RESILIENCE AS A PROTECTIVE FACTOR IN THE RELATIONSHIP BETWEEN FINANCIAL TOXICITY AND PSYCHOLOGICAL DISTRESS AMONG FAMILY CAREGIVERS OF CANCER PATIENTS UNDERGOING CHEMOTHERAPY

Abstract

Financial toxicity is an important concern for family caregivers of cancer patients and may contribute to psychological distress during chemotherapy. Resilience may serve as a protective factor by helping caregivers cope with financial and emotional challenges. This study examined the relationship between financial toxicity and psychological distress and investigated the mediating role of resilience among family caregivers of cancer patients undergoing chemotherapy. A quantitative, cross-sectional, correlational design was used. A purposive sample of 139 family caregivers was recruited from MINAR Hospital, Multan, Pakistan. Data were collected using the Comprehensive Score for Financial Toxicity (COST-FACIT), Kessler Psychological Distress Scale (K10), and Connor-Davidson Resilience Scale (CD-RISC-10). Pearson correlation and mediation analysis with 5,000 bootstrap samples were performed. Financial toxicity was positively associated with psychological distress (r = .48, p < .001) and negatively associated with resilience (r = −.36, p < .001). Resilience was negatively associated with psychological distress (r = −.52, p < .001). Financial toxicity significantly predicted lower resilience (β = −.36, p < .001), while resilience significantly predicted lower psychological distress (β = −.40, p < .001). The indirect effect through resilience was significant (B = 0.15, 95% CI [0.06, 0.26]), while the direct effect remained significant (β = .31, p < .001), indicating partial mediation. Financial toxicity is significantly associated with psychological distress among family caregivers, while resilience may partially buffer this relationship. Strengthening resilience and addressing caregivers’ financial difficulties may help reduce psychological distress during cancer treatment.