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Nakamura ZM, Ali NT, Crouch A, Dhillon H, Federico A, Gates P, Grech L, Kesler SR, Ledbetter L, Mantovani E, Mayo S, Ng DQ, Pembroke L, Pike KE, Tamburin S, Tan CJ, Toh YL, Yang Y, Von Ah D, Allen DH. Impact of Cognitive Rehabilitation on Cognitive and Functional Outcomes in Adult Cancer Survivors: A Systematic Review. Semin Oncol Nurs 2024; 40:151696. [PMID: 39048409 PMCID: PMC11402594 DOI: 10.1016/j.soncn.2024.151696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVES This systematic review (PROSPERO CRD42021275421) synthesized evidence on the efficacy of cognitive rehabilitation on cognitive and functional outcomes in adult cancer survivors. METHODS Articles were identified though PubMed/MEDLINE, EMBASE, PsycINFO, and Web of Science from inception through June 30, 2023. Studies included participants ≥18 years old, diagnosed with cancer. Primary outcomes were validated measures of subjective and objective cognition. Articles were dual reviewed for eligibility and data extraction. Risk of bias was assessed with the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. RESULTS The search yielded 3,811 articles; 65 full-text articles were reviewed; 53 articles (15 cognitive training, 14 strategy-based, 21 combinations, three inpatient rehabilitation), representing 52 unique studies, were included. Positive effects were observed in at least one objective cognitive measure in 93% of strategy training, 81% of cognitive training, 79% of combination rehabilitation interventions. Positive effects were observed in subjective cognition in 100% of strategy training, 55% of cognitive training, and 92% of combination interventions. Among studies with comparator groups, processing speed improved in 60% of cognitive training studies, while strategy training did not improve processing speed; otherwise, cognitive domain effects were similar between intervention types. Impact on functional outcomes was inconclusive. CONCLUSIONS Cognitive rehabilitation appear beneficial for cancer-related cognitive impairment (CRCI). Differential effects on specific cognitive domains (eg, processing speed) and subjective cognition may exist between intervention types. IMPLICATIONS FOR NURSING PRACTICE Nurses should increase patient and provider awareness of the benefits of cognitive rehabilitation for CRCI.
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Affiliation(s)
- Zev M Nakamura
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | | | - Adele Crouch
- Indiana University School of Nursing, Indianapolis, Indiana
| | - Haryana Dhillon
- Psycho-Oncology Cooperative Research Group, Faculty of Science, The University of Sydney, New South Wales, Australia
| | - Angela Federico
- Department of Neurosciences, Biomedicine and Movement Sciences, GB Rossi Hospital, University of Verona, Verona, Italy
| | - Priscilla Gates
- Peter Mac Callum Cancer Center, Deakin University, Burwood, Victoria, Australia
| | - Lisa Grech
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | | | - Leila Ledbetter
- Duke University Medical Center Library, DUMC 3702, Durham, North Carolina
| | - Elisa Mantovani
- Department of Neurosciences, Biomedicine and Movement Sciences, GB Rossi Hospital, University of Verona, Verona, Italy
| | | | - Ding Quan Ng
- University of California Irvine, School of Pharmacy & Pharmaceutical Sciences, Irvine, CA, USA
| | - Lorna Pembroke
- School of Psychological Sciences Level 3, Australian Hearing Hub, Health and Human Sciences, Macquarie University, New South Wales, Australia
| | - Kerryn E Pike
- School of Applied Psychology, Griffith University, Gold Coast, Queensland, Australia
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, GB Rossi Hospital, University of Verona, Verona, Italy
| | - Chia Jie Tan
- College of Pharmacy, University of Utah, Salt Lake City, Utah
| | - Yi Long Toh
- Department of Pharmacy, National University of Singapore, Singapore
| | - Yesol Yang
- The Ohio State University Comprehensive Cancer Center, Colombus, Ohio
| | - Diane Von Ah
- The Ohio State University, College of Nursing, Colombus, Ohio
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Zanotto A, Glover RN, Zanotto T, Boele FW. Rehabilitation in People Living with Glioblastoma: A Narrative Review of the Literature. Cancers (Basel) 2024; 16:1699. [PMID: 38730651 PMCID: PMC11083409 DOI: 10.3390/cancers16091699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/21/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Glioblastoma is the most common primary malignant brain tumor. While preliminary data point to the positive effects of rehabilitation for patients with glioblastoma, there are unique challenges for clinicians working with this population, including limited life expectancy and/or rapid neurological deterioration. The aim of this article is to review the literature on rehabilitation of adults with glioblastoma, including the feasibility of interventions, their effectiveness, as well as the current clinical practice. The reviewed literature suggests that rehabilitation has been found beneficial for improving the functional prognosis and quality of life of adults with glioblastoma and is desired by patients. We summarize the qualitative evidence regarding healthcare professionals' and patients' perspectives on the use of supportive care services. We conclude there is a need for the design of effective rehabilitation programs for patients with glioblastoma, as well as for the development of glioblastoma-specific clinical guidelines for rehabilitation practitioners.
