Effect of Socioeconomic Status on Financial Toxicity: The Chain Mediating Roles of Social Support and Self-Efficacy

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-07-25 DOI:10.1002/cam4.71083

Yan Liu, Pengfei Li, Boyu Liu, Yuantao Qi, Weimin Guan, Nan Zhang, Youhua Lu

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Abstract

Objective

Cancer patients experience severe financial toxicity, with the mechanisms influencing the relationship between socioeconomic status and financial toxicity in lung cancer patients remaining poorly defined. This study aims to investigate how social support and self-efficacy mediate the association between socioeconomic status and financial toxicity among lung cancer patients in China.

Methods

A survey of 755 lung cancer patients was conducted at a tertiary oncology hospital in Shandong Province, China, from October to December 2023, utilizing random sampling. Data collection included demographic and socioeconomic details, along with assessments of social support, self-efficacy, and financial toxicity. Regression and Bootstrap analyses were used to explore the sequential mediating effects of socioeconomic status, self-efficacy, social support, and financial toxicity.

Results

(1) Significant correlations emerged among socioeconomic status, social support, self-efficacy, and financial toxicity (p < 0.05). (2) Socioeconomic status was significantly associated with financial toxicity (p < 0.05). (3) Self-efficacy mediated the relationship between socioeconomic status and financial toxicity (β = 0.203, p < 0.05), whereas social support did not exhibit a mediating effect in this relationship (β = 0.039, p = 0.194). (4) Social support and self-efficacy had a chain-mediated role in the relationship between socioeconomic status and financial toxicity in patients with multimorbidity (β = 0.072, p < 0.05).

Conclusion

This study identifies social support and self-efficacy as chained mediators that link socioeconomic status with financial toxicity among lung cancer patients. It is recommended that targeted interventions be implemented to increase social support for patients with lower socioeconomic status to mitigate financial toxicity.

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社会经济地位对财务毒性的影响：社会支持和自我效能的链式中介作用

癌症患者经历了严重的经济毒性，但影响社会经济地位与肺癌患者经济毒性关系的机制尚不明确。本研究旨在探讨社会支持和自我效能感在中国肺癌患者社会经济地位与经济毒性之间的中介作用。方法于2023年10月至12月对山东省某三级肿瘤医院755例肺癌患者进行随机抽样调查。收集的数据包括人口统计和社会经济细节，以及对社会支持、自我效能和财务毒性的评估。采用回归和Bootstrap分析探讨社会经济地位、自我效能、社会支持和财务毒性的序贯中介效应。结果(1)社会经济地位、社会支持、自我效能感与财务毒性之间存在显著相关（p < 0.05）。(2)社会经济地位与财务毒性显著相关（p < 0.05）。(3)自我效能感在社会经济地位与金融毒性的关系中起中介作用（β = 0.203, p < 0.05），而社会支持在社会经济地位与金融毒性的关系中不起中介作用（β = 0.039, p = 0.194）。(4)社会支持和自我效能在多重疾病患者社会经济地位与财务毒性的关系中具有连锁中介作用（β = 0.072, p < 0.05）。结论社会支持和自我效能在社会经济地位与肺癌患者经济毒性之间起连锁中介作用。建议实施有针对性的干预措施，增加对社会经济地位较低的患者的社会支持，以减轻经济毒性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.