Pok Ja Oh; Jung Ran Lee

doi:10.4040/jkan.2016.46.3.420

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Original Article
Effect of Cancer Symptoms and Fatigue on Chemotherapy-related Cognitive Impairment and Depression in People with Gastrointestinal Cancer: Pok Ja Oh, Jung Ran Lee; Journal of Korean Academy of Nursing 2016;46(3):420-430.
DOI: https://doi.org/10.4040/jkan.2016.46.3.420
Published online: June 30, 2016

Department of Nursing, Sahmyook University, Seoul, Korea.

Address reprint requests to: Lee, Jung Ran. Department of Nursing, Sahmyook University, 815 Kongnung-dong, Hwarang-ro, Nowon-gu, Seoul 01795, Korea. Tel: +82-2-3399-1589, Fax: +82-2-3399-1594, jrwin@naver.com

• Received: October 22, 2015 • Revised: January 12, 2016 • Accepted: March 30, 2016

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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Abstract
NOTES
REFERENCES

Abstract

Purpose
The purpose of this study was to test a hypothetical model of chemotherapy-related cognitive impairment (CRCI) and depression in people with gastrointestinal cancer.
Methods
A purposive sample of 198 patients undergoing chemotherapy was recruited from November 2014 to July 2015. The instruments were Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module. Data were analyzed using descriptive statistics, correlation, and path analysis.
Results
CRCI was directly affected by cancer symptoms (β=.19, p=.004) and fatigue (β=.56, p<.001)(R²=47.2%). Depression was directly affected by fatigue (β=.48, p<.001) and CRCI (β=.27, p<.001). However, The impact of cancer symptoms on depression was confirmed through the mediating effect of CRCI.
Conclusion
Results indicate that in patients with gastrointestinal cancer undergoing chemotherapy along with the direct physiologic effects (fatigue, symptoms) of cancer treatment may have altered cognitive function leading to depression.
Keywords: Mild cognitive impairment; Neoplasm; Fatigue; Depression

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2014R1A1A2053517)

The authors declared no conflict of interest.

REFERENCES

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Figure 1-A

Path diagram of the hypothetical model.

Figure 1-B

Modified path diagram of the study.

Table 1

Cancer Symptoms, Fatigue, Cognitive Function, and Depression according to General Characteristics of Participants (N=198)

ECOG=Eastern cooperative oncology group.

Table 2

Descriptive Statistics of Cancer Symptoms, Fatigue, Objective Cognitive Function, Perceived Cognitive Decline, and Depression (N=198)

Table 3

Correlations among Cancer Symptoms, Anemia, Fatigue, Objective Cognitive Function, Perceived Cognitive Decline, and Depression (N=198)

Table 4

Total Effect, Direct Effect, and Indirect Effect

SE=Standard error; CR=Critical ratio; SMC=Squared multiple correlations.

Figure & Data

REFERENCES

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Effect of Cancer Symptoms and Fatigue on Chemotherapy-related Cognitive Impairment and Depression in People with Gastrointestinal Cancer

J Korean Acad Nurs. 2016;46(3):420-430. Published online June 30, 2016

DOI: https://doi.org/10.4040/jkan.2016.46.3.420

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Effect of Cancer Symptoms and Fatigue on Chemotherapy-related Cognitive Impairment and Depression in People with Gastrointestinal Cancer

Figure 1-A Path diagram of the hypothetical model.

Figure 1-B Modified path diagram of the study.

Figure 1-A

Figure 1-B

Effect of Cancer Symptoms and Fatigue on Chemotherapy-related Cognitive Impairment and Depression in People with Gastrointestinal Cancer

Table 1

Cancer Symptoms, Fatigue, Cognitive Function, and Depression according to General Characteristics of Participants (N=198)

ECOG=Eastern cooperative oncology group.

Table 2

Descriptive Statistics of Cancer Symptoms, Fatigue, Objective Cognitive Function, Perceived Cognitive Decline, and Depression (N=198)

Table 3

Correlations among Cancer Symptoms, Anemia, Fatigue, Objective Cognitive Function, Perceived Cognitive Decline, and Depression (N=198)

Table 4

Total Effect, Direct Effect, and Indirect Effect

SE=Standard error; CR=Critical ratio; SMC=Squared multiple correlations.

Table 1 Cancer Symptoms, Fatigue, Cognitive Function, and Depression according to General Characteristics of Participants (N=198)

ECOG=Eastern cooperative oncology group.

Table 2 Descriptive Statistics of Cancer Symptoms, Fatigue, Objective Cognitive Function, Perceived Cognitive Decline, and Depression (N=198)

Table 3 Correlations among Cancer Symptoms, Anemia, Fatigue, Objective Cognitive Function, Perceived Cognitive Decline, and Depression (N=198)