Pok Ja Oh; Jeong Hye Kim

doi:10.4040/jkan.2016.46.1.19

Articles

Page Path: HOME > J Korean Acad Nurs > Volume 46(1); 2016 > Article

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

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.

256 Views
5 Download
19 Crossref
11 Scopus

prev next

Full Article

Download PDF

Abstract
Acknowledgments
ACKNOWLEDGMENTS
NOTES
REFERENCES

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 (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.
Keywords: Quality of life; Mild cognitive impairment; Neoplasm; Depression

Acknowledgments

ACKNOWLEDGMENTS

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.

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (No.2014R1A1A2053517).

The authors declared no conflict of interest.

REFERENCES

1. Ministry of Health & Welfare. Korea Central Cancer Registry. National Cancer Center. Annual report of cancer statistics in Korea in 2012. Seoul: Ministry of Health & Welfare; 2014.
2. Gehring K, Roukema JA, Sitskoorn MM. Review of recent studies on interventions for cognitive deficits in patients with cancer. Expert Rev Anticancer Ther. 2012;12(2):255–269. Article PubMed
3. Schagen SB, Muller MJ, Boogerd W, Mellenbergh GJ, van Dam FS. Change in cognitive function after chemotherapy: A prospective longitudinal study in breast cancer patients. J Natl Cancer Inst. 2006;98(23):1742–1745. Article PubMed
4. Gilroy J. Basic neurology. 3rd ed. New York, NY: McGraw-Hill Professional Publishing; 2000.
5. de Ruiter MB, Reneman L, Boogerd W, Veltman DJ, Caan M, Douaud G, et al. Late effects of high-dose adjuvant chemotherapy on white and gray matter in breast cancer survivors: Converging results from multimodal magnetic resonance imaging. Human Brain Mapping. 2012;33(12):2971–2983. Article PubMed
6. Hutchinson AD, Hosking JR, Kichenadasse G, Mattiske JK, Wilson C. Objective and subjective cognitive impairment following chemotherapy for cancer: A systematic review. Cancer Treat Rev. 2012;38(7):926–934. Article PubMed
7. Hess LM, Insel KC. Chemotherapy-related change in cognitive function: A conceptual model. Oncol Nurs Forum. 2007;34(5):981–994. Article PubMed
8. Wefel JS, Kayl AE, Meyers CA. Neuropsychological dysfunction associated with cancer and cancer therapies: A conceptual review of an emerging target. Br J Cancer. 2004;90(9):1691–1696. Article PubMed PMC PDF
9. Jenkins V, Shilling V, Deutsch G, Bloomfield D, Morris R, Allan S, et al. A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer. Br J Cancer. 2006;94(6):828–834. Article PubMed PMC PDF
10. Pullens MJ, De Vries J, Roukema JA. Subjective cognitive dysfunction in breast cancer patients: A systematic review. Psychooncology. 2010;19(11):1127–1138. Article PubMed
11. National Cancer Information Center. Recommendations for distress management in cancer patients, version 1.0 [Internet]. Seoul, Ministry for Health, Welfare and Family Affairs. 2008;cited 2012 October 8. Available from: http://www.cancer.go.kr/2010/04/22/Recommendations_Distress_Management_version1.pdf
12. Pasquini M, Biondi M. Depression in cancer patients: A critical review. Clin Pract Epidemiol Ment Health. 2007;3:2Article PubMed PMC
