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Original Article
Chemotherapy-related Cognitive Impairment and Quality of Life in People with Colon Cancer: The Mediating Effect of Psychological Distress
Pok Ja Oh, Jeong Hye Kim
Journal of Korean Academy of Nursing 2016;46(1):19-28.
DOI: https://doi.org/10.4040/jkan.2016.46.1.19
Published online: February 29, 2016

1Department of Nursing, Sahmyook University, Seoul, Korea.

2Department of Clinical Nursing, University of Ulsan, Seoul, Korea.

Address reprint requests to: Kim, Jeong Hye. Department of Clinical Nursing, University of Ulsan, 88 Olympic-ro 43 gil, Songpa-gu, Seoul 05505, Korea. Tel: +82-2-3010-5335, Fax: +82-2-3010-5332, kimjh@amc.seoul.kr
• Received: August 4, 2015   • Revised: August 16, 2015   • Accepted: September 30, 2015

© 2016 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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  • 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 (β= -.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.
The authors would like to thank the following people who provided support at various stages of the study process. Hye Youn Han, Volunteer Research Assistant, Sahmyook University, Seoul, Korea.
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Figure 1

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

jkan-46-19-g001.jpg
Table 1

Cognitive Function, Psychological Distress, and Quality of Life according to General Characteristics of Participants (N =130)

jkan-46-19-i001.jpg

ECOG=Eastern cooperative oncology group; K-MMSE=Korean mini–mental state examination.

Table 2

Descriptive Statistics of K-MMSE Scores, Perceived Cognitive Decline, Psychological Distress, and Quality of Life (N =130)

jkan-46-19-i002.jpg

K-MMSE=Korean mini–mental state examination.

Table 3

Correlations among K-MMSE Scores, Perceived Cognitive Decline, Psychological Distress, and Quality of Life (N =130)

jkan-46-19-i003.jpg

K-MMSE=Korean mini–mental state examination.

Table 4

Mediating Effect of Psychological Distress in the Relationship between Perceived Cognitive Decline and Quality of Life (N =130)

jkan-46-19-i004.jpg

Figure & Data

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        Chemotherapy-related Cognitive Impairment and Quality of Life in People with Colon Cancer: The Mediating Effect of Psychological Distress
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      Chemotherapy-related Cognitive Impairment and Quality of Life in People with Colon Cancer: The Mediating Effect of Psychological Distress
      Image
      Figure 1 Mediating effect of psychological distress in the relationship between perceived cognitive decline and quality of life.
      Chemotherapy-related Cognitive Impairment and Quality of Life in People with Colon Cancer: The Mediating Effect of Psychological Distress

      Cognitive Function, Psychological Distress, and Quality of Life according to General Characteristics of Participants (N =130)

      ECOG=Eastern cooperative oncology group; K-MMSE=Korean mini–mental state examination.

      Descriptive Statistics of K-MMSE Scores, Perceived Cognitive Decline, Psychological Distress, and Quality of Life (N =130)

      K-MMSE=Korean mini–mental state examination.

      Correlations among K-MMSE Scores, Perceived Cognitive Decline, Psychological Distress, and Quality of Life (N =130)

      K-MMSE=Korean mini–mental state examination.

      Mediating Effect of Psychological Distress in the Relationship between Perceived Cognitive Decline and Quality of Life (N =130)

      Table 1 Cognitive Function, Psychological Distress, and Quality of Life according to General Characteristics of Participants (N =130)

      ECOG=Eastern cooperative oncology group; K-MMSE=Korean mini–mental state examination.

      Table 2 Descriptive Statistics of K-MMSE Scores, Perceived Cognitive Decline, Psychological Distress, and Quality of Life (N =130)

      K-MMSE=Korean mini–mental state examination.

      Table 3 Correlations among K-MMSE Scores, Perceived Cognitive Decline, Psychological Distress, and Quality of Life (N =130)

      K-MMSE=Korean mini–mental state examination.

      Table 4 Mediating Effect of Psychological Distress in the Relationship between Perceived Cognitive Decline and Quality of Life (N =130)


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