ORIGINAL RESEARCH article
Front. Public Health
Sec. Children and Health
This article is part of the Research TopicManaging the Burden of Child Health in China: Focus on Common ConditionsView all 6 articles
Financial toxicity, social support, and negative emotions among caregivers of children with cancer: a cross-sectional study in Western China
Provisionally accepted
- 1Department of Nursing, Sichuan University West China Second University Hospital, Chengdu, China
- 2Department of hematology, West China Second University Hospital, Sichuan University, Chengdu, China
- 3Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- 4Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, China
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Purpose: To assess the level of financial toxicity (FT) experienced by carers of children with cancer in Western China, identify associated factors. Methods: A cross-sectional survey was conducted at a large tertiary hospital (N=304 carers). Data included sociodemographic, Comprehensive Score for Financial Toxicity – Patient-Reported Outcome Measure (COST-PROM), perceived social support (PSSS), and anxiety/depression (HADS). Univariate analyses were employed to compare FT scores across groups, Pearson correlations to examine associations between continuous variables, and hierarchical multiple linear regression analysis to identify predictors of FT. Results: The mean COST-PROM score was 12.24 (SD=8.44), indicating moderate FT. Elevated FT demonstrated significant correlations with heightened anxiety (r=-0.44), depression (r=-0.47), and diminished total social support (r=0.32) (all P < .01). The final regression model (Adjusted R²=0.309, P < .001) revealed that factors significantly associated with increased FT included: carers' employment change (β=-0.113), out-of-pocket medical expenses exceeding 40% of annual household income (β=- 0.112), and the presence of loans (β=-0.135). Conversely, the perception that family income was sufficient to cover treatment costs (β=0.257) and greater perceived support from friends (PSSS; This is a provisional file, not the final typeset article β=0.234) were significantly associated with decreased FT. In addition, both anxiety and depression scores were significantly correlated with higher FT. Conclusions: Carers in this sample experience moderate FT, which is strongly linked to economic hardship, and diminished social support (particularly from friends). Interventions should address modifiable factors like social support, anxiety, depression, alongside financial navigation and psychological support services.
Keywords: child1, neoplasms2, caregivers3, financial stress4, social support5, anxiety6, depression7
Received: 01 Aug 2025; Accepted: 03 Dec 2025.
Copyright: © 2025 Chen, Tan, Li, Chen and Dai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yuan Li
Qiurong Chen
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