13. Oh PJ, Jang ES. Effects of psychosocial interventions on cortisol and immune parameters in patients with cancer: A meta-analysis. J Korean Acad Nurs. 2014;44(4):446–457. Article PubMed
14. Lange M, Rigal O, Clarisse B, Giffard B, Sevin E, Barillet M, et al. Cognitive dysfunctions in elderly cancer patients: A new challenge for oncologists. Cancer Treat Rev. 2014;40(6):810–817. Article PubMed
15. Chung BY, Cho EJ. Correlates influencing cognitive impairment in breast cancer patients receiving chemotherapy. Asian Oncol Nurs. 2012;12(3):221–229. Article PDF
16. Park JH, Bae SH, Jung YS, Jung YM. Prevalence and characteristics of chemotherapy-related cognitive impairment in patients with breast cancer. J Korean Acad Nurs. 2015;45(1):118–128. Article PubMed PDF
17. Kaiser J, Bledowski C, Dietrich J. Neural correlates of chemotherapy-related cognitive impairment. Cortex. 2014;54:33–50. Article PubMed
18. Kang Y. A normative study of the Korean-Mini Mental State Examination (K-MMSE) in the elderly. Korean J Psychol. 2006;25(2):1–12.
19. Prabhu RS, Won M, Shaw EG, Hu C, Brachman DG, Buckner JC, et al. Effect of the addition of chemotherapy to radiotherapy on cognitive function in patients with low-grade glioma: Secondary analysis of RTOG 98-02. J Clin Oncol. 2014;32(6):535–541. Article PubMed PMC
20. Oh SM, Min KJ, Park DB. A study on the standardization of the hospital anxiety and depression scale for Koreans: A comparison of normal, depressed and anxious groups. J Korean Neuropsychiatr Assoc. 1999;38(2):289–296.
21. Kim H, Yoo HJ, Kim YJ, Han OS, Lee KH, Lee JH, et al. Development and validation of Korean functional assessment cancer therapy-general (FACT-G). Korean J Clin Psychol. 2003;22(1):215–229.
22. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Person Soc Psychol. 1986;51(6):1173–1182.Article
23. Pereira J, Hanson J, Bruera E. The frequency and clinical course of cognitive impairment in patients with terminal cancer. Cancer. 1997;79(4):835–842.Article PubMed
24. Park JH, Bae SH. A meta-analysis of chemotherapy related cognitive impairment in patients with breast cancer. J Korean Acad Nurs. 2012;42(5):644–658. Article PubMed
25. Meyers CA, Wefel JS. The use of the mini-mental state examination to assess cognitive functioning in cancer trials: No ifs, ands, buts, or sensitivity. J Clin Oncol. 2003;21(19):3557–3558. Article PubMed
26. Hall KE, Isaac CL, Harris P. Memory complaints in epilepsy: An accurate reflection of memory impairment or an indicator of poor adjustment? A review of the literature. Clin Psychol Rev. 2009;29(4):354–367. Article PubMed
27. Hutter N, Vogel B, Alexander T, Baumeister H, Helmes A, Bengel J. Are depression and anxiety determinants or indicators of quality of life in breast cancer patients? Psycho Health Med. 2013;18(4):412–419. Article
28. Baek Y. The correlation among symptoms, anxiety, depression and quality of life in patients with colorectal cancer undergoing chemotherapy [master's thesis]. Seoul, Seoul National University. 2013.
29. Park JH, Jun EY, Kang MY, Joung YS, Kim GS. Symptom experience and quality of life in breast cancer survivors. J Korean Acad Nurs. 2009;39(5):613–621. Article PubMed

