Association among financial toxicity, depression and fear of cancer recurrence in young breast cancer patient-family caregiver dyads: an actor-partner interdependence mediation model

Abstract Purpose This study aimed to investigate the depression situation and the mediating role of fear of cancer recurrence (FCR) in the relationship between financial toxicity and depression in young breast cancer (BC) patient-family caregiver dyads. Methods A total of 196 young BC patient-family...

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Main Authors: Tianye Yang, Zhu Zhu, Jianjun Shi, Lingling Tong, Jia Yang, Songli Mei, Hui Ren
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Psychiatry
Subjects:
Online Access:https://doi.org/10.1186/s12888-025-06546-4
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author Tianye Yang
Zhu Zhu
Jianjun Shi
Lingling Tong
Jia Yang
Songli Mei
Hui Ren
author_facet Tianye Yang
Zhu Zhu
Jianjun Shi
Lingling Tong
Jia Yang
Songli Mei
Hui Ren
author_sort Tianye Yang
collection DOAJ
description Abstract Purpose This study aimed to investigate the depression situation and the mediating role of fear of cancer recurrence (FCR) in the relationship between financial toxicity and depression in young breast cancer (BC) patient-family caregiver dyads. Methods A total of 196 young BC patient-family caregiver dyads at four hospitals in China were investigated. The Comprehensive scores for financial toxicity based on patient-reported outcome measures, the Hospital Anxiety and Depression Scale, and the FCR Inventory Short Form were assessed. The actor-partner interdependence mediation model using structural equation modelling in AMOS software was applied to examine the direct and indirect effects. Results In this study, there were 196 pairs of patients and family caregivers. The findings indicated a significant correlation between financial toxicity and FCR in both young BC patients and their family caregivers. Two significant partner effects were observed: the family caregiver’s financial toxicity significantly influenced the patient’s FCR (β=-0.450, P < 0.001), and the patient’s FCR influenced the family caregiver’s depression (β = 0.570, P < 0.001). Furthermore, financial toxicity in both young BC patients and family caregivers markedly affected both the actor and partner effects on dyadic depression, primarily through the patients’ FCR. Conclusions Depression in young BC patients was affected not only by themselves but also by their family caregivers. Emphasis should be placed on the interplay between financial toxicity and FCR of patients and family caregivers, with the aim of improving depression for young BC patients. Clinical implications The study emphasized the importance of addressing the experiences of both patient and family caregivers in clinical interventions. By demonstrating how financial toxicity and FCR are interlinked with depression in both parties, the study supports the development of we offer empirical support for developing comprehensive intervention strategies to alleviate mental distress and enhance mental health for patients and family caregivers.
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spelling doaj-art-efc40bc3b8c04d5089bfc0e394b20ca32025-02-09T12:49:18ZengBMCBMC Psychiatry1471-244X2025-02-0125111010.1186/s12888-025-06546-4Association among financial toxicity, depression and fear of cancer recurrence in young breast cancer patient-family caregiver dyads: an actor-partner interdependence mediation modelTianye Yang0Zhu Zhu1Jianjun Shi2Lingling Tong3Jia Yang4Songli Mei5Hui Ren6Department of Plastic Surgery, The First Hospital of Jilin UniversityDepartment of Breast Surgery, The First Hospital of Jilin UniversityDepartment of Breast Surgery, Heping Hospital Affiliated to Changzhi Medical CollegeThe Third Bethune Hospital of Jilin UniversityChangchun Central HospitalJilin University School of Public HealthThe First Hospital of Jilin UniversityAbstract Purpose This study aimed to investigate the depression situation and the mediating role of fear of cancer recurrence (FCR) in the relationship between financial toxicity and depression in young breast cancer (BC) patient-family caregiver dyads. Methods A total of 196 young BC patient-family caregiver dyads at four hospitals in China were investigated. The Comprehensive scores for financial toxicity based on patient-reported outcome measures, the Hospital Anxiety and Depression Scale, and the FCR Inventory Short Form were assessed. The actor-partner interdependence mediation model using structural equation modelling in AMOS software was applied to examine the direct and indirect effects. Results In this study, there were 196 pairs of patients and family caregivers. The findings indicated a significant correlation between financial toxicity and FCR in both young BC patients and their family caregivers. Two significant partner effects were observed: the family caregiver’s financial toxicity significantly influenced the patient’s FCR (β=-0.450, P < 0.001), and the patient’s FCR influenced the family caregiver’s depression (β = 0.570, P < 0.001). Furthermore, financial toxicity in both young BC patients and family caregivers markedly affected both the actor and partner effects on dyadic depression, primarily through the patients’ FCR. Conclusions Depression in young BC patients was affected not only by themselves but also by their family caregivers. Emphasis should be placed on the interplay between financial toxicity and FCR of patients and family caregivers, with the aim of improving depression for young BC patients. Clinical implications The study emphasized the importance of addressing the experiences of both patient and family caregivers in clinical interventions. By demonstrating how financial toxicity and FCR are interlinked with depression in both parties, the study supports the development of we offer empirical support for developing comprehensive intervention strategies to alleviate mental distress and enhance mental health for patients and family caregivers.https://doi.org/10.1186/s12888-025-06546-4Young breast cancer patientsDepressionFinancial toxicityFear of cancer recurrenceActor-partner interdependence mediation model
spellingShingle Tianye Yang
Zhu Zhu
Jianjun Shi
Lingling Tong
Jia Yang
Songli Mei
Hui Ren
Association among financial toxicity, depression and fear of cancer recurrence in young breast cancer patient-family caregiver dyads: an actor-partner interdependence mediation model
BMC Psychiatry
Young breast cancer patients
Depression
Financial toxicity
Fear of cancer recurrence
Actor-partner interdependence mediation model
title Association among financial toxicity, depression and fear of cancer recurrence in young breast cancer patient-family caregiver dyads: an actor-partner interdependence mediation model
title_full Association among financial toxicity, depression and fear of cancer recurrence in young breast cancer patient-family caregiver dyads: an actor-partner interdependence mediation model
title_fullStr Association among financial toxicity, depression and fear of cancer recurrence in young breast cancer patient-family caregiver dyads: an actor-partner interdependence mediation model
title_full_unstemmed Association among financial toxicity, depression and fear of cancer recurrence in young breast cancer patient-family caregiver dyads: an actor-partner interdependence mediation model
title_short Association among financial toxicity, depression and fear of cancer recurrence in young breast cancer patient-family caregiver dyads: an actor-partner interdependence mediation model
title_sort association among financial toxicity depression and fear of cancer recurrence in young breast cancer patient family caregiver dyads an actor partner interdependence mediation model
topic Young breast cancer patients
Depression
Financial toxicity
Fear of cancer recurrence
Actor-partner interdependence mediation model
url https://doi.org/10.1186/s12888-025-06546-4
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