Chemotherapy-related cognitive impairment decreases functional ability

Chemotherapy-related cognitive impairment (CRCI) is associated with decreased functional ability in breast cancer patients who receive the treatment, according to research presented at the Oncology Nursing Society 36th Annual Congress.

CRCI, also known as “chemo brain,” is a commonly reported side effect of breast cancer treatment. Women often complain about being uninformed about the risk of CRCI prior to treatment and express frustration at the lack of validation of the experience. Only limited information about the experience of CRCI has been published, and oncology nurses have access to very few educational materials about the condition. Changes in cognitive function have the ability to significantly impact patients' quality of life.

In a qualitative descriptive study led by Jamie S. Myers, PhD, RN, AOCN®, of the School of Nursing, University of Kansas, Edwardsville, Kansas, researchers sought to describe the experience of chemotherapy-related cognitive impairment for women being treated for breast cancer and to identify information that would be useful to educate women with prior to therapy. The research team used the Revised Conceptual Model of Chemotherapy-Related Changes in Cognitive Function Based on the Theory of Unpleasant Symptoms as the theoretical framework for their research.

For the study, the researchers conducted in-depth interviews with 18 adult women aged 25 to 65 years who were within 6 to 12 months of completing therapy and reported changes in cognitive function. Qualitative content analysis was used to analyze the data. A focus group then validated and refined the data analysis. Expert and peer review enhanced the credibility and trustworthiness of the study results.The overarching study theme was “Life with ‘Chemo Brain;'” subthemes included “How I change,” “How I cope,” and “How to teach me.” During the interviews, the patients reported difficulty with short-term memory, focusing, word finding, reading, and driving. They also experienced increased fatigue and trouble with balance and/or coordination. Patients utilized coping strategies such as writing things down, depending on others, and giving themselves permission to make mistakes. The study results also revealed that all patients wanted to be educated about CRCI prior to starting chemotherapy, preferably by a survivor of breast cancer, and desired an individualized approach to education. Participants recommended specific educational content, reinforcement of education, and on-going assessment for CRCI.

The study results support the claim that CRCI decreases functional ability and suggest that fatigue may require further evaluation as a potential moderating factor of CRCI. Incorporating the results of the study into patient care for women with breast cancer receiving chemotherapy will help to validate the experience of CRCI and to increase patient satisfaction with the delivery of care.
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