Korean Journal of Adult Nursing (성인간호학회지)

Korean Society of Adult Nursing (한국성인간호학회)
권호 표지
DOI QR코드

DOI QR Code

Cognitive Decline and Quality of Life among Patients with Breast Cancer undergoing Chemotherapy: The Mediating Effect of Health Promotion Behavior

항암화학요법을 받는 유방암 환자의 인지기능감퇴와 삶의 질에 관한 연구: 건강증진행위의 매개효과

  • Lee, Jung Ran (Department of Nursing, Graduate School, Sahmyook University) ;
  • Oh, Pok Ja (Department of Nursing, Sahmyook University)
  • 이정란 (삼육대학교 대학원 간호학과) ;
  • 오복자 (삼육대학교 간호학과)
  • Received : 2016.02.17
  • Accepted : 2016.04.19
  • Published : 2016.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to assess the relationship between cognitive function impairment and quality of life (QoL) among patients with breast cancer. Specifically, the intention was to verify the mediating effects for promoting behaviors leading to better health and QoL. Methods: A purposive sample of 152 patients undergoing chemotherapy was recruited. A cross-sectional survey design was used. Data were collected using four instruments: Everyday Cognition Scale, Korean Mini-Mental State Examination, Functional Assessment of Cancer Therapy-Breast Cancer Version 4, and Health Promoting Lifestyle Profile. Results: The mean score for subjective cognitive decline was 65.84; the health promotion behavior was 95.89, and 83.34 for QoL. Health promotion behavior was directly affected by cognitive decline ($R^2=6.0%$) as was QoL ($R^2=43%$). Subjective cognitive decline (${\beta}=-.57$ p<.001) and health promotion behavior (${\beta}=.37$, p<.001) were seen as predicting factors in QoL and explained 56% ($R^2=56%$). Health promotion behavior had a partial mediating effect in the relationship between self-reported cognitive decline and QoL (Sobel test: Z=-3.37, p<.001). Conclusion: Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline and promoting health promotion behavior are highly recommended to improve QoL in cancer patients.

