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Haywood D, O’Connor M, Baughman FD, Chan A, Chan RJ, Dauer E, Dhillon HM, Henneghan AM, Lawrence BJ, Lustberg M, Vardy JL, Rossell SL, Hart NH. Protocol for the Development and Initial Validation of the COG-IMPACT Tool: A Purpose-Built Unmet Needs Assessment for Cancer-Related Cognitive Impairment. Methods Protoc 2024; 7:54. [PMID: 39051268 PMCID: PMC11270296 DOI: 10.3390/mps7040054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/24/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024] Open
Abstract
(1) Background: A significant proportion of cancer survivors report experiencing a cognitive 'fog' that affects their ability to think coherently and quickly, and reason with clarity. This has been referred to as cancer-related cognitive impairment (CRCI). CRCI has extensive impacts on the daily lives of people living with or beyond cancer, including occupational, social, and psychological functioning. Oncology health professionals report feeling under-resourced to effectively assess the needs of an individual with CRCI and then provide optimal care and referral. (2) Methods: The objective of this project is to develop and provide an initial validation of the first purpose-built unmet needs assessment for CRCI: the Unmet Needs Assessment of Cancer-Related Cognitive Impairment Impact (COG-IMPACT). We will use a multiple-stage, co-design, mixed-methods approach to develop and provide an initial validation of the COG-IMPACT. (3) Results: The primary anticipated result of this research is the production of the COG-IMPACT, the first purpose-built unmet needs assessment for CRCI. The assessment could be used by health professionals to understand the unmet needs and facilitate optimal care and referral for cancer survivors, by survivors to elucidate their supportive needs and advocate for their care, and by researchers to examine the correlates of unmet needs relating to CRCI, as well as how best to support people with CRCI.
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Affiliation(s)
- Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, NSW 2021, Australia
- Department of Mental Health, St Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3010, Australia
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Moira O’Connor
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Frank D. Baughman
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Alexandre Chan
- School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA 92619, USA
| | - Raymond J. Chan
- School of Nursing, Queensland University of Technology (QUT), Kelvin Grove, Brisbane, QLD 4059, Australia
- Cancer Care Services, Royal Brisbane and Women’s Hospital, Herston, QLD 4006, Australia
| | - Evan Dauer
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, NSW 2021, Australia
- Department of Mental Health, St Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia
| | - Haryana M. Dhillon
- Faculty of Science, School of Psychology, Psycho-Oncology Cooperative Research Group, The University of Sydney, Sydney, NSW 2006, Australia
- Centre for Medical Psychology & Evidence-Based Decision-Making, Sydney, NSW 2006, Australia
| | - Ashley M. Henneghan
- School of Nursing, The University of Texas at Austin, Austin, TX 78701, USA
- Department of Oncology, Dell Medical School, The University of Texas at Austin, Austin, TX 78701, USA
| | - Blake J. Lawrence
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Maryam Lustberg
- School of Medicine, Yale University, New Haven, CT 06520, USA
| | - Janette L. Vardy
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Susan L. Rossell
- Department of Mental Health, St Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Nicolas H. Hart
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, NSW 2021, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia
- Exercise Medicine Research Institute, School of Medical and Health Science, Edith Cowan University, Joondalup, WA 6027, Australia
- Institute for Health Research, University of Notre Dame Australia, Fremantle, WA 6160, Australia
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Ibrar M, Rai HK, Main A, McCartney H, Maguire R, Rodriguez MAP. The Experience of Cancer-Related Cognitive Impairment Across Common Cancers: Protocol for a Qualitative Systematic Review. JMIR Res Protoc 2024; 13:e56888. [PMID: 38820581 PMCID: PMC11179027 DOI: 10.2196/56888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/02/2024] [Accepted: 04/10/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Cancer-related cognitive impairment (CRCI) is commonly experienced by patients with cancer during treatment, and 35% of patients experience cognitive impairment after treatment completion. Impairments in memory, attention, executive functioning, and information processing speed are most reported and often negatively impact daily functioning and quality of life (QoL). Despite the large scale of reports, this adverse side effect is underinvestigated across common cancer types, and there is a lack of insight into the CRCI experience. OBJECTIVE This qualitative synthesis aims to explore the evidence in relation to the experience of CRCI across common cancers. It also aims to understand the prevalence of CRCI across various cancer types, cognitive domains, and its impact on QoL and functional ability. METHODS A comprehensive search of databases, including PubMed, American Psychological Association PsycINFO, CINAHL, and Scopus, will be conducted. A total of 2 independent reviewers will screen titles and abstracts for inclusion, followed by full-text screening. A third reviewer will resolve any arising conflicts in the process of data screening and inclusion. Subsequently, data extraction and quality assessment using the Critical Appraisal Skills Programme (CASP) tool will be conducted. The results will be analyzed using thematic analysis. RESULTS This review is part of a PhD program funded in January 2023. The review commenced in June 2023, and data analysis is currently in progress. The qualitative synthesis will explore the experiences of CRCI across common cancers. The included studies are expected to report on numerous cancer types such as breast cancer, prostate cancer, leukemia, and lung cancer. The included study types are most likely to be interviews, focus groups, and surveys with qualitative components. CONCLUSIONS This protocol highlights the need for a qualitative synthesis that will explore the experience of CRCI across common cancer types. It will provide valuable insight into the lived experience of CRCI and the cognitive domains that may be disproportionately affected. There is a growing demand for further management interventions and clinically tested treatments of CRCI and the qualitative exploration of patient experience is crucial for their development. This qualitative synthesis will inform future developments and will contribute to improving QoL after cancer. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56888.
