Feasibility of using remotely-delivered metacognitive strategy training to address cancer-related cognitive impairment in breast cancer

7.项目摘要/摘要 该项目的长期目标是帮助改善癌症相关认知障碍(CRCI)的康复。 在接受乳腺癌治疗后。影响复苏的两个主要因素必须是 为实现这一长期目标而采取的措施：(1)乳腺癌幸存者获得康复的机会不足 (2)支持有效干预措施的证据相对较少 解决乳腺癌幸存者的CRCI问题。这一提议的总体假设是以活动为基础的 元认知-策略培训干预，对日常工作绩效的认知定向 OP)方法，可以可行地远程管理，以改善活动绩效，主观和客观 CRCI乳腺癌存活者的认知和生活质量。这项研究的具体目的是：(1) 评估远程向自我报告CRCI的乳腺癌幸存者提供CO-OP的可行性；以及(2) 评估CO-OP对老年人的活动表现、主客观认知和生活质量的影响 自我报告CRCI的乳腺癌幸存者样本。本研究的两个具体目标都将完成 通过单盲、探索性、随机对照试验。接受治疗的乳腺癌患者 将确定过去三年内的化疗情况。这些女性将被要求完成一份 预筛选调查，以评估资格并确定他们是否有CRCI。那些自我报告的CRCI患者 提供书面同意将接受基线评估。在完成基线评估后 电池，参与者(n=44)将被随机分成两组：(1)12次COOP干预；或 (2)12次注意控制组。干预完成后，参与者将完成 与基线时完成的评估单元相同。本R03的目的是获得以下方面的估计 回答对结果测量的影响和精确度。治疗结果将根据 意向治疗模型。采用独立样本t检验和卡方检验评价是否 随机化成功。描述性统计，以95%的可信区间报告，将用于 评估可行性数据。这两项成果衡量标准的前后变动都将计算在内 组。科恩的d效应大小报告的精度约为估计的95%可信区间，将是 用于评估干预措施对小学和中学学生的组内和组间效果 结果衡量标准。最后，使用皮尔逊相关系数的相关矩阵将被开发为 评估结果衡量标准之间的关系。这项研究的预期结果是：(1) 支持对该人群远程管理Co-op的可行性的数据；以及(2)要估计的数据 CO-OP效应大小与注意对照组比较。这一建议与研究结果一致。 国家医疗康复研究中心(NCMRR)识别、预防和治疗关键因素的优先事项 与残疾相关的继发性疾病，如癌症。

7. Project Summary/Abstract The long-term goal of this project is to help improve recovery from cancer-related cognitive impairment (CRCI) following treatment for breast cancer. There are two primary factors impacting recovery that must be addressed to achieve this long-term goal: (1) breast cancer survivors have inadequate access to rehabilitation services to address CRCI; and (2) there is relatively little evidence supporting effective interventions that address CRCI in breast cancer survivors. The overall hypothesis of this proposal is that an activity-based metacognitive-strategy training intervention, the Cognitive Orientation to daily Occupational Performance (CO- OP) approach, can feasibly be administered remotely to improve activity performance, subjective and objective cognition, and quality of life in breast cancer survivors with CRCI. The specific aims of this study are: (1) to assess the feasibility of delivering CO-OP remotely to breast cancer survivors who self-report CRCI; and (2) to assess the effect of CO-OP on activity performance, subjective and objective cognition, and quality of life in a sample of breast cancer survivors who self-report CRCI. Both specific aims of this study will be completed through a single-blind, exploratory, randomized controlled trial. Breast cancer patients who received chemotherapy within the past three years will be identified. These women will be asked to complete a prescreening survey to evaluate eligibility and identify if they have CRCI. Those with self-reported CRCI who provide written consent will undergo a baseline assessment battery. After completing the baseline assessment battery, participants (n=44) will be randomized to one of two groups: (1) a 12 session CO-OP intervention; or (2) a 12 session attention control group. Following the completion of the intervention, participants will complete the same assessment battery that was completed at baseline. The purpose of this R03 is to obtain estimates of effect and precision of response on the outcome measures. Treatment outcomes will be analyzed under the intention to treat model. Independent samples t-test and chi square test will be used to evaluate whether randomization was successful. Descriptive statistics, reported with 95% confidence intervals, will be used to evaluate the feasibility data. Pre-to-post change in each of the outcome measures will be calculated for both groups. Cohen’s d effect size reported with precision around the estimate, 95% confidence intervals, will be used to evaluate the within and between group effects of the interventions on the primary and secondary outcome measures. Finally, a correlation matrix using Pearson correlation coefficients will be developed to evaluate the relationships between the outcome measures. The expected outcomes of this study will be: (1) data to support the feasibility of remotely administering CO-OP to this population; and (2) data to estimate effect sizes of CO-OP compared to the attention control group. This proposal is consistent with the research priority of the National Center for Medical Rehabilitation Research (NCMRR) to identify, prevent, and treat key secondary conditions associated with disabilities, e.g., cancer.