The association between neuropsychological impairment, self-perceived cognitive deficits, fatigue and health related quality of life in breast cancer survivors following standard adjuvant versus high-dose chemotherapy
The association between neuropsychological impairment, self-perceived cognitive deficits, fatigue and health related quality of life in breast cancer survivors following standard adjuvant versus high-dose chemotherapy
复制标题
DOI：
10.1016/j.pec.2006.11.005
复制
发表时间：
2007-04-01
影响因子：
3.5
通讯作者：
Koch, Uwe
中科院分区：
文献类型：
--
作者：
Mehnert, Anja;Scherwath, Angela;Koch, Uwe
目的：研究标准辅助治疗（n = 23） vs高剂量化疗（n = 24） 5年高危乳腺癌幸存者和放疗后早期乳腺癌患者（n = 29）（对照组）的神经心理损伤、自我认知缺陷、疲劳和健康相关生活质量之间可能存在的关联。方法：采用包括注意、记忆和执行功能在内的神经心理学评估法，结合注意力自我知觉缺陷问卷（FEDA）、多维疲劳量表（MFI-20）和EORTC-QLQ-C30量表。结果：研究结果表明，神经心理障碍与自我认知缺陷、疲劳和HRQOL无直接关系。然而，46%的患者报告自我认知缺陷，82%的患者抱怨与癌症相关的疲劳。除了活动减少外，我们没有发现显著的组间差异，尽管接受标准剂量化疗的患者始终存在较高水平的自我认知缺陷和疲劳，以及最低的HRQOL。结论：结果强调了在治疗阶段进行心理社会咨询和支持以及后续护理的必要性。根据神经心理学测量，需要对不同认知领域的自我认知缺陷进行敏感的癌症特异性评估。实践启示：自我认知缺陷和疲劳的作用应在教育干预和咨询中加以考虑。应制定、实施和评估具体的康复措施，以满足这些患者的需求，并减少癌症治疗后认知功能障碍的频率。2006爱思唯尔爱尔兰有限公司版权所有。
Objective: The possible association between neuropsychological impairment, self-perceived cognitive deficits, fatigue and health related quality of life has been studied in high-risk breast cancer survivors 5 years following standard adjuvant (n = 23) versus high-dose chemotherapy (n = 24) and in early-stage breast cancer patients (n = 29) (comparison group) following radiation therapy.Methods: A neuropsychological assessment covering attention, memory and executive functions was used together with the questionnaire for self-perceived deficits in attention (FEDA), the multidimensional fatigue inventory (MFI-20) and the EORTC-QLQ-C30.Results: Findings have shown that neuropsychological impairment is not directly associated with self-perceived cognitive deficits, fatigue and HRQOL. However, 46% of patients reported self-perceived cognitive deficits and 82% of the patients complained about cancer related fatigue. Except for reduced activity we did not find significant group differences, even though patients who received standard-dose chemotherapy had consistently higher levels of self-perceived cognitive deficits and fatigue, and the lowest HRQOL.Conclusion: Results emphasize the need for psychosocial counseling and support during treatment phase and follow up care as well. Sensitive cancer-specific measures for the assessment of self-perceived cognitive deficits in different cognitive domains according to neuropsychological measurements are required.Practice implications: The role of self-perceived cognitive deficits and fatigue should be considered in educational interventions and counseling. Specific rehabilitation measures should be developed, implemented and evaluated in order to meet the needs of these patients and to decrease the frequency of cognitive deficits following cancer treatment. (c) 2006 Elsevier Ireland Ltd. All rights reserved.