Dyadic Effects of Family Function and Financial Toxicity on Quality of Life in Lung Cancer Patients and Family...

Lung cancer has a profound impact on the whole family, particularly patients and family caregivers. This research adopted a dyadic method to examine the dyadic effect of family function on quality of life (QoL) and the mediating role of financial toxicity in lung cancer patient-caregiver dyads.

This was a cross-sectional research that included 218 pairs of participants. Family function, financial toxicity, and QoL were assessed by the General Function of Family Assessment Device (FAD-GF), Comprehensive Scores for Financial Toxicity based on Patient-Reported Outcome Measures (COST-PROM) and Global Health Status/Quality of Life (GHS/QoL) subscale of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). SPSS 24.0 and AMOS 23.0 statistical software were used for statistical analysis.

The actor-partner interdependence mediation model analysis demonstrated good model fit (χ²/df = 1.300, root mean square error of approximation (RMSEA) = 0.037, normed fit index (NFI) = 0.997, Tucker-Lewis index (TLI) = 0.998, comparative fit index (CFI) = 0.992, and standard root mean squared residual (SRMR) = 0.004). Results revealed significant dyadic interdependence, showing that both patients' and family caregivers' QoL was associated with their own and their partner's family function and financial toxicity. Notably, family function exerted both actor effects (individual's family function influencing their own QoL) and partner effects (individual's family function influencing their partner's QoL). Mediation analysis further indicated that these effects operated through both direct pathways and indirect pathways mediated by financial toxicity-where one's family function could impact either their own or their partner's QoL via their own or their partner's financial toxicity.

The findings highlight the need for integrated interventions targeting both family dynamics and financial distress to enhance well-being in cancer care dyads. Adopting this dyadic approach may significantly improve QoL for patients and caregivers, particularly in oncological settings where financial toxicity intensifies disease-related challenges.