{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:47:08Z","timestamp":1782798428277,"version":"3.54.5"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Aim<\/jats:title>\n To explore the longitudinal interaction between financial toxicity and psychological distress in breast cancer patients and their spouses based on the actor-partner interdependence model.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Convenience sampling method was used to select 258 breast cancer patients and their spouses as the research partners. The financial toxicity scale and distress thermometer were used to investigate the patients in the early stage (T1), the middle stage (T2) and the end of chemotherapy (T3).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The actor effects of financial toxicity on psychological distress were significant for both breast cancer patients and their spouses. Specifically, the level of financial toxicity in patients significantly predicted their own psychological distress at the next time point (T1\u202f\u2192\u202fT2:\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.19, T2\u202f\u2192\u202fT3:\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.18, both\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), and the level of financial toxicity in spouses significantly predicted their own psychological distress at the next time point (T1\u202f\u2192\u202fT2:\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.15, T2\u202f\u2192\u202fT3:\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.14, both\n p<\/jats:italic>\n \u202f&lt;\u202f0.01). The actor effects of psychological distress on financial toxicity were also significant. That is, the level of psychological distress in patients significantly predicted their own financial toxicity at the next time point (T1\u202f\u2192\u202fT2:\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.18, T2\u202f\u2192\u202fT3:\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.17, both\n p<\/jats:italic>\n \u202f&lt;\u202f0.01), and the level of psychological distress in spouses significantly predicted their own financial toxicity at the next time point (T1\u202f\u2192\u202fT2:\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.16, T2\u202f\u2192\u202fT3:\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.15,\n p<\/jats:italic>\n \u202f&lt;\u202f0.01). The partner effects of psychological distress were significant. Specifically, patients\u2019 psychological distress significantly and positively predicted their spouses\u2019 psychological distress at the next time point (T1\u202f\u2192\u202fT2:\n \u03b2<\/jats:italic>\n \u202f=\u202f0.18, T2\u202f\u2192\u202fT3:\n \u03b2<\/jats:italic>\n \u202f=\u202f0.17, both\n p<\/jats:italic>\n \u202f&lt;\u202f0.01), and spouses\u2019 psychological distress significantly and positively predicted patients\u2019 psychological distress at the next time point (T1\u202f\u2192\u202fT2:\n \u03b2<\/jats:italic>\n \u202f=\u202f0.20,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001; T2\u202f\u2192\u202fT3:\n \u03b2<\/jats:italic>\n \u202f=\u202f0.20,\n p<\/jats:italic>\n \u202f&lt;\u202f0.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The financial toxicity and psychological distress of breast cancer patients and their spouses have a two-way actor prediction effect.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1838284","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:41:16Z","timestamp":1782798076000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cross-lagged analysis of financial toxicity and psychological distress between breast cancer patients and spouses during chemotherapy: an actor\u2013partner interdependence model"],"prefix":"10.3389","volume":"14","author":[{"given":"Qing","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Pang","sequence":"additional","affiliation":[{"name":"School of National Audit, Nanjing Audit University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weijuan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s43440-022-00426-4","article-title":"Alcohol and breast cancer","volume":"75","author":"Starek-Swiechowicz","year":"2023","journal-title":"Pharmacol Rep"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1002\/jso.27627","article-title":"Breast cancer survivorship","volume":"130","author":"Valente","year":"2024","journal-title":"J Surg Oncol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3390\/cancers12113281","article-title":"Development of innovative formulations for breast cancer chemotherapy","volume":"12","author":"Fraguas-Sanchez","year":"2020","journal-title":"Cancers 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