Association Of Cognitive Impairment And Quality Of Life In Breast Cancer Survivors PDF Download

Author: Diane Von Ah
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Book Description
Introduction: The diagnosis and treatment for breast cancer can disrupt quality of life. Many breast cancer survivors (BCS) also incur lingering symptoms, such as cognitive impairment, which has also been associated with diminished quality of life. However, the impact of cancer survivorship and cognitive impairment on quality of life is not well known. Objective: The purpose of this study was to examine whether cognitive impairment, breast cancer status (BCS versus healthy control [HC]), or both, are associated with quality of life, including psychological (depressive symptoms, overall well-being, post-traumatic stress and personal growth) and physical well-being (physical functioning and fatigue). Methods: 498 BCS who were 3 to 8 years post-chemotherapy treatment and 397 HC completed subjective memory and quality of life questionnaires and a one-time neuropsychological assessment, including tests of attention, memory, speed of processing, and verbal fluency. Cognitive impairment was defined as scoring 1.5 standard deviations below the mean of the control group on each test and overall composite. Separate linear regression models were used controlling for age, education, and income. Results: BCS reported significantly more memory loss than HC (p

Author: Christina A. Meyers
Publisher: Cambridge University Press
ISBN: 9781107411814
Category : Medical
Languages : en
Pages : 0

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This book is a unique resource on the influence cancer and cancer treatments have on cognition. The majority of cancer patients on active treatment experience cognitive impairments often referred to as 'chemobrain' or 'chemofog'. In addition, patients with primary or metastatic tumors of the brain often experience direct neurologic symptoms. This book helps health care professionals working with cancer patients who experience cognitive changes and provides practical information to help improve care by reviewing and describing brain-behavior relationships; research-based evidence on cognitive changes that occur with various cancers and cancer treatments; assessment techniques, including neurocognitive assessment and neuroimaging techniques; and intervention strategies for affected patients. In short, it will explain how to identify, assess and treat these conditions.

Author: Gary Rodin
Publisher: Oxford University Press
ISBN: 0190236442
Category : Medical
Languages : en
Pages : 265

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Book Description
Managing Cancer and Living Meaningfully provides valuable insight into the experience of patients and families living with advanced cancer and describes a novel psychotherapeutic approach to help them live meaningfully, while also facing the threat of mortality. Managing Cancer and Living Meaningfully, also known by the acronym CALM, is a brief supportive-expressive intervention that can be delivered by a wide range of trained healthcare providers as part of cancer care or early palliative care. The authors provide an overview of the clinical experience and research that led to the development of CALM, a clear description of the intervention, and a manualized guide to aid in its delivery. Situated in the context of early palliative care, this text is destined to be become essential reading for healthcare professionals engaged in providing psychological support to patients and their families who face the practical and profound problems of advanced disease.

Author: Michael H. Antoni
Publisher: Oxford University Press
ISBN: 0190450029
Category : Psychology
Languages : en
Pages : 144

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Book Description
Living with HIV can be stressful, which can affect both your emotional and physical well-being. You may feel a loss of control over your life, socially isolated, or anxious and depressed. Studies have shown that prolonged stress can negatively impact the immune system, making it less effective in fighting illness. If you are concerned about the impact stress has on your life and on your health, this book can help you learn to relax and manage stress more effectively. This book presents a group treatment program that has been scientifically proven to reduce stress in individuals living with HIV. Written by the developers of this groundbreaking program, this workbook is based on the principles of Cognitive-Behavioral Stress Management (CBSM). You will learn a variety of relaxation techniques, all designed to help you reduce tension and stress. As you become more aware of stress and its effects, stress management skills will increase your ability to cope. This workbook comes complete with user-friendly monitoring forms and homework exercises designed to help reinforce the skills learned in group. It also includes instructions for relaxation practice that will remain useful long after you've completed the program. Used in conjunction with the group program described in the corresponding facilitator guide, this workbook will help you successfully manage stress and lead a more healthy life. TreatmentsThatWorkTM represents the gold standard of behavioral healthcare interventions! · All programs have been rigorously tested in clinical trials and are backed by years of research · A prestigious scientific advisory board, led by series Editor-In-Chief David H. Barlow, reviews and evaluates each intervention to ensure that it meets the highest standard of evidence so you can be confident that you are using the most effective treatment available to date · Our books are reliable and effective and make it easy for you to provide your clients with the best care available · Our corresponding workbooks contain psychoeducational information, forms and worksheets, and homework assignments to keep clients engaged and motivated · A companion website (www.oup.com/us/ttw) offers downloadable clinical tools and helpful resources · Continuing Education (CE) Credits are now available on select titles in collaboration with PsychoEducational Resources, Inc. (PER)

