Trajectories of family functioning and financial toxicity in patients with glioma: a longitudinal study
ObjectiveThis 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.MethodsThis prospe...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1573000/full |
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| author | Yue Wu Yihao Wu Botao Zhou Yongmou Sun Rufei Dai |
| author_facet | Yue Wu Yihao Wu Botao Zhou Yongmou Sun Rufei Dai |
| author_sort | Yue Wu |
| collection | DOAJ |
| description | ObjectiveThis 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.MethodsThis 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.ResultsA 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 (β = 0.478, p = 0.01; β = 0.463, p < 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, p < 0.001) and financial toxicity (slope [S] = −0.102, p < 0.001) both decreased significantly from T1 to T3. At baseline, family functioning showed positive correlation with financial toxicity scores (r = 0.377, p = 0.002). Initial family functioning level demonstrated dual regulatory effects: (1) negative auto-regulation (β = −0.352, p = 0.007) and (2) inverse prediction of financial toxicity’s developmental trajectory (β = −0.516, p = 0.002). Crucially, the initial family functioning level exhibited compensatory effects on financial toxicity dynamics, showing negative coupling with its growth rate (β = −0.534, p < 0.001).ConclusionFamily 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. |
| format | Article |
| id | doaj-art-db751eec43f041228816392472da7803 |
| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-db751eec43f041228816392472da78032025-08-20T03:27:29ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.15730001573000Trajectories of family functioning and financial toxicity in patients with glioma: a longitudinal studyYue Wu0Yihao Wu1Botao Zhou2Yongmou Sun3Rufei Dai4Department of Neurosurgery, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Neurosurgery, Xuzhou Central Hospital, Xuzhou, Jiangsu, ChinaDepartment of Neurosurgery, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Neurosurgery, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Neurosurgery, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaObjectiveThis 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.MethodsThis 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.ResultsA 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 (β = 0.478, p = 0.01; β = 0.463, p < 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, p < 0.001) and financial toxicity (slope [S] = −0.102, p < 0.001) both decreased significantly from T1 to T3. At baseline, family functioning showed positive correlation with financial toxicity scores (r = 0.377, p = 0.002). Initial family functioning level demonstrated dual regulatory effects: (1) negative auto-regulation (β = −0.352, p = 0.007) and (2) inverse prediction of financial toxicity’s developmental trajectory (β = −0.516, p = 0.002). Crucially, the initial family functioning level exhibited compensatory effects on financial toxicity dynamics, showing negative coupling with its growth rate (β = −0.534, p < 0.001).ConclusionFamily 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.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1573000/fullgliomafamily functioningfinancial toxicitydevelopment trajectorylatent variable growth modelcross-lag model |
| spellingShingle | Yue Wu Yihao Wu Botao Zhou Yongmou Sun Rufei Dai Trajectories of family functioning and financial toxicity in patients with glioma: a longitudinal study Frontiers in Public Health glioma family functioning financial toxicity development trajectory latent variable growth model cross-lag model |
| title | Trajectories of family functioning and financial toxicity in patients with glioma: a longitudinal study |
| title_full | Trajectories of family functioning and financial toxicity in patients with glioma: a longitudinal study |
| title_fullStr | Trajectories of family functioning and financial toxicity in patients with glioma: a longitudinal study |
| title_full_unstemmed | Trajectories of family functioning and financial toxicity in patients with glioma: a longitudinal study |
| title_short | Trajectories of family functioning and financial toxicity in patients with glioma: a longitudinal study |
| title_sort | trajectories of family functioning and financial toxicity in patients with glioma a longitudinal study |
| topic | glioma family functioning financial toxicity development trajectory latent variable growth model cross-lag model |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1573000/full |
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