FINANCIAL TOXICITY AND PSYCHOLOGICAL BURDEN AMONG FAMILY CAREGIVERS OF BREAST CANCER PATIENTS UNDERGOING CHEMOTHERAPY: THE MEDIATING ROLE OF COPING STRATEGIES

Abstract

Breast cancer treatment, particularly chemotherapy, imposes substantial physical, emotional, and financial challenges not only on patients but also on their family caregivers. Family caregivers play a crucial role in supporting patients throughout the cancer journey; however, the demands of caregiving can result in significant psychological distress and financial strain, commonly referred to as financial toxicity. This study aims to examine the relationship between financial toxicity and psychological burden among family caregivers of breast cancer patients undergoing chemotherapy and to investigate the mediating role of coping strategies in this association. Correlational research design was used by employing survey with the help of structured questionnaires. Purposive sampling technique was used and select 89 family caregivers as a sample of the study. The findings revealed that financial toxicity was significantly associated with higher levels of depression, anxiety, and stress among family caregivers of breast cancer patients undergoing chemotherapy. Psychological distress indicators were also strongly interrelated, suggesting that depression, anxiety, and stress commonly co-occur among caregivers. The mediation analysis showed that problem-focused coping strategy partially mediated the relationship between financial toxicity and psychological burden, indicating that financial strain may increase distress by reducing caregivers’ ability to use effective coping approaches. In contrast, avoidant coping strategy did not significantly mediate the relationship between financial toxicity and psychological burden. Financial toxicity emerged as an important contributor to caregivers’ psychological distress, while adaptive coping strategies may help reduce its negative impact.