DOI: 10.25442/hku.30205906
title: Supporting data for "Mapping the trajectory of financial hardship in dyads of patients with lung cancer and family caregivers: a longitudinal mixed methods study"

description: This project investigates the development and impact of financial hardship experienced by lung cancer patients and their family caregivers over the course of six months. Recognizing that cancer-related financial strain is a significant and growing concern worldwide—particularly in lung cancer, which incurs the highest treatment costs—this study adopts a comprehensive dyadic, longitudinal, mixed-methods approach to better understand how financial difficulties evolve within families, how they influence psychological well-being and quality of life, and how families cope with these challenges.The research involved tracking 305 patient-caregiver pairs at three key points: baseline, three months, and six months. Quantitative data assessed general financial distress, different dimensions of financial hardship, including material (financial depletion and work-related changes), psychological (perceived stress and worry), and behavioral (cost-related care non-adherence). It also measured psychological distress, quality of life, and caregiver burden. Advanced statistical techniques, such as Growth Mixture Modeling, identified distinct hardship trajectories, revealing that financial hardship is multidimensional, persistent, and unevenly distributed—psychological hardship peaking at diagnosis and accumulating over time, with some families experiencing ongoing hardship or crisis.Complementing the quantitative analysis, qualitative interviews provided contextual insights into families’ lived experiences, coping strategies, and systemic barriers. Thematic analysis uncovered themes around family financial resilience, navigating financial challenges in cancer care, and systemic gaps that exacerbate hardship, emphasizing the importance of internal family capacities and external systemic factors.Key findings highlight the dyadic interdependence of financial hardship and health outcomes: higher baseline financial distress and perceived hardship predicted worse psychological and quality-of-life outcomes for both patients and caregivers, with evidence of mutual influence within dyads. Certain risk factors—such as rural residence, low income, late-stage disease, and employment disruption—were associated with greater hardship, particularly among vulnerable groups like farmers and rural residents.The study underscores the importance of early, family-centered screening for financial difficulties and suggests targeted interventions, including expanded financial navigation and systemic reforms to address inequities related to rurality, occupation, and insurance coverage. Integrating both quantitative and qualitative insights, the research introduces the concept of family financial resilience—highlighting shared coping resources, decision-making, and collective strategies that help families manage financial adversity.Overall, this project provides a nuanced understanding of the complex, interrelated nature of financial hardship in lung cancer families, emphasizing the need for multidimensional, systemic, and family-focused approaches to promote financial well-being and health equity in cancer care.