“Chemobrain” in childhood cancer survivors—the impact on social, academic, and daily living skills: a qualitative systematic review

Abstract

Purpose To examine children’s experiences of chemotherapy-induced cognitive impairment––colloquially “chemobrain”––and the impact on children’s social, academic, and daily living skills via a qualitative systematic review. Experiencing chemotherapy as a child, when the brain is still developing, may cause lifelong detriment to survivors’ lives. There is a significant gap in understanding their lived experience, including the self-identified barriers that children face following treatment. Such a gap can only be fully bridged by listening to the child’s own voice and/or parent proxy report through an exploration of the qualitative research literature. Methods A search of MEDLINE, Embase, PsycINFO, and CINAHL databases was conducted. Inclusion criteria were qualitative studies with a focus on children (0–18 years) during and/or following chemotherapy treatment and explored children’s experiences of chemobrain. Results Two synthesized findings were identified from six studies. (1) Chemobrain has an academic and psychosocial impact, which may not be understood by education providers. (2) Children and their parents have concerns about their reintegration and adaptation to school, social lives, and their future selves as independent members of society. Children’s experiences primarily related to changes in their academic and social functioning. Conclusion This review highlights two important considerations: (1) the lived experiences of pediatric childhood cancer survivors guiding where future interventions should be targeted, and (2) a need to perform more qualitative research studies in this area, as well as to improve the quality of reporting among the existing literature, given that this is a current gap in the field.

Parents' Distress & Demands for Children with Cancer-Related Cognitive Impairment in Western China: A qualitative study

“…I hope that the government can pay more attention to these children and open up green channels for them. parent 18 DISCUSSION Enhancing disease education can encourage parents to respond positively This study reveals that despite parents' concerns about their children's futures, most of them do not actively seek treatment methods for their children's cognitive impairments.This nding aligns with previous research results 26 .One possible explanation is that parents may have limited knowledge about cognitive impairments associated with cancer.On the one hand,parents may not be fully aware of the potential long-term impact of cognitive impairments on their children due to limited educational backgrounds 15 .On the other hand, as domestic hospitals have not given su cient attention to cognitive impairments related to childhood cancer,parents often rely on short videos and anecdotal accounts from other patients as their primary sources of information, leading to a lack of comprehensive and accurate understanding of cancer-related cognitive impairments.Furthermore,an increasing number of parents have expressed their desire to learn more about cognitive impairments associated with childhood cancer to effectively cope with the situation 27,28 It is advisable for medical professionals to enhance the education and dissemination of knowledge related to cancer-related cognitive impairment.Firstly,for parents who are older or have limited comprehension abilities,regular training sessions should be organized to cover topics such as the de nition,etiology,and clinical manifestations of cancer-related cognitive impairment.During these sessions, it is crucial to take into account their receptive abilities and use simple, straightforward language to ensure effective communication. Secondly, for younger parents,digital education methods like mobile push noti cations,videos,and social media posts can be employed to help them better understand the disease.Thirdly,for hospitalized cancer patients, methods such as posters, brochures,and personalized education sessions can be used to raise awareness about the severity of cancer-related cognitive impairment in children,as well as the importance of regular screenings and early intervention.These efforts aim to assist parents in gaining a comprehensive understanding of cancerrelated cognitive impairment in their children and establishing positive coping strategies accordingly.…”

“…However,current research both domestically and internationally primarily relies on quantitative methods to explore factors in uencing cognitive impairments and prognosis in cancer patients, which cannot comprehensively re ect the symptom burden and needs faced by both parents and patients 13,14 . While a few scholars have conducted interviews with children with cancerrelated cognitive impairments, these interviews have primarily focused on the impact of cognitive impairments on children's lives and academic performance, without delving into the parents' distress and multidimensional needs related to the symptom burden of their children's cognitive impairments 15,16 .…”