Mediating Role of Family Resilience and Avoidance Between Financial Toxicity and Quality of Life in Cancer Patients: A Cross-Sectional Study.

BACKGROUND: Financial toxicity has become a critical issue in cancer treatment. The substantial financial burden associated with cancer care may negatively affect patients' physical and psychological well-being and reduce their quality of life. However, the mechanisms underlying the relationship between financial toxicity and quality of life remain underexplored in the Chinese context. This study examined the roles of family resilience and avoidance coping in this relationship among patients with cancer in China. METHODS: A total of 722 patients with cancer were recruited through convenience sampling from seven tertiary hospitals in Henan, Shaanxi, Sichuan, Heilongjiang, Jilin, and Hubei Provinces. Data were collected using four standardized scales. Statistical analyses were performed using SPSS and AMOS, including descriptive analyses and mediation analysis. RESULTS: Family resilience and avoidance coping independently mediated the association between financial toxicity and quality of life (β family resilience = -0.061, 95% CI: -0.109, -0.019; β avoidance coping = -0.049, 95% CI: -0.091, -0.021), accounting for 21.03% and 16.90% of the total effect, respectively. The serial indirect effect through family resilience and avoidance coping was also significant. CONCLUSION: Higher financial toxicity was associated with poorer quality of life among patients with cancer. Family resilience and avoidance coping may play important mediating roles in this association, both independently and sequentially. These findings provide a basis for developing patient- and family-centered interventions aimed at mitigating the adverse effects of financial toxicity.