Figure 1

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

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)

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by

Disease Perception, Stigma, Distress, Physical Symptom Experience and Quality of Life in Colorectal Cancer Patients Undergoing Chemotherapy: A Cross-Sectional Study
Eun-Hee Lee, Dongwon Choi
Journal of Korean Academy of Fundamentals of Nursing.2024; 31(4): 494. CrossRef
Aldehyde dehydrogenase 2 polymorphism is associated with chemotherapy‐related cognitive impairment in patients with breast cancer who receive chemotherapy
Senbang Yao, Wen Li, Shaochun Liu, Yinlian Cai, Qianqian Zhang, Lingxue Tang, Sheng Yu, Yanyan Jing, Xiangxiang Yin, Huaidong Cheng
Cancer Medicine.2023; 12(5): 5209. CrossRef
Factors Associated with Self-reported Memory Problems of Adult Cancer Survivors Based on the Korea National Health and Nutrition Examination Survey 2019
Sangjin Ko
Journal of Health Informatics and Statistics.2023; 48(1): 51. CrossRef
Colon Cancer Survivorship in Patients Who Have Received Adjuvant Chemotherapy
Meghana Kesireddy, Laura Tenner
Clinical Colorectal Cancer.2023; 22(4): 361. CrossRef
Predictors of cognitive impairment in patients undergoing ileostomy for colorectal cancer: a retrospective analysis
Jing Xu, Yuelan Yang, Die Hu
PeerJ.2023; 11: e15405. CrossRef
Self-disclosure in Adult Patients With Cancer
Hyungran Lee, Younhee Jeong
Cancer Nursing.2023;[Epub] CrossRef
Symptom Experience, Social Support, and Quality of Life in Patients with Hematologic Malignancies Undergoing Chemotherapy
Ga Eun Kim, Ju-Eun Song, Mi-Ae You, Jin-Hee Park
Asian Oncology Nursing.2022; 22(1): 29. CrossRef
Effect of Ambulatory Chemotherapy (Portable Infusion Pump Use) Video Education on Knowledge, Self-efficacy and Anxiety of Colorectal Cancer Patients
Eun Hee Choi, Eun Young Park, Young A Park, You Hee Son, Myung Jin Jang
Asian Oncology Nursing.2022; 22(3): 193. CrossRef
A pilot retrospective study of comprehensive nursing care on psychological disorder in colorectal cancer undergoing chemotherapy
Zhou-Yi Zhang, Rui Wang, Li Zhang, Ming-Li Gu, Xiu-E Guan
Medicine.2022; 101(28): e29707. CrossRef
The Experience of Chemotherapy Related Cognitive Impairment in Patients with Cancer
Pok Ja Oh, Ji Hyun Kim
Asian Oncology Nursing.2022; 22(1): 1. CrossRef
The Mediating Effect of Depression on the Relationship between Cognitive Function and the Activities of Daily Living in Post-stroke Patient
Ji Eun Kim, Hwee Wee
Journal of Korean Academy of psychiatric and Mental Health Nursing.2021; 30(4): 309. CrossRef
A serial multiple mediator model of sense of coherence, coping strategies, depression, and quality of life among gynecologic cancer patients undergoing chemotherapy
Hee Sun Kim, Ju-Hee Nho, Joo-Hyun Nam
European Journal of Oncology Nursing.2021; 54: 102014. CrossRef
Impact of changes in perceived attentional function on postsurgical health-related quality of life in breast cancer patients awaiting adjuvant treatment
Mi Sook Jung, Moira A. Visovatti, Eun Hee Sohn, Hwa-Seung Yoo, Mijung Kim, Je Ryong Kim, Jin Sun Lee
Health and Quality of Life Outcomes.2020;[Epub] CrossRef
Factors influencing quality of life in patients with multiple myeloma
Hee-Young Kang, Eun-Young Choi
Contemporary Nurse.2019; 55(2-3): 109. CrossRef
The role of depression in the relationship between cognitive decline and quality of life among breast cancer patients
Jin-Hee Park, Yong Sik Jung, Young-Mi Jung, Sun Hyoung Bae
Supportive Care in Cancer.2019; 27(7): 2707. CrossRef
A Longitudinal Path Analysis of Symptom, Fatigue and Quality of life in Patients with Colorectal Cancer during Chemotherapy
Eun Hee Kim, Soon Rim Suh
Journal of Health Informatics and Statistics.2018; 43(3): 200. CrossRef
Factors Affecting Cognitive Function in Patients with Stomach Cancer
Yeoung Ji Yu, Seung Hee Ahn, Yong Ae Cho, Eunjung Ryu, Eun-Ju Kim
Asian Oncology Nursing.2018; 18(4): 241. CrossRef
Serum lipid changes following the onset of depressive symptoms in postmenopausal women
Jane E. Persons, Jennifer G. Robinson, Martha E. Payne, Jess G. Fiedorowicz
Psychiatry Research.2017; 247: 282. CrossRef
Development of the Cognitive Function Scale for Breast Cancer Patients
Bok Yae Chung, Eun Hee Choi, Gyung Duck Kim, Kyung Hae Kim, Hye Sun Byun
Asian Oncology Nursing.2017; 17(1): 12. CrossRef

Cite

CITE: export Copy Download Format; Close

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

RIS — For EndNote, ProCite, RefWorks, and most other reference management software
BibTeX — For JabRef, BibDesk, and other BibTeX-specific software

Include:

Citation for the content below
Citation and abstract for the content below

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

J Korean Acad Nurs. 2016;46(1):19-28. Published online February 29, 2016

DOI: https://doi.org/10.4040/jkan.2016.46.1.19

XML Download

Figure

We recommend

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

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

Figure 1

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

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)

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)