Work

Influence of financial toxicity on posttraumatic growth in primary caregivers of cancer patients undergoing chemotherapy: the chain mediating effect of benefit finding and self-disclosure

Year: 2026

Type: article

Abstract: BACKGROUND: Primary caregivers of cancer patients undergoing chemotherapy frequently experience posttraumatic growth. While financial toxicity has been linked to this phenomenon, the pathways through which it exerts its effects remain poorly understood. METHODS: Using a cross-sectional design, 242 primary caregivers of cancer patients undergoing chemotherapy were recruited through convenience sampling between September 2025 and December 2025 at a tertiary hospital in Qingdao, China. Data were collected using a custom-designed Sociodemographic Information Questionnaire, the Comprehensive Score for Financial Toxicity (COST), the Benefit Finding Scale (BFS), the Distress Disclosure Index (DDI), and the Posttraumatic Growth Questionnaire (PTG). Chain mediation analysis was performed using PROCESS v3.3 Model 6 for SPSS. RESULTS: Financial toxicity showed a significant negative direct effect on posttraumatic growth within the mediation model (Bootstrap 95% CI: − 0.228, − 0.036). In addition, higher levels of financial toxicity were associated with lower benefit finding (Bootstrap 95% CI: − 0.262, − 0.113) and reduced self-disclosure (Bootstrap 95% CI: − 0.113, − 0.012). Benefit finding and self-disclosure together served as significant mediators in the relationship between financial toxicity and posttraumatic growth (Bootstrap 95% CI: − 0.071, − 0.022). CONCLUSIONS: Financial toxicity influences posttraumatic growth through both direct and indirect pathways, with benefit finding and self-disclosure acting as key mediators. Notably, benefit finding appears to weaken the mediating role of self-disclosure. Clinical strategies aimed at enhancing benefit finding and promoting self-disclosure may help promote posttraumatic growth and improve quality of life among primary caregivers of cancer patients undergoing chemotherapy. CLINICAL TRIAL NUMBER: Not applicable.

Source: BMC Nursing

DOI: 10.1186/s12912-026-04685-x