Neuropsychological Effects of Chemotherapy: Systematic Review of Longitudinal Studies on Objective Cognitive Impairment in Breast Cancer Patients.

BACKGROUND: Findings from longitudinal studies can provide more conclusive evidence as to the impact of chemotherapy on cognitive functioning. OBJECTIVES: This study aimed to ( a ) synthesize the evidence from longitudinal studies of the neuropsychological effects associated with chemotherapy in breast cancer patients, ( b ) identify associated factors, and ( c ) evaluate methodological issues. METHODS: Data were extracted from PubMed, EMBASE, CINAHL, PsycINFO, and the Cochrane Library. Inclusion criteria included the original study with the breast cancer sample, validated measure, and at least 1 baseline data point before and after chemotherapy began. Data accrued for sample characteristics, data-collection time points, statistical methods for longitudinal data analysis, outcome measures, and major findings (eg, longitudinal changes in cognitive function). RESULTS: We selected 42 articles for this review. The sample sizes ranged from 20 to 610, and most recruited were younger than 70 years. We found a trend across studies-statistically significant objective cognitive function deteriorations in severity and prevalence after initiating chemotherapy compared with a control group or relative to their baseline observations. A subsample, as high as 65%, experienced marked declines in cognitive function after initiating chemotherapy. The memory domain was most affected. The consistently associated factors were education, IQ, and regimen. Major methodological concerns were the measurement-the wide range of neuropsychological tests and a test's unclear domains. CONCLUSION: Chemotherapy affects objective cognitive function in some subsets. The highest-impact time point, mechanisms, and clinical significance of chemotherapy-associated cognitive impairment need additional evidence. IMPLICATION FOR PRACTICE: Clinicians must assess and manage cognitive impairment during and after chemotherapy.

The trajectory of the caring role in Korea: A grounded theory study of mothers of children with blood cancer.

PURPOSE: The purpose of this study was to investigate the trajectory of mothers caring for children with blood cancer. METHOD: Fourteen mothers of children with blood cancer participated in in-depth interviews, from 30 min to 2 h in length, from July 1 through September 30, 2019. Grounded theory was used to investigate the trajectory for mothers of children with blood cancer. Purposive sampling and semi-structured questionnaires were employed to obtain in-depth interviews. RESULTS: 10 categories and 28 concepts were extracted from the raw data. The core category was 'living with anxiety: from life to independence of their sick child' which consisted of three phases: feeling chaos, immersing oneself in treatment, and returning to normal life. In the trajectory of mothers of caring for children with blood cancer, some participants felt like being on an island and hope to forget, whereas others tended to thank for the support of those near and find their own life according to the dimension of anxiety, support from others, and acceptance of illness. CONCLUSIONS: Healthcare providers must have a better understanding of how the mothers of children with blood cancer can accept and cope with their child's illness in spite of the ongoing anxiety as well as need to explore the ways in which families can accept their child's chronic illness and reconstruct their life.

Factor analysis of the Korean version of the Illness Cognition Questionnaire for adolescents with chronic illness.

AIM: The purpose of this study was to examine the reliability and validity of the Korean version of the Illness Cognition Questionnaire. METHODS: A total of 237 adolescent Participants ages 13-20 years were collected from two hospitals for purposes of the study. The participants were diagnosed with blood cancer, congenital heart disease, paediatric rheumatoid arthritis, multiple sclerosis and diabetes mellitus. RESULTS: The Illness Cognition Questionnaire is composed of three subscales and 18 items. Exploratory factor analysis and confirmatory factor analysis were performed for all 18 items. The data used in the exploratory factor analysis were obtained from 126 adolescents with blood cancer. The data used for confirmatory factor analysis were obtained from 111 adolescents who had chronic diseases. The three-factor model of 18 items showed general fitness close to the standard but not a very good fit. CONCLUSIONS: This study indicated that the Korean version of the Illness Cognition Questionnaire is reasonable to use for Korean adolescents with chronic illness. The authors recommend that the meaning of Item 10 be clarified from 'I have learned to accept the limitations imposed by my illness' to 'I have learned to positively accept the limitations imposed by my illness'.

Clinging to My Child: Mothers' Experiences Taking Care of a Child Hospitalized with Leukemia.

The purpose of this study was to investigate, within the sociocultural context of Korea, mothers' experiences caring for their child being treated in a hospital for leukemia. Study participants included 11 mothers who visited a hospital for their child's follow-up care after treatment for leukemia. The researchers investigated the mothers' experiences in caring for their children using a qualitative study design. Through interviews, the researchers identified five categories of experiences among participants, including, "Death anxiety," "Feeling guilty," "Fulfilling responsibilities as a mom," "Feeling overwhelmed by life," and "Feeling grateful." In the course of treatment, mothers tended to feel pressured to be a good mother, and sometimes felt overwhelmed by life. Healthcare providers need to grasp the difficulties faced by mothers taking care of their children hospitalized for treatment of leukemia, and must develop programs to reduce the burden on mothers and increase their families' functioning.