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KMID : 0939920220540030834
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대한암학회지
2022 Volume.54 No. 3 p.834 ~ p.841
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Validation of Korean Version of the COmprehensive Score for Financial Toxicity (COST) among Breast Cancer Survivors
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Shim Sung-Keun
Kang Dan-Bee
Kim Na-Yeon
Han Ga-Yeon
Lim Ji-Hyun
Kim Hyun-Soo
Park Jeong-Hyun
Lee Man-Kyung
Lee Jeong-Eon
Kim Seok-Won
Yu Jong-Han
Chae Byung-Joo
Ryu Jai-Min
Nam Seok-Jin
Lee Se-Kyung
Cho Ju-Hee
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Abstract
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Purpose: Little is known about the impact of financial toxicity in disease-free breast cancer survivors. We aim to validate the COmprehensive Score for financial Toxicity in Korean (COST-K) and evaluate financial toxicity among disease-free breast cancer survivors.
Materials and Methods: We conducted linguistic validation following a standardized methodology recommended by Functional Assessment of Chronic Illness Therapy multilingual translation (FACITtrans). For psychometric validation, we conducted a cross-sectional survey with 4,297 disease-free breast cancer survivors at a tertiary hospital in Seoul, Korea between November 2018 and April 2019. Survivors were asked to complete the COST-K and European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30) questionnaires. The test-retest reliability, internal consistency, and validity of the COST-K were assessed using standard scale construction techniques.
Results: The COST-K demonstrated good internal consistency, with a Cronbach’s α of 0.81. The test-retest analysis revealed an intraclass correlation coefficient of 0.78. The COST-K had moderate correlation (r=?0.60) with the financial difficulty item of the EORTC QLQ-C30 and week correlation with the items on acute and chronic symptom burdens (nausea/vomiting, ?0.18; constipation, ?0.14; diarrhea, ?0.14), showing good convergent and divergent validity. The median COST-K was 27 (range, 0 to 44; mean±standard deivation [SD], 27.1±7.5) and about 30% and 5% of cancer survivors experienced mild and severe financial toxicity, respectively. Younger age, lower education, lower household income was associated with higher financial toxicity.
Conclusion: The COST-K is a valid and reliable instrument for measuring financial toxicity in disease-free breast cancer survivors. Considering its impact on the health-related quality of life, more studies need to be conducted to evaluate financial toxicity in cancer survivors and design interventions.
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KEYWORD
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Financial stress, Quality of life, Breast neoplasms, Cancer survivors, Validation study
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