Psychometric Evaluation of the Comprehensive Score for Financial Toxicity Scale Among Iranian Cancer Patients
Abstract Objective This study aims to evaluate the psychometric properties of the Persian version of financial toxicity (COST) scale in a sample of cancer patients in Iran. Methods A total of 398 cancer patients completed a demographic questionnaire and the 11-item Persian COST. Performing a Maximum likelihood exploratory factor analysis, extracted three factors of financial worry (four items), financial distress (three items) and direct and indirect cost of control (three items) accounting for 65.204% of the variance. The highest load was related to financial distress and the lowest was related to direct and indirect costs concerns. Results The results of conducting confirmatory factor analysis indicated that the three-factor measurement model had a good fit. Moreover, the measurement model showed good items consistency, good construct reliability, as well as good construct validity in terms of convergent and discriminant validity. Conclusion This study highlights the importance of validating the scale in different contexts as the structure and loadings of the factors have appeared diffidently in various countries. The validated Persian COST can be used in future studies in Iran as a reliable and valid scale to measure financial toxicity among cancer patients.