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Affiliation(s)
- Anna Zanotto
- Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA; (R.N.G.); (T.Z.)
| | - Rebecca N. Glover
- Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA; (R.N.G.); (T.Z.)
| | - Tobia Zanotto
- Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA; (R.N.G.); (T.Z.)
| | - Florien W. Boele
- Patient Centred Outcomes Research Group, Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds LS2 9JT, UK
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9JT, UK
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Loughan AR, Willis KD, Braun SE, Rodin G, Lanoye A, Davies AE, Svikis D, Mazzeo S, Malkin M, Thacker L. Managing cancer and living meaningfully (CALM) in adults with malignant glioma: a proof-of-concept phase IIa trial. J Neurooncol 2022; 157:447-456. [PMID: 35437687 PMCID: PMC9909556 DOI: 10.1007/s11060-022-03988-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Managing Cancer and Living Meaningfully (CALM) is an evidence-based, brief, semi-structured psychotherapy designed to help patients with advanced cancer cope with the practical and profound challenges of their illness. However, no study to date has investigated its feasibility, acceptability, and preliminary effectiveness in adults with malignant glioma, despite the well-documented incidence of psychological distress in this vulnerable and underserved population. METHODS Fourteen patients with glioma and elevated symptoms of depression and/or death anxiety enrolled in the trial: 83% glioblastoma, 75% female, Mage = 56 years (SD = 15.1; range = 27-81). Feasibility was assessed based on established metrics. Acceptability was measured by post-session surveys and post-intervention interviews. Preliminary intervention effects were explored using paired t-tests, comparing psychological distress at baseline and post-intervention. RESULTS Of the 14 enrolled patients, 12 were evaluable. Nine completed the study (75% retention rate). Three patients withdrew due to substantial disease progression which affected their ability to participate. Participants reported high perceived benefit, and all recommended the program to others. Baseline to post-intervention assessments indicated reductions in death anxiety, generalized anxiety, and depression, and increases in spirituality. Quality of life and fear of cancer recurrence remained stable throughout the study period. CONCLUSIONS CALM appears feasible for use with adults with malignant glioma. Enrollment and retention rates were high and comparable to psychotherapy trials for patients with advanced cancer. High perceived benefit and reductions in symptoms of death anxiety, generalized anxiety, and depression were reported by participants. These findings are extremely encouraging and support further study of CALM in neuro-oncology. TRIAL REGISTRATION NUMBER NCT04646213 registered on 11/27/2020.
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Affiliation(s)
- Ashlee R Loughan
- Department of Neurology, School of Medicine, Virginia Commonwealth University, 1201 East Marshall St, Richmond, VA, 23298-0037, USA.
- Massey Cancer Center, Richmond, VA, USA.
- Division of Neuro-Oncology, Department of Neurology, Virginia Commonwealth University, School of Medicine, VCU Massey Cancer Center, 1201 East Marshall St, Richmond, VA, 23298-0037, USA.
| | - Kelcie D Willis
- Massey Cancer Center, Richmond, VA, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Sarah Ellen Braun
- Department of Neurology, School of Medicine, Virginia Commonwealth University, 1201 East Marshall St, Richmond, VA, 23298-0037, USA
- Massey Cancer Center, Richmond, VA, USA
| | - Gary Rodin
- Princess Margaret Cancer Center, Toronto, Canada
| | - Autumn Lanoye
- Massey Cancer Center, Richmond, VA, USA
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Alexandria E Davies
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Dace Svikis
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Suzanne Mazzeo
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Mark Malkin
- Department of Neurology, School of Medicine, Virginia Commonwealth University, 1201 East Marshall St, Richmond, VA, 23298-0037, USA
- Massey Cancer Center, Richmond, VA, USA
| | - Leroy Thacker
- Massey Cancer Center, Richmond, VA, USA
- Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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