Keywords

References

  1. Korean Breast Cancer Society. Breast cancer facts and figures. http://www.kbcs.or.kr. Accessed March 1, 2013.
  2. Brem S, Kumar NB. Management of treatment-related symptoms in patients with breast cancer: Current strategies and future directions. Clinical Journal of Oncology Nursing. 2011;15(1):63-71. http://dx.doi.org/10.1188/11.CJON.63-71
  3. Calvio L, Peugeot M, Bruns GL, Todd BL, Feuerstein M. Measures of cognitive function and work in occupationally active breast cancer survivors. Journal of Occupational and Environmental Medicine. 2010;52(2):219-27. http://dx.doi.org/10.1097/JOM.0b013e3181d0bef7
  4. Kim KH, Yae CB, Kim GD, Byun HS, Choi EH, Cho EJ. Cognitive function in breast cancer patients receiving adjuvant chemotherapy. Asian Oncology Nursing, 2012;12:1-11. https://doi.org/10.5388/aon.2012.12.1.1
  5. Rottok J, Ross B. Cognitive rehabilitation. Washington DC: American Psychiatric Press; 1994.
  6. Wefel JS, Saleeba AK, Buzdar AU, Meyers CA. Acute and late onset cognitive dysfunction associated with chemotherapy in women with breast cancer. Cancer. 2010;116(14):3348-56. http://dx.doi.org/10.1002/cncr.25098
  7. Hess LM, Insel KC. Chemotherapy-related change in cognitive function: A conceptual model. Oncology Nursing Forum 2007;34(5):981-94. http://dx.doi.org/10.1188/07.ONF.981-994
  8. Matsuda T, Takayama T, Tashiro M, Nakamura Y, Ohashi Y, Shimozuma K. Mild cognitive impairment after adjuvant chemotherapy in breast cancer patients-evaluation of appropriate research design and methodology to measure symptoms. Breast Cancer. 2005;12(4):279-87. http://dx.doi.org/10.2325/jbcs.12.279
  9. Min HS, Park SY, Lim JS, Park MO, Won HJ, Kim Ji. A study of behaviors for preventing recurrence and quality of life in breast cancer survivors. Journal of Korean Academy of Nursing. 2008;38(2):187-94. http://dx.doi.org/10.4040/jkan.2008.38.2.187
  10. Walker SN, Sechrist KR, Pender NJ. The health-promoting lifestyle profile: Development and psychometric characteristics. Nursing Research. 1987;36(2):76-81. https://doi.org/10.1097/00006199-198703000-00002
  11. Yaffe K, Barnes D, Nevitt M, Lui L-Y, Covinsky K. A prospective study of physical activity and cognitive decline in elderly women who walk. Archives of Internal Medicine. 2001;161(14):1703-8. https://doi.org/10.1001/archinte.161.14.1703
  12. Harding M. Health promotion behaviors and psychological distress in cancer survivors. Oncology Nursing Forum. 2012;39(2):E132-40. http://dx.doi.org/10.1188/12.ONF.E132-E140
  13. Oh PJ, Hong YS. A structural model for health promotion and quality of life in people with cancer. Journal of Korean Academy of Adult Nursing. 1996;8(1):291-308.
  14. Farias ST, Mungas D. The measurement of everyday cognition (ECog): Scale development and psychometric properties. Neuropsychology. 2008;22(4):531-44. http://dx.doi.org/10.1037/0894-4105.22.4.531
  15. Chung BY, Cho EJ. Correlates influencing cognitive impairment in breast cancer patients receiving chemotherapy. Asian Oncology Nursing. 2012;12(3);221-9. http://dx.doi.org/10.5388/aon.2012.12.3.221
  16. Kang Y. A normative study of the Korean-Mini Mental State Examination (K-MMSE) in the elderly. Korean Journal of Psychology. 2006;25(2):1-12.
  17. 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. Journal of Clinical Oncology. 2014;32(6):535-41. http://dx.doi.org/10.1200/jco.2013.53.1830
  18. Functional Assessment of Chronic Illness Therapy. http://www.facit.org/. Accessed November 22, 2013.
  19. Kim HJ, So HS. A study on health promoting behavior in post-mastectomy patients. Journal of Korean Academy of Adult Nursing. 2001;13(1):82-95.
  20. Park JG, Park CI, Kim NK. Oncology. Seoul: Ilchokak publishing; 2003.
  21. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology. 1986;51(6):1173-82. https://doi.org/10.1037/0022-3514.51.6.1173
  22. Lee IH. Easyflow regression analysis. 1st ed. Seoul: Hannarae publishing; 2014.
  23. Kim GD, Chung BY, Kim KH, Byun HS, Choi EH. Comparison of climacteric symptoms and cognitive impairment in breast cancer survivors and healthy women. Asian Oncology Nursing. 2013;13:11-7. https://doi.org/10.5388/aon.2013.13.1.11
  24. Cimprich B, So H, Roni DL, Trask C. Pre-treatment factors related to cognitive functioning in women newly diagnosed with breast cancer. Psycho-Oncology, 2005;14(1):70-8. https://doi.org/10.1002/pon.821
  25. Ahles TA, Saykin AJ. Breast cancer chemotherapy-related cognitive dysfunction. Clinical Breast Cancer, 2002;3 Suppl 3:84-90. https://doi.org/10.3816/CBC.2002.s.018
  26. Kim JM, Yoon JS, Lee HY. Comparison of diagnostic validities between MMSE-K and K-MMSE for screening of dementia. Journal of Korean Neuropsychiatric Association. 2003;42(1):124-30.
  27. Bender CM, Sereika SM, Berga SL, Vogel VG, Brufsky AM, Paraska KK, et al. Cognitive impairment associated with adjuvant therapy in breast cancer. Psycho-Oncology. 2006;15(5):422-30. http://dx.doi.org/10.1002/pon.964
  28. Jeong KS, Heo JU, Tae YS. Relationships among distress, family support, and health promotion behavior in breast cancer survivors. Asian Oncology Nursing. 2014;14(3):146-54. http://dx.doi.org/10.5388/aon.2014.14.3.146
  29. Kwon EJ, Yi MS. Distress and quality of life in breast cancer survivors in Korea. Asian Oncology Nursing. 2012;12(4):289-96. http://dx.doi.org/10.5388/aon.2012.12.4.289
  30. Park JH, Bae SH, Jung YM. Changes of symptom distress and quality of life in breast cancer patients receiving adjuvant therapy. Asian Oncology Nursing. 2015;15(2):67-74. http://dx.doi.org/10.5388/aon.2015.15.2.67

Cited by

  1. Development of the Cognitive Function Scale for Breast Cancer Patients vol.17, pp.1, 2017, https://doi.org/10.5388/aon.2017.17.1.12
  2. Menopause Symptoms and Perceived Cognitive Decline in Menopausal Women: The Mediating Effect of Health Promotion Behavior vol.29, pp.2, 2017, https://doi.org/10.7475/kjan.2017.29.2.200
  3. Changes of Cognitive Function and Depression following Chemotherapy in Women with Breast Cancer: A Prospective Study vol.18, pp.2, 2018, https://doi.org/10.5388/aon.2018.18.2.66
  4. Symptom Distress and Depression in Patients with Recurrent Gynecologic Cancer Undergoing Chemotherapy: Mediating Effect of Resilience vol.31, pp.1, 2019, https://doi.org/10.7475/kjan.2019.31.1.28
  5. Factors associated with Oncology Nurses' Adherence to Chemotherapy-Induced Neutropenia Guidelines based on Pender's Health Promotion Model vol.31, pp.4, 2019, https://doi.org/10.7475/kjan.2019.31.4.389
  6. 유방암 환자의 항암화학요법 관련 인지기능 변화와 삶의 질의 구조모형 vol.49, pp.4, 2019, https://doi.org/10.4040/jkan.2019.49.4.375
  7. Computerized programs for cancer survivors with cognitive problems: a systematic review vol.13, pp.6, 2016, https://doi.org/10.1007/s11764-019-00807-4
  8. Analysis of Health management Awareness and Practice Experience of Breast Cancer Survivors using Focus Group Interviews vol.23, pp.1, 2016, https://doi.org/10.7587/kjrehn.2020.48