J Korean Acad Nurs.  2016 Feb;46(1):19-28. 10.4040/jkan.2016.46.1.19.

Chemotherapy-related Cognitive Impairment and Quality of Life in People with Colon Cancer: The Mediating Effect of Psychological Distress

• Oh PJ
• Kim JH

• KMID: 2373159
• DOI: http://doi.org/10.4040/jkan.2016.46.1.19

Abstract

PURPOSE
The purpose of this study was to test the mediating effect of psychological distress in the relationship between chemotherapy related cognitive impairment (CRCI) and quality of life (QOL) in people with cancer.
METHODS
A purposive sample of 130 patients undergoing chemotherapy was recruited for the cross-sectional survey design. Data were collected from November 2014 to June 2015. The instruments were K-MMSE (Korean Mini-Mental State Examination), Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). Data were analyzed using descriptive statistics, correlation, and multiple regression using Baron and Kenny steps for mediation.
RESULTS
The mean score for objective cognitive function was 27.95 and 69.32 for perceived cognitive decline. Overall quality of life was 91.74. The mean score was 17.52 for psychological distress. The prevalence was 56.2% for anxiety and 63.1% for depression, and 20.0% for CRCI. There were significant correlations among the variables, objective cognitive function and self-reported cognitive decline, psychological distress, and quality of life. Psychological distress was directly affected by CRCI. (R2=29%). QOL was directly affected by CRCI. Psychological distress and CRCI effected QOL (R2=43%). Psychological distress had a partial mediating effect (beta= -.56, p <.001) in the relationship between self-reported cognitive decline and quality of life (Sobel test: Z= -5.08, p <.001).
CONCLUSION
Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline, and decreasing psychological distress are highly recommended to improve quality of life in cancer patients.

Keyword

Quality of life; Mild cognitive impairment; Neoplasm; Depression

MeSH Terms

Adult
Aged
Antineoplastic Agents/therapeutic use
Anxiety/epidemiology/etiology
Cognitive Dysfunction/epidemiology/*etiology
Colonic Neoplasms/drug therapy/*psychology
Cross-Sectional Studies
Depression/epidemiology/etiology
Female
Humans
Middle Aged
*Quality of Life
*Stress, Psychological
Surveys and Questionnaires
Antineoplastic Agents

Figure

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  Figure 1 Mediating effect of psychological distress in the relationship between perceived cognitive decline and quality of life.

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