目的 基于三维度经济困境概念框架，探索心力衰竭患者及其家庭应对经济负担的困境和需求，以期为识别经济负担并构建干预策略方案提供参考。 方法 基于最大差异化的抽样原则，在2024年3月—5月对上海市某三级甲等医院的21个心力衰竭患者家庭开展半结构式访谈，采用NVivo Plus 12.2软件管理文本资料，Colaizzi 7步分析法进行资料分析和主题提取。 结果 凝练出3个主题：心力衰竭治疗过程中沉重的经济负担体验与经济状态改变；心力衰竭治疗过程中的经济顾虑与心理压力；心力衰竭治疗过程中采取的行为应对策略与调节适应。结论 医护人员应关注心力衰竭患者应对经济负担的困境和需求，通过增加心理干预，提供教育项目，开展成本对话，从而帮助其更好地应对经济负担。

Objective To explore predicament and needs of coping financial toxicity in heart failure patients and families based on the three-dimensional conceptual framework of financial hardship，in order to provide reference for identifying financial toxicity and developing intervention strategies. Methods From March to May 2024，21 heart failure families from a tertiary class A hospital in Shanghai were selected to participate in the semi-structured interview by the principle of maximum differentiation. NVivo Plus 12.2 software was used to manage the text data and Colaizzi 7-step analysis method was used for data analysis and topic extraction. Results 3 themes were condensed，including financial toxicity-related experience and the change of economic status during the treatment of heart failure，financial concerns and psychological pressure during the treatment of heart failure，behavioral coping strategies and adaptation in the treatment of heart failure. Conclusion Medical staff should concern to the plight and needs of heart failure patients in coping with financial toxicity，and increase psychological intervention，provide educational programs，conduct cost dialogues to help them better cope with financial toxicity.