Abstract
Financial toxicity is a side effect of cancer treatment showing the financial burden experienced by cancer patients for funding their treatment. An instrument for its evaluation can contribute towards the creation of coping strategies. In Brazil, a developing country, cancer patients certainly feel the effects of this serious adverse event, however, the discussion on the theme and research concerning these issues is scarce and an instrument for evaluation can help in the promotion of coping strategies. Thus, the study objective was to: 1) translate and adapt the COmprehensive Score for financial Toxicity (COST) questionnaire to Brazilian culture and 2) evaluate the COST psychometric properties in Brazil. Thus, a methodological study was developed in two stages. In the first stage, the translation and cross-cultural adaptation were performed, and in the second stage, two groups of participants were recruited to evaluate the psychometric properties. In the first stage, 21 individuals participated, including translators and cancer patients, and in the second stage, 126 patients participated who were undergoing cancer treatment. For validation, exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and Cronbach’s alpha coefficient were performed to verify internal consistency. For the first stage’s outcome, the pre-test Cronbach’s alpha was 0.83. The EFA and CFA carried out in the second stage of the study revealed that the COST Brazilian version measures a single construct with a value of—χ2/gl = 179.78, comparative fit index = 0.00, Parsimony goodness of fit index = 0.302, root mean square error of approximation = 1.196 and p-value of close fit = 0.000. When comparing the average of the COST score and the standard deviation of the two samples, the significance value was p = 0.001. Therefore, it is possible to confirm that the COST is a valid and reliable questionnaire to measure the financial toxicity of cancer patients in Brazil.
Highlights
IntroductionFinancial toxicity is a side effect of cancer treatment, which describes the financial burden experienced by cancer patients, who may find it difficult to afford their treatment
It is possible to confirm that the COST is a valid and reliable questionnaire to measure the financial toxicity of cancer patients in Brazil
Financial toxicity is a side effect of cancer treatment, which describes the financial burden experienced by cancer patients, who may find it difficult to afford their treatment
Summary
Financial toxicity is a side effect of cancer treatment, which describes the financial burden experienced by cancer patients, who may find it difficult to afford their treatment. Financial toxicity refers to objective financial burdens such as medical care, and the subjective suffering from monthly co-payments, leading to changes in the budget by changing family routines and habits [2]. It can cause disruptions both in the quality of life of the family and in the quality of life-related to the health (HRQoL) of patients. Studies highlight changes in life habits, non-adherence or decreased use of the prescribed medication, discontinuity of treatment [7], indebtedness [8], increased anxiety [9], psychological symptoms [10] and decreased HRQoL [7]
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