Ma Guiyuan, Long Nannan, Mao Ping, Li Yuanyuan, Li Fang, Li Chengyuan
Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, China.
Xiangya School of Nursing, Central South University, Changsha, China.
Asia Pac J Oncol Nurs. 2025 Jul 22;12:100761. doi: 10.1016/j.apjon.2025.100761. eCollection 2025 Dec.
To identify latent subgroups of financial toxicity among patients with hematologic malignancies, examine associated sociodemographic and clinical predictors, and explore the relationship between financial toxicity and anxiety-depression symptoms.
A cross-sectional study was conducted among 486 patients with hematologic malignancies recruited through convenience sampling from provincial-level hospitals in Hunan Province, China. Participants completed the General Information Questionnaire, the Patient-Reported Outcome Financial Toxicity (PRO-FT) Scale, the Patient Health Questionnaire-4 (PHQ-4), and the Perceived Social Support Scale (PSSS). Latent profile analysis (LPA) was used to identify subgroups of financial toxicity. Multinomial logistic regression was employed to explore influencing factors, and Kruskal-Wallis tests were used to compare anxiety and depression levels across the identified subgroups.
Three distinct profiles of financial toxicity were identified: "No financial toxicity" (13.99%), "Mild financial toxicity" (38.68%), and "Moderate financial toxicity" (47.33%). Compared with the no-toxicity profile, predictors of being in the mild or moderate toxicity profiles included sex, marital status, occupation, residence, family monthly income, treatment stage, insurance, and social support. When the mild toxicity profile was used as the reference, progression to the moderate profile was further associated with residence, family monthly income, diagnosis, chronic disease, course of disease, insurance, and social support. Higher levels of financial toxicity were significantly associated with increased anxiety and depression scores.
Financial toxicity among patients with hematologic malignancies is heterogeneous and closely linked to sociodemographic and clinical characteristics. Moreover, increased financial toxicity is associated with elevated psychological distress. Target interventions addressing financial strain and enhancing psychological support are essential to improve patient outcomes.
识别血液系统恶性肿瘤患者中潜在的财务毒性亚组，研究相关的社会人口学和临床预测因素，并探讨财务毒性与焦虑抑郁症状之间的关系。
在中国湖南省省级医院通过便利抽样招募了486例血液系统恶性肿瘤患者，进行横断面研究。参与者完成了一般信息问卷、患者报告结局财务毒性（PRO-FT）量表、患者健康问卷-4（PHQ-4）和感知社会支持量表（PSSS）。采用潜在类别分析（LPA）识别财务毒性亚组。采用多项逻辑回归探索影响因素，使用Kruskal-Wallis检验比较所识别亚组之间的焦虑和抑郁水平。
识别出三种不同的财务毒性特征：“无财务毒性”（13.99%）、“轻度财务毒性”（38.68%）和“中度财务毒性”（47.33%）。与无毒性特征相比，处于轻度或中度毒性特征的预测因素包括性别、婚姻状况、职业、居住地、家庭月收入、治疗阶段、保险和社会支持。以轻度毒性特征为参照，进展为中度特征还与居住地、家庭月收入、诊断、慢性病、病程、保险和社会支持有关。较高水平的财务毒性与焦虑和抑郁得分升高显著相关。
血液系统恶性肿瘤患者的财务毒性具有异质性，且与社会人口学和临床特征密切相关。此外，财务毒性增加与心理困扰加剧有关。针对财务压力的针对性干预措施和加强心理支持对于改善患者结局至关重要。
