Financial Toxicity Among Family Caregivers of Pediatric, Adolescent, and Young Adult Patients With Cancer: A Qualitative Meta-Synthesis.

PROBLEM IDENTIFICATION: Family caregivers of pediatric (aged 0-14 years) and adolescent and young adult (aged 15-39 years) patients with cancer face multifaceted financial toxicity involving multisource economic burdens, psychological distress, and unmet support needs, requiring evidence-based nursing and policy interventions. LITERATURE SEARCH: Systematic searches were performed across Wanfang Data, Web of Science, SINOMED, PubMed®, CNKI, EBSCO, VIP Chinese Science and Technology Periodicals Full-Text Database, and Cohrane Library from inception to April 15, 2025, to identify relevant qualitative studies. DATA EVALUATION: According to ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) guidelines, two investigators independently screened studies, extracted data, and synthesized findings via JBI meta-aggregation. The ConQual (Confidence in the Output of Qualitative Research Synthesis) approach was used to rate conclusions. SYNTHESIS: The 24 included studies yielded 103 findings (98 unequivocal themes and 5 credible themes), which were aggregated into eight main themes. The two core findings were as follows: (a) Financial toxicity among family caregivers is multifaceted, involving substantial multisource economic burdens and severe perceived financial distress, and (b) despite adopting diverse coping strategies, caregivers consistently reported unmet needs and persistent expectations for additional support. IMPLICATIONS FOR RESEARCH: Future research can focus on mechanisms specific to the United States, nurse navigator interventions, and subgroup differences. Clinical and policy interventions should integrate insurance navigation, paid leave, and culturally competent support.