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Affiliation(s)
- Maryam Ibrar
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Harleen Kaur Rai
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Ashleigh Main
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Haruno McCartney
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Roma Maguire
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
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Chapman B, Louis CC, Moser J, Grunfeld EA, Derakshan N. Benefits of adaptive cognitive training on cognitive abilities in women treated for primary breast cancer: Findings from a 1-year randomised control trial intervention. Psychooncology 2023; 32:1848-1857. [PMID: 37882108 PMCID: PMC10946857 DOI: 10.1002/pon.6232] [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: 05/02/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE While adaptive cognitive training is beneficial for women with a breast cancer diagnosis, transfer effects of training benefits on perceived and objective measures of cognition are not substantiated. We investigated the transfer effects of online adaptive cognitive training (dual n-back training) on subjective and objective cognitive markers in a longitudinal design. METHODS Women with a primary diagnosis of breast cancer completed 12 sessions of adaptive cognitive training or active control training over 2 weeks. Objective assessments of working memory capacity (WMC), as well as performance on a response inhibition task, were taken while electrophysiological measures were recorded. Self-reported measures of cognitive and emotional health were collected pre-training, post-training, 6-month, and at 1-year follow-up times. RESULTS Adaptive cognitive training resulted in greater WMC on the Change Detection Task and improved cognitive efficiency on the Flanker task together with improvements in perceived cognitive ability and depression at 1-year post-training. CONCLUSIONS Adaptive cognitive training can improve cognitive abilities with implications for long-term cognitive health in survivorship.
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Affiliation(s)
- Bethany Chapman
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
- Department of Psychological SciencesBirkbeck, University of LondonLondonUK
| | - Courtney C. Louis
- Department of PsychologyMichigan State UniversityEast LansingMichiganUSA
| | - Jason Moser
- Department of PsychologyMichigan State UniversityEast LansingMichiganUSA
| | | | - Nazanin Derakshan
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
- Department of Psychological SciencesBirkbeck, University of LondonLondonUK
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Haywood D, Dauer E, Baughman FD, Lawrence BJ, Rossell SL, Hart NH, O’Connor M. "Is My Brain Ever Going to Work Fully Again?": Challenges and Needs of Cancer Survivors with Persistent Cancer-Related Cognitive Impairment. Cancers (Basel) 2023; 15:5331. [PMID: 38001592 PMCID: PMC10669848 DOI: 10.3390/cancers15225331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Many cancer survivors experience cognitive impairments that impact memory, concentration, speed of information processing, and decision making. These impairments, collectively known as cancer-related cognitive impairments (CRCIs), are a key domain of unmet needs and can significantly impact a cancer survivor's identity and quality of life. However, there are no purpose-built, multi-domain, needs assessment tools specifically for CRCI. The development of such tools requires an in-depth understanding of cancer survivors' CRCI-specific challenges and associated needs. This study explored the challenges and associated needs of cancer survivors with persistent CRCI. An in-depth qualitative design using semi-structured interviews with (a) cancer survivors with perceived CRCI (n = 32) and (b) oncology health professionals (n = 19) was utilised. A reflexive thematic analysis of the interviews resulted in five overarching themes: (1) executing regular activities, (2) relational difficulties, (3) occupational functioning, (4) psychological distress, and (5) social functioning, as well as an additional informational needs domain. Ultimately, CRCI was found to directly produce a range of challenges that negatively, and persistently, impact cancer survivors' quality of life. Cancer survivors were also found to have a range of needs associated with these challenges. This research should be used to inform future challenges and needs assessment tools as well as treatment and supportive care priority areas directly relating to CRCI.
