Impact of Climacteric Symptoms and Fatigue on the Quality of Life in Breast Cancer Survivors: The Mediating Effect of Cognitive Dysfunction

Factors Associated With Quality of Life Among Posttreatment Cancer Survivors in Korea: A Meta-analysis

BACKGROUND

Identification of factors associated with quality of life (QOL) among cancer survivors is crucial for identifying potential targets for intervention.

OBJECTIVES

We aimed to provide evidence of factors associated with the QOL among posttreatment cancer survivors in Korea.

METHODS

We performed a systematic literature search from January 2000 to September 2022 using PubMed, EMBASE, CINAHL, PsycINFO, and Korean databases (RISS, SCIENCEON). We evaluated study quality using the Joanna Briggs Institute Quality Appraisal Checklists for Analytical Cross-sectional Studies and performed statistical analysis using the R 3.0 software (R Foundation for Statistical Computing, Vienna, Austria) package. We analyzed the pooled effect sizes of potential QOL correlates by the random-effects model.

RESULTS

This meta-analysis included 31 studies with 8934 participants. The pooled estimates were significantly large for economic status (r = -0.53); significantly medium for fatigue (r = -0.39), anxiety (r = -0.29), depression (r = -0.42), self-efficacy (r = 0.37), and social support (r = 0.30); and significantly small for education level (r = -0.18), job status (r = -0.09), cancer stage (r = -0.20), and time since diagnosis (r = -0.26).

CONCLUSIONS

Low education level, having no job, low economic status, advanced cancer stage, short disease period, fatigue, anxiety, and depression were significantly associated with worse QOL, whereas self-efficacy and social support were significantly associated with better QOL.

IMPLICATIONS FOR PRACTICE

The findings have potential implications for identifying "at-risk survivors" of deteriorated QOL and for suggesting powerful strategies (eg, enhancing self-efficacy or social support) for improving QOL.

Predictors of cognitive decline in people with cancer undergoing chemotherapy

PURPOSE

The purpose of this study was to investigate the impact of demographic factors, disease/treatment-related factors, and psychological factors on cognitive function.

METHOD

A cross-sectional study was conducted. Participants were recruited from the oncology inpatient units of two hospitals. A convenience sample of 175 patients with cancer who underwent chemotherapy were recruited. The Everyday Cognition Scale (ECog), the Korean version of the Mini Mental State Examination (K-MMSE), Functional Assessment of Cancer Therapy-Fatigue (FACT-F) scale, Hospital Anxiety and Depression Scale (HADS), and a questionnaire to collect information about demographic, disease, and treatment information were completed.

RESULTS

More participants showed a mild decline in cognitive function and self-reported cognitive decline (39.4%) than had objectively confirmed decline (20%). Notably, 53.7-62.9% of the participants showed memory loss and a decline in divided attention. Demographic factors (age, sex), disease/treatment-related factors (chemotherapy cycles, fatigue), and psychological factors (depression) were predictors of cognitive decline in 49.6% of participants.

CONCLUSIONS

Old age and cumulative chemotherapy cycles were the main influential factors for objectively confirmed cognitive decline, and fatigue was the most common predictor of self-reported cognitive decline. Depression was one of the predictors of perceived cognitive decline, but it was not significant for objectively measured cognitive function. Thus, treatment-related factors such as fatigue had a greater impact on cognitive decline than psychological factors.

Impact of Cognitive Function and Cancer Coping on Quality of Life among Women with Post-chemotherapy Breast Cancer

PURPOSE

This study was done to identify effects of cognitive function and cancer coping on quality of life among women with breast cancer treated with antineoplastic agents.

METHODS

The study was correlational research and participants were 145 women with breast cancer who had received antineoplastic agents. Data were collected from October to November, 2015 via online replies. Cognitive function was measured with the Functional Assessment of Cancer Therapy-Cognitive Function Version-3 (FACT-Cog), cancer coping, with the Korean Cancer Coping Questionnaire (K-CCQ), and quality of life with the Functional Assessment of Cancer Therapy-Breast Version-4 (FACT-B). Data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, ANCOVA, Bonferroni test, partial correlation coefficient, and hierarchical multiple regression with SPSS 21.

RESULTS

Cognitive functions, total individual coping, and interpersonal coping explained 42% of quality of life. Cognitive function (β=.35, p<.001) was the best predictor of quality of life, followed by total individual coping (β=.34, p<.001), and interpersonal coping (β=.26, p<.001).

CONCLUSION

Results indicate that cognitive function and cancer coping are meaningful factors for quality of life among breast cancer survivors. Therefore when developing intervention programs for these women, content on cognitive function and coping skills as well as coping resources should be included.

[Effect of Cancer Symptoms and Fatigue on Chemotherapy-related Cognitive Impairment and Depression in People with Gastrointestinal Cancer]

PURPOSE

The purpose of this study was to test a hypothetical model of chemotherapy-related cognitive impairment (CRCI) and depression in people with gastrointestinal cancer.

METHODS

A purposive sample of 198 patients undergoing chemotherapy was recruited from November 2014 to July 2015. The instruments were Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module. Data were analyzed using descriptive statistics, correlation, and path analysis.

RESULTS

CRCI was directly affected by cancer symptoms (β=.19, p=.004) and fatigue (β=.56, p<.001)(R²=47.2%). Depression was directly affected by fatigue (β=.48, p<.001) and CRCI (β=.27, p<.001). However, The impact of cancer symptoms on depression was confirmed through the mediating effect of CRCI.

CONCLUSION

Results indicate that in patients with gastrointestinal cancer undergoing chemotherapy along with the direct physiologic effects (fatigue, symptoms) of cancer treatment may have altered cognitive function leading to depression.