Psychosocial Predictors of Cancer-Related Cognitive Change

描述(申请人提供)：今年将有超过211,000名妇女被诊断为浸润性乳腺癌，国家癌症研究所估计，目前美国有230万乳腺癌幸存者。癌症相关的认知障碍是被诊断为乳腺癌的女性的一个重要担忧，20%-30%的女性在诊断和治疗后的某个时候报告了认知困难，包括注意力、注意力和记忆力方面的问题。因此，50多万妇女可能面临认知功能的不利变化，这些变化可能会干扰癌症前生活角色的恢复和整体生活质量的恢复。与癌症相关的认知变化知之甚少，我们对乳腺癌女性在日常生活中经历的认知困难的性质和过程也知之甚少。对可能导致这些认知变化的心理社会和情景因素更是知之甚少。短期使用认知失败事件的日常实地日记可以提供对这些经验的洞察。我们建议每天收集三个评估点的特定认知困难、生活应激源、状态影响和疲劳的7天日记报告；治疗前(基线)、化疗期间(T1)和化疗完成后1个月(T2)。其具体目的是：1)描述乳腺癌女性患者认知障碍的性质和频率，以及这些困难发生的现实背景；2)研究日常认知障碍事件与客观认知功能之间的关系；3)描绘认知功能客观缺陷患者的心理社会特征。我们将检查心理社会、人口统计学和临床变量，以努力确定与客观测量的、标准定义的、与癌症相关的认知变化相关的因素。这一建议为研究乳腺癌的认知后遗症提供了一种新的方法。研究结果将用于完善筛查和评估策略，以早期识别易受癌症相关认知变化影响的女性，并将指导教育和康复干预措施的设计，以针对特定的认知困难，改善整体认知表现，并提高生活质量。与癌症相关的认知困难，包括记忆和注意力问题，是乳腺癌患者和幸存者的重大关切，并可能干扰妇女回到癌症前的生活角色和整体生活质量。然而，研究人员对女性在日常生活中经历的认知困难知之甚少，也不知道为什么一些女性比其他女性有更严重的认知问题。更好地了解这些问题将有助于医疗保健提供者识别有癌症相关认知困难风险的妇女，并将指导教育和康复干预措施的设计，以针对特定的认知困难，改善整体认知表现，并提高生活质量。

DESCRIPTION (provided by applicant): More than 211,000 women will be diagnosed with invasive breast cancer this year and the National Cancer Institute estimates that there are currently 2.3 million breast cancer survivors in the United States. Cancer-related cognitive impairment is a significant concern for women diagnosed with breast cancer and 20-30% of women report cognitive difficulties, including problems with attention, concentration, and memory, at some point following diagnosis and treatment. Thus, more than one half million women may be facing adverse changes in cognitive function that can interfere with resumption of pre- cancer life roles and recovery of overall quality of life. Cancer-related cognitive change is poorly understood and we know little about the nature and course of the cognitive difficulties women with breast cancer experience in their everyday lives. Even less is known about the psychosocial and situational factors that may contribute to these cognitive changes. Short-term use of daily field diaries of cognitive failure events can provide insight into these experiences. We propose collecting 7-day daily diary reports of specific cognitive difficulties, life stressors, state affect, and fatigue at each of three assessment points; before treatment (baseline), during chemotherapy (T1), and 1 month after completion of chemotherapy (T2). The specific aims are 1) to describe the nature and frequency of cognitive difficulties that women with breast cancer experience and the real-life context in which these difficulties occur; 2) Examine relationships among daily cognitive failure events and objective cognitive function, 3) Delineate the psychosocial profiles of patients who experience objective deficits in cognitive function. We will examine psychosocial, demographic, and clinical variables in an effort to identify factors associated with objectively measured, criterion defined, cancer-related cognitive changes. This proposal presents a novel approach to the study of the cognitive sequelae of breast cancer. Findings will be used to refine screening and assessment strategies for early identification of women vulnerable to cancer-related cognitive changes, and will guide the design of educational and rehabilitative interventions to target specific cognitive difficulties, improve overall cognitive performance, and improve quality of life. to Public Health Cancer-related cognitive difficulties, including problems with memory and attention, are a significant concern for breast cancer patients and survivors and can interfere with women's return to pre-cancer life roles and overall quality of life. However, researchers know very little about the everyday cognitive difficulties women experience in their lives or why some women have more severe cognitive problems than others. A better understanding of these issues will help health care providers identify women at risk for cancer-related cognitive difficulties and will guide the design of educational and rehabilitative interventions to target specific cognitive difficulties, improve overall cognitive performance, and improve quality of life.