DOI
https://doi.org/10.25772/BDCY-DJ42
Author ORCID Identifier
https://orcid.org/0000-0001-8850-4497
Defense Date
2017
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Health Related Sciences
First Advisor
Tony Gentry, PhD, OTR/L, FAOTA
Second Advisor
Vernon Chinchilli, PhD
Third Advisor
Angela Starkweather, Ph.D., RN, ACNP-BC, CNRN, FAAN
Fourth Advisor
Tara Albrecht, Ph.D.,RN, ACNP-BC
Fifth Advisor
Albert Copolillo, Ph.D., OTR/L
Abstract
Cognitive impairment related to treatment for breast cancer, affects as many as 75% of patients in study samples (Jansen, Cooper, Dodd & Miaskowski, 2011). Deficits in the cognitive domains of short-term memory, attention, speed of information processing, judgment, reasoning, spatial attention, and verbal memory have been documented. The extent to which these deficits impact functional performance within this population has not yet been quantified. The purpose of this study was to investigate the impact of breast cancer on self-reported cognition and functional performance in the six months post-completion in two groups of breast cancer survivors, a chemotherapy group and chemotherapy and radiotherapy group. Cognition and functional performance were measured with the Patient Reported Outcomes Measurement Information System (PROMIS®). Cognition was measured in terms of abilities and concerns. Functional performance measures addressed the constructs of physical function, ability to participate in social roles and activities, and satisfaction with participation in social roles and activities.
Sixteen female participants (ages 28-45) completed online surveys three weeks following the conclusion of chemotherapy or radiotherapy and three and six months later. Linear mixed-effects models were used to analyze changes over time within groups and compare differences between groups. Over the six months post-treatment the chemotherapy group had a significant improvement in physical function (p=.0178), and the chemotherapy + radiotherapy group showed significant gains in the ability to participate in social roles and activities (p=.0447). Fatigue was a significant factor in the chemotherapy + radiotherapy group (p=.015). No significant differences between groups were noted for changes in cognition, functional performance or psychosocial factors.
This research provides insight into self-reported changes in cognition and functional performance in the six months following breast cancer treatment. Cognition and functional performance appear to be interrelated and impacted by a constellation of factors that occupational therapists and oncology providers need to be aware of in order to best support cancer survivors in the resumption of occupations after treatment. A comprehensive approach to assessment and intervention that considers the complexity of cognitive performance as it relates to physical capacity and concurrent symptoms is recommended.
Rights
© Ann Marie Potter, PhD, OTR/L
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
12-6-2017