Objective  To sinicize the InCharge Financial Distress/Financial Well-Being Scale (IFDFW), and to test the reliability and validity.

Methods  The Brislin Scale Translation Model was used to translate and back-translate the IFDFW, and cross-cultural adaptation was completed after expert consultation and pre-survey. Convenience sampling method was used to select chronically ill patients from September to December in 2023 to conduct the questionnaire survey and test the reliability and validity of the scale.

Results  A total of 328 patients with chronic diseases were included. The Chinese version of the Chronic Disease Economic Toxicity Scale contained 8 entries, and the Cronbach's alpha coefficient of the scale was 0.929, the folded reliability was 0.872, and the re-test reliability was 0.760. The item-content validity index of the entries ranged from 0.900 to 1.000, and the scale-content validity was 0.987. One factor was extracted in the exploratory factor analysis, and the cumulative variance contribution rate was 67.335%.

Conclusion  The Chinese version of the Chronic Disease Economic Toxicity Scale has good reliability and validity and can be used as a tool for assessing the status of economic toxicity in patients with chronic diseases.

1.Katende D, Kasamba I, Sekitoleko I, et al. Medium-to-long term sustainability of a health systems intervention to improve service readiness and quality of non-communicable disease (NCD) patient care and experience at primary care settings in Uganda[J]. BMC Health Serv Res, 2023, 23(1): 1022. DOI: 10.1186/s12913-023-09983-7.

2.The Lancet. Non-communicable diseases in China: a rising tide[J]. Lancet, 2023, 402(10417): 2045. DOI: 10.1016/S0140-6736(23)02691-0.

3.Dong X, Chen L, Xu Z, et al. An assessment of the economic burden of senile chronic diseases in China based on China Health and Retirement Longitudinal Survey[J]. Expert Rev Pharmacoecon Outcomes Res, 2020, 20(3): 305-312. DOI: 10.1080/14737167.2020.1688661.

4.Liu J, Liu M, Chai Z, et al. Projected rapid growth in diabetes disease burden and economic burden in China: a spatio-temporal study from 2020 to 2030[J]. Lancet Reg Health West Pac, 2023, 33: 100700. DOI: 10.1016/j.lanwpc.2023.100700.

5.Chen S, Kuhn M, Prettner K, et al. The global economic burden of chronic obstructive pulmonary disease for 204 countries and territories in 2020-50: a health-augmented macroeconomic modelling study[J]. Lancet Glob Health, 2023, 11(8): e1183-e1193. DOI: 10.1016/S2214-109X(23)00217-6.

6.Khanmohammadi S, Mobarakabadi M, Mohebi F. The economic burden of malignant brain tumors[J]. Adv Exp Med Biol, 2023, 1394: 209-221. DOI: 10.1007/978-3-031-14732-6_13.

7.Zafar SY, Abernethy AP. Financial toxicity, Part I: a new name for a growing problem[J]. Oncology (Williston Park), 2013, 27(2): 80-81, 149. https://pubmed.ncbi.nlm.nih.gov/23530397/

8.McLean L, Hong W, McLachlan SA. Financial toxicity in patients with cancer attending a public Australian tertiary hospital: a pilot study[J]. Asia Pac J Clin Oncol, 2021, 17(3): 245-252. DOI: 10.1111/ajco.13448.

9.Silva ECS, Mantovani MF, Nogueira LA, et al. Financial toxicity in people with chronic kidney disease undergoing hemodialysis treatment[J]. Rev Bras Enferm, 2023, 76(4): e20220671. DOI: 10.1590/0034-7167-2022-0671.

10.Valero-Elizondo J, Javed Z, Khera R, et al. Unfavorable social determinants of health are associated with higher burden of financial toxicity among patients with atherosclerotic cardiovascular disease in the US: findings from the National Health Interview Survey[J]. Arch Public Health, 2022, 80(1): 248. DOI: 10.1186/s13690-022-00987-z.

11.Bloomfeld RS, Bickston SJ. Financial toxicity in people with inflammatory bowel disease[J]. Inflamm Bowel Dis, 2021, 27(7): 1170-1171. DOI: 10.1093/ibd/izaa267.

12.Bergeron M, Ishman SL. Persistent obstructive sleep apnea burden on family finances and quality of life[J]. Otolaryngol Head Neck Surg, 2021, 165(3): 483-489. DOI: 10.1177/0194599820986566.

13.Henry G, Webb A, Galea C, et al. Out-of-pocket costs for families and people living with cerebral palsy in Australia[J]. PLoS One, 2023, 18(7): e0288865. DOI: 10.1371/journal.pone.0288865.

14.Given BA, Given CW, Stommel M. Family and out-of-pocket costs for women with breast cancer[J]. Cancer Pract, 1994, 2(3): 187-193. https://pubmed.ncbi.nlm.nih.gov/8055022/

15.Head BA, Faul AC. Development and validation of a scale to measure socioeconomic well-being in persons with cancer[J]. J Support Oncol, 2008, 6(4): 183-192. https://pubmed.ncbi.nlm.nih.gov/18491687/

16.Khera N. Reporting and grading financial toxicity[J]. J Clin Oncol, 2014, 32(29): 3337-3338. DOI: 10.1200/JCO.2014.57.8740.

17.Prawitz AD, Garman ET, Benoit S, et al. InCharge financial distress/financial well-being scale: development, administration, and score interpretation[J]. J Financ Couns Plan, 2006, 17(1): 34-50. DOI: 10.1037/t60365-000.

18.World Health Organization. ICD-10: international statistical classification of diseases and related health problems: tenth revision, 2nd ed[EB/OL]. (2024) [2024-03-10]. https://iris.who.int/handle/10665/42980

19.Song J, Pan T, Xu Z, et al. A systematic analysis of chronic kidney disease burden attributable to lead exposure based on the Global Burden of Disease Study 2019[J]. Sci Total Environ, 2024, 908: 168189. DOI: 10.1016/j.scitotenv.2023.168189.

20.张珍,魏诗意,田艳珍,等. 慢性病患者主观经济毒性的潜在剖面及其影响因素分析[J]. 医学新知, 2025, 35(3): 262-270. [Zhang Z, Wei SY, Tian YZ, et al. Analysis of the latent profiles and infiuencing factors of subjective economic toxicity in chronic patients[J]. Yixue Xinzhi Zazhi, 2025, 35(3): 262-270.] DOI: 10.12173/j.issn.1004-5511.202409161.

21.徐骏,吉小静,戴欢欢,等. 维持性血液透析患者慢性病共病治疗负担潜在类别及影响因素分析[J]. 华西医学, 2024, 39(8): 1252-1258. [Xu J, Ji XJ, Dai HH, et al. Analysis of potential categories and influencing factors of chronic comorbidity treatment burden in maintenance hemodialysis patients[J]. West China Medicine, 2024, 39(8): 1252-1258.] DOI: 10.7507/1002-0179.202307081.

22.Wright EP, Kiely M, Johnston C, et al. Development and evaluation of an instrument to assess social difficulties in routine oncology practice[J]. Qual Life Res, 2005, 14(2): 373-386. DOI: 10.1007/s11136-004-5332-4.