纵向预测作用。潜在增长曲线模型显示出平行下降轨迹：家庭功能（斜率[S] = -0.410，p < 0.001）和经济毒性（斜率[S] = -0.102，p < 0.001）从T1到T3均显著下降。在基线时，家庭功能与经济毒性评分呈正相关（r = 0.377，p = 0.002）。初始家庭功能水平显示出双重调节作用：（1）负向自我调节（γ = -0.352，p = 0.007）和（2）对经济毒性发展轨迹的反向预测（γ = -0.516，p = 0.002）。至关重要的是，初始家庭功能水平对经济毒性动态具有补偿作用，与其增长率呈负耦合（γ = -0.534，p < 0.001）。 结论：胶质瘤患者的家庭功能和经济毒性可以相互预测。家庭功能的初始水平可以正向预测经济毒性的初始水平，家庭功能的初始水平可以负向预测其自身和经济毒性的发展速度，家庭功能的发展速度可以正向预测经济毒性的发展速度。
Front Public Health. 2025-7-18
Sichuan Da Xue Xue Bao Yi Xue Ban. 2025-3-20
J Med Internet Res. 2025-7-18
Cochrane Database Syst Rev. 2022-5-20
Health Technol Assess. 2001
Clin Orthop Relat Res. 2024-9-1
Crit Rev Oncol Hematol. 2023-12
Neurooncol Pract. 2023-4-20
Adv Exp Med Biol. 2023
Zhonghua Zhong Liu Za Zhi. 2023-3-23
Palliat Support Care. 2023-6
CA Cancer J Clin. 2022-9
Zotero 插件
