J Korean Acad Nurs.  2019 Aug;49(4):375-385. 10.4040/jkan.2019.49.4.375.

A Structural Model for Chemotherapy Related Cognitive Impairment and Quality of Life in Breast Cancer Patients

• Lee JR
• Oh PJ

• KMID: 2456142
• DOI: http://doi.org/10.4040/jkan.2019.49.4.375

Abstract

PURPOSE
This study aimed to develop and test a structural model for chemotherapy-related cognitive impairment of breast cancer patients based on a literature review and Hess and Insel's chemotherapy-related cognitive change model.
METHODS
The Participants consisted of 250 patients who were ≥19 years of age. The assessment tools included the Menopause Rating Scale, Symptom Experience Scale, Hospital Anxiety and Depression Scale, Everyday Cognition, and Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs.
RESULTS
The modified model was a good fit for the data. The model fit indices were χ2=423.18 (p<.001), χ2/df=3.38, CFI=.91, NFI=.91, TLI=.89, SRMR=.05, RMSEA=.09, and AIC=515.18. Chemotherapy-related cognitive impairment was directly influenced by menopausal symptoms (β=.38, p=.002), depression and anxiety (β=.25, p=.002), and symptom experiences (β=.19, p=.012). These predictors explained 47.7% of the variance in chemotherapy-related cognitive impairment. Depression and anxiety mediated the relations among menopausal symptoms, symptom experiences, and with chemotherapy related cognitive impairment. Depression and anxiety (β=−.51, p=.001), symptom experiences (β=−.27, p=.001), menopausal symptoms (β=−.22, p=.008), and chemotherapy-related cognitive impairment (β=−.15, p=.024) had direct effects on the quality of life and these variables explained 91.3%.
CONCLUSION
These results suggest that chemotherapy-related toxicity is highly associated with cognitive decline and quality of life in women with breast cancer. Depression and anxiety increased vulnerability to cognitive impairment after chemotherapy. Nursing intervention is needed to relieve chemotherapy-related toxicity and psychological factor as well as cognitive decline for quality of life in patients undergoing chemotherapy.

Keyword

Breast Neoplasms; Chemotherapy Adjuvant; Menopause; Cognitive Dysfunction; Quality of Life

MeSH Terms

Anxiety
Breast Neoplasms*
Breast*
Cognition
Cognition Disorders*
Depression
Drug Therapy*
Female
Humans
Menopause
Models, Structural*
Nursing
Psychology
Quality of Life*

Figure

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  Figure 1. Conceptual framework of this study.

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  Figure 2. Hypothetical model and path diagram for the modified model. (A) Hypothetical model. (B) Path diagram for the modified model.

Reference

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