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

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.

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.

(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).

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.