Author: Adele Crouch
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Introduction: Breast cancer is the most common cancer in women. Aging is the greatest risk factor for the development of cancer. With improved screening and treatment, more women are surviving; however, breast cancer survivors (BCS) can be left facing disturbing symptoms including cognitive impairment (CI). Little research has been conducted in older BCS experiencing CI. Objectives: The objectives of this integrative review were to: (1) describe the incidence of CI in older BCS, (2) identify the cognitive domains impacted and measures used to assess CI, and (3) determine factors associated with CI in older BCS. Methods: Databases searched included PubMed, CINAHL, PsycINFO, and MEDLINE. This review focused on studies that examined CI in female BCS who were 65 years of age or older. Eligible studies were published in peeru2013reviewed journals, written in English, and measured CI subjectively or objectively. We excluded studies that included women with a dementia diagnosis. Results: Eight quantitative studies met inclusion criteria. Six used prospective designs and 2 were cross-sectional. Before treatment, incidence of CI ranged between 11%-41% using objective measures and ranged from 6%-64% when subjective measures were used. Four primary cognitive domains of impairment were identified, including memory, executive function, speed of processing, and language/verbal functioning. Factors associated with CI included older age, increased number of comorbidities, poorer physical functioning, frailty and poorer quality of life. Conclusions: CI is a common and significant problem in older BCS. Healthcare providers need to assess and address CI to promote quality of life in older BCS.

Author: Adele Crouch
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Background/Framework: For millions of cancer survivors, cognitive dysfunction is a prevalent, severe, and persistent problem that is associated with poorer quality of life. Unfortunately, the scientific basis for managing these cognitive changes in cancer survivors is extremely limited. Available evidence from pilot studies, including work by our own group, suggests that computerized cognitive training, which is based on the principles of neuroplasticity (ability of brain neurons to re-organize and form new neural networks), may be a viable treatment option. However, previous trials have been limited by their designs (failure to have attention control comparison), delivery (failure to offer in the home) and lack of inclusion of a response biomarker such as brain derived neurotrophic factor (BDNF), which we now know is associated with neural plasticity. Purpose: The purpose of this 2-group, double-blind, randomized controlled trial is to test the feasibility, satisfaction, and preliminary efficacy of a computerized home-based cognitive training program compared to attention control in breast cancer survivors (BCS) as well as to explore potential biomarkers of intervention effects. Methods: A total of 68 eligible BCS will be randomized to computerized cognitive training or attention control. A blinded and trained tester will perform data collection and neuropsychological testing at two time points: baseline prior to intervention (T1) and immediately after the 10-week cognitive training -program (+/- 7 days) (T2). Feasibility and satisfaction will be assessed through objective indicators (study adherence, completion rate) and self-report (facilitators, barriers, and perceived satisfaction) and cognitive performance will be assessed through objective neuropsychological tests. In addition, we will measure the effects of cognitive training on self-report measures of perceived cognitive function, associated symptoms (depressive symptoms, anxiety and fatigue), perceived work ability, and quality of life. Data will be analyzed using descriptive statistics and a general linear mixed model (GLMM). Simple main effects analyses will be used to follow up statistically significant interactions. Findings and Conclusions: Preliminary results of this trial will be presented, including an assessment of treatment fidelity measures used in this intervention trial. This work will represent the first rigorous trial of computerized cognitive training delivered in the home to BCS. Positive or negative study findings will provide empirical evidence for cliniciansu2019 recommendations and survivorsu2019 treatment selections for managing cognitive impairment in BCS. Acknowledgement: This work was funded by a grant from the Indiana University School of Nursing, Center for Enhancing Quality of Life (CEQL).

Author: Adele Deborah Lenae Crouch
Publisher:
ISBN:
Category :
Languages : en
Pages : 234

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Up to 75% of the more than 3.5 million breast cancer survivors (BCS) living in the United States report cognitive dysfunction. However, little is known about cognitive dysfunction among older BCS, who may be at greater risk. Therefore, the purpose of this dissertation was to characterize cognitive dysfunction in older BCS. Specific aims included: (1) synthesize the literature regarding cognitive dysfunction in older BCS; and (2) examine the relationships between a) objective cognitive function (immediate memory, delayed memory, attention, executive function-working memory, verbal fluency) and subjective cognitive function (attention); b) demographic factors, medical factors, treatment factors, and cancer-related symptoms (depressive symptoms, anxiety, fatigue, sleep disturbance) and cognitive function; and c) comorbidity and cognitive function and physical functioning, and quality of life (QoL) in older BCS. In an integrative review, to address aim 1, 12 studies were identified. Up to 41% of older BCS showed objective cognitive dysfunction on neuropsychological assessment, up to 64% reported subjective cognitive dysfunction concerns pre-treatment, and 50% incurred cognitive decline from pre- to post-treatment. Cognitive dysfunction was associated with older age, multiple comorbidities, chemotherapy, sleep disturbance, neuropsychological symptom cluster, frailty, and poorer QoL. To address aim 2, data were leveraged from a large, nationwide, QoL in younger versus older BCS study (PI: Champion), which included 335 older BCS who were e"0 years of age, had breast cancer (stage I-IIIa), received chemotherapy, and were 3-8 years post-diagnosis without recurrence. Findings included up to 19% of older BCS had mild-moderate objective cognitive dysfunction on at least one neuropsychological assessment, with 26% reporting poor-moderate subjective attention function. BCS, who were older, had less education and more depressive symptoms had greater cognitive dysfunction. Objective attention and executive function-working memory significantly and positively correlated with subjective attention. In turn, subjective cognitive dysfunction and increased number of comorbidities were related to poorer physical functioning. Subjective cognitive dysfunction was also related to poorer QoL. The findings from this study highlights the prevalence and complexity of cognitive dysfunction in older BCS. Further research is needed to better understand the intersection of aging, cancer, comorbidities and cognitive dysfunction and the negative implications in older BCS

Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309134161
Category : Medical
Languages : en
Pages : 455

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Cancer care today often provides state-of-the-science biomedical treatment, but fails to address the psychological and social (psychosocial) problems associated with the illness. This failure can compromise the effectiveness of health care and thereby adversely affect the health of cancer patients. Psychological and social problems created or exacerbated by cancer-including depression and other emotional problems; lack of information or skills needed to manage the illness; lack of transportation or other resources; and disruptions in work, school, and family life-cause additional suffering, weaken adherence to prescribed treatments, and threaten patients' return to health. Today, it is not possible to deliver high-quality cancer care without using existing approaches, tools, and resources to address patients' psychosocial health needs. All patients with cancer and their families should expect and receive cancer care that ensures the provision of appropriate psychosocial health services. Cancer Care for the Whole Patient recommends actions that oncology providers, health policy makers, educators, health insurers, health planners, researchers and research sponsors, and consumer advocates should undertake to ensure that this standard is met.

Author: Erin O'Farrell
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Advances in cancer treatment have led to increasing numbers of survivors left to struggle with the long-term adverse effects of disease and treatment. Many possible effects have been described including anxiety, depression, as well as physical side effects and consequences of cancer treatment. One particular adverse effect that is frequently reported but often overlooked in clinical practice is disturbances of cognitive functioning. Cancer-related cognitive impairment (CRCI) is a growing area of research with important clinical implications for current patients and survivors. Despite a huge increase in this research endeavour in the last 20 years, many important questions remain unanswered due, in large part, to methodological limitations of many of the studies. The overall goal of this dissertation is to critically examine previous CRCI research from a methodological perspective. It will explore limitations and confounds in this research and provide suggestions for improving future work. This dissertation is comprised of three manuscripts, a critical literature review and two original papers, addressing specific research questions. The first original paper addresses the disparity between the results of objective (performance-based) and subjective (self-report) measures of cognition that is typically observed in samples of cancer patients, using multilevel modeling to explore the hypothesis that this is due to failure to address measures of change over time. Despite negative findings, the methodological approach taken to this research question provided greater evidence for this subjective-objective disparity as well as methodological suggestions for future studies. The second original paper explores the sensitivity and validity of a computerized cognitive test for measuring CRCI to determine if it might be an appropriate alternative to traditional, resource-intensive neuropsychological testing. This study found that, although the computerized measure of cognitive functioning was not sensitive enough to detect changes at the individual level or within specific domains, it was sensitive to changes in cognitive functioning at the group level suggesting its usefulness as a screening tool in research settings. By addressing methodological limitations of research to date and, specifically, the two issues identified above, this dissertation aims to a) make recommendations to help improve the quality of future research, b) validate the cognitive complaints of cancer patients, and c) improve access to cognitive assessments leading to increased detection and treatment of cognitive side effects and improvement in quality of life of cancer survivors.

Author: Amanda Lucas
Publisher:
ISBN:
Category :
Languages : en
Pages : 86

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Book Description
Chemotherapy, radiation therapy, and targeted biological therapies are cancer treatments that can increase survivorship in patients with breast cancer, yet the associated cognitive side effects of therapy can significantly reduce quality of life (QOL). Cognitive Impairment has been identified by oncology nurses and patient's as one of the most difficult symptoms to manage. However, methods to detect cognitive impairment are inconsistent in the literature. The purpose of this study was to examine the effect of cancer treatment on cognitive impairment in women with breast cancer using self-reported instruments. A descriptive, correlational pilot study was used to compare healthy women of similar age and those women who receive surgery, radiation, and chemotherapy for breast cancer at six months or less of endocrine therapy. This study evaluated three-self reported tools on cognition (attention, memory, and executive function) in conjunction with self-reported tools on symptom burden, QOL, anxiety, and depression. Results showed a significant difference between groups in attention and executive function but not in memory. Women with breast cancer reported significantly more symptoms and demonstrated more anxiety and depression than the healthy women. The findings of this study corresponded with findings from previous studies. However, a larger scale study with a larger sample size needs to be completed to validate these findings.