Subjective cognitive impairment in patients with cancer: A network approach

Abstract

Purpose: Cognitive impairment is a commonly reported side or late effect of cancer treatment deteriorating patients’ quality of life. As such, it is essential to look at patients’ self-evaluation in addition to objective assessments. The goals of the current study were to (1) examine the sociodemographic, clinical and psychological factors related to subjective cognitive impairment (SCI) perception; (2) analyze the complex mutual interconnections between SCIs; and (3) address patients’ perspectives on SCI and supportive care.Method: A heterogeneous sample of oncological patients (N = 566; 68.6% female; M = 54, SD = 14.2, the most prevalent being breast cancer - 31.1%) was recruited. Eighteen items covering the senses, attention, memory, spatial functions, decision-making and speech were administered. The response scale was constructed to reflect the chemotherapy-induced cognitive impairment (CICI) and post-traumatic growth (PTG) theories. A network of subjectively perceived changes in cognitive functions was estimated while three open-ended questions addressed patients’ perspectives on SCI.Results: Within the network, deficits in spatial perception, attention focus and problem-solving ability were the highest on the strength index while the deficits related to the senses were the least influential. From the moderating factors, finishing chemotherapy, cancer relapse, pain, PTSD and sadness caused invariance in the network’s global strength or structure. Conclusion: The findings indicate that psychological-based interventions focused on higher cognitive functions could improve patients’ quality of life. The presence of supportive care and available information could strengthen SCI intervention and prevention for patients with cancer.