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Affiliation(s)
- Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, NSW 2021, Australia;
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (E.D.); (S.L.R.)
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3052, Australia
| | - Evan Dauer
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (E.D.); (S.L.R.)
| | - Frank D. Baughman
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (F.D.B.); (B.J.L.); (M.O.)
| | - Blake J. Lawrence
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (F.D.B.); (B.J.L.); (M.O.)
| | - Susan L. Rossell
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (E.D.); (S.L.R.)
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Nicolas H. Hart
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, NSW 2021, Australia;
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Park, SA 5042, Australia
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane City, QLD 4000, Australia
- Exercise Medicine Research Institute, School of Medical and Health Science, Edith Cowan University, Joondalup, WA 6027, Australia
- Institute for Health Research, University of Notre Dame Australia, Fremantle, WA 6160, Australia
| | - Moira O’Connor
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (F.D.B.); (B.J.L.); (M.O.)
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Yan X, Wei S, Liu Q. Effect of cognitive training on patients with breast cancer reporting cognitive changes: a systematic review and meta-analysis. BMJ Open 2023; 13:e058088. [PMID: 36592995 PMCID: PMC9809226 DOI: 10.1136/bmjopen-2021-058088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Cognitive training is a non-drug intervention to improve the cognitive function of participants by training them in different cognitive domains. We investigated the effectiveness of cognitive training for patients with breast cancer reporting cognitive changes. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Embase, Cochrane Library, WOS, CINAHL, CNKI, VIP, SinoMed, Wanfang, Grey literature and trial registries were searched (from inception to 1 October 1, 2022). ELIGIBILITY CRITERIA Inclusion of randomized controlled trials (RCTs) assessing the effects of cognitive training on breast cancer patients reporting cognitive changes The primary outcome was subjective cognitive function. Secondary outcomes were objective cognitive functioning (eg, executive functioning and attention) and psychological outcomes(eg, anxiety, depression, and fatigue). DATA EXTRACTION AND SYNTHESIS Two reviewers worked independently to screen the literature, extract data, and assess the methodological quality and risk bias of the included studies. Results are reported as standardizedstandardised mean differences (SMDs) with 95% confidence intervals(CI). Grades of Recommendation, Assessment, Development, and Evaluation(GRADE) were used to assess the quality of evidence. MAIN OUTCOMES AND MEASURES The primary outcome was subjective cognitive function. Secondary outcomes were objective cognitive functioning (eg, executive functioning and attention) and psychological outcomes(eg, anxiety, depression and fatigue). RESULTS A total of 9 RCTs involving 666 patients with breast cancer were included. The frequency of cognitive training varied and the duration was mostly focused on 5-12 weeks. It can be delivered to patients in an individual or group mode, both online and face to face. Meta-analysis revealed that cognitive training aimed at adaptive training in cognitive field has statistically significant effects on improving subjective cognitive function (SMD=0.30, 95% CI (0.08 to 0.51), moderate certainty). Some objective cognitive functions such as processing speed (SMD=0.28, 95% CI (0.02 to 0.54), low certainty), verbal memory (SMD=0.32, 95% CI (0.05 to 0.58), moderate certainty), working memory (SMD=0.39, 95% CI (0.17 to 0.61), moderate certainty) and episodic memory (SMD=0.40, 95% CI (0.11 to 0.69), moderate certainty) were significantly improved after the intervention. In addition, we did not find statistically significant changes in attention, short-term memory, execution function, depression, anxiety and fatigue in patients with breast cancer after the intervention. Subgroup analyses revealed that based on the delivery of individual sessions, the use of web-based cognitive training software may be more beneficial in improving the outcome of the intervention. CONCLUSION Evidence of low to moderate certainty suggests that cognitive training may improve subjective cognition, processing speed, verbal memory, working memory and episodic memory in patients with breast cancer reporting cognitive changes. But it did not improve patients' attention, short-term memory, executive function, depression, anxiety and fatigue. PROSPERO REGISTRATION NUMBER CRD42021264316.
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Affiliation(s)
- Xue Yan
- Lanzhou University School of Nursing, Lanzhou, Gansu, China
| | - Siqi Wei
- Lanzhou University School of Nursing, Lanzhou, Gansu, China
| | - Qianqian Liu
- Lanzhou University School of Nursing, Lanzhou, Gansu, China
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