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. 2017 Mar;25(3):783-793.
doi: 10.1007/s00520-016-3461-2. Epub 2016 Oct 20.

Characteristics associated with inter-individual differences in the trajectories of self-reported attentional function in oncology outpatients receiving chemotherapy

Juliet Shih  1 , Heather Leutwyler  1 , Christine Ritchie  2 , Steven M Paul  1 , Jon D Levine  2 , Bruce Cooper  1 , Fay Wright  3 , Yvette P Conley  4 , Christine Miaskowski  5   6
Affiliations

Characteristics associated with inter-individual differences in the trajectories of self-reported attentional function in oncology outpatients receiving chemotherapy

Juliet Shih et al. Support Care Cancer. 2017 Mar.

Abstract

Purpose: Between 14 and 85 % of patients report noticeable changes in cognitive function during chemotherapy (CTX). The purposes of this study were to determine which demographic, clinical, and symptom characteristics were associated with inter-individual variability in initial levels of attentional function as well as with changes in the trajectories of attentional function in a sample of oncology patients who received two cycles of CTX.

Methods: Oncology outpatients (n = 1329) were recruited from two comprehensive cancer centers, one veteran's affairs hospital, and four community-based oncology programs. The Attentional Function Index (AFI) was used to assess perceived effectiveness in completing daily tasks that required working memory and attention. Hierarchical linear modeling (HLM) was used to evaluate for inter-individual variability in initial levels and in the trajectories of attentional function.

Results: Demographic, clinical, and symptom characteristics associated with inter-individual differences of attentional function at enrollment (i.e., intercept) were as follows: employment status, functional status, trait anxiety, depressive symptoms, sleep disturbance, evening fatigue, and morning energy. Gender was the only characteristic associated with inter-individual differences in the trajectories of attentional function. Morning fatigue was the only characteristic associated with both initial levels and the trajectories of attentional function.

Conclusions: Prior to their next dose of CTX, patients reported moderate levels of attentional function that persisted over two cycles of CTX. Many of the clinical and symptom characteristics associated with decrements in attentional function are amenable to interventions. Clinicians need to assess patients for changes in attentional function and associated characteristics and recommend evidence-based interventions.

Keywords: Attentional function; Chemotherapy; Cognitive function; Executive function; Hierarchical linear modeling.

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Figures

Figure 1
Figure 1
Figure 1. A – Piecewise model of mean Attentional Function Index scores for six assessment points over two cycles of chemotherapy (CTX). Figure 1. B - Spaghetti plots of individual attentional function trajectories for a random sample of 50 patients over two cycles of CTX. Abbreviation: AFITOT = Attentional Function Index score.
Figure 2
Figure 2
A–B - Influence of employment status (A) and Karnofsky Performance Status (KPS) score at enrollment (B) on inter-individual differences in the intercept for attentional function.
Figure 3
Figure 3
A–E - Influence of enrollment scores for trait anxiety (A), depressive symptoms (B), sleep disturbance (C), evening fatigue (D), and morning energy (E) on inter-individual differences in the intercept for attentional function.
Figure 4
Figure 4
A–B - Influence of gender (A) on inter-individual differences in the slope parameters for attentional function and influence of enrollment scores for morning fatigue on inter-individual differences in the intercept and slope parameters for attentional fatigue (B).
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References

    1. Joly F, Giffard B, Rigal O, De Ruiter MB, Small BJ, Dubois M, LeFel J, Schagen SB, Ahles TA, Wefel JS, Vardy JL, Pancre V, Lange M, Castel H. Impact of cancer and its treatments on cognitive function: Advances in Research From the Paris International Cognition and Cancer Task Force Symposium and Update Since 2012. J Pain Symptom Manage. 2015;50(6):830–841. doi: 10.1016/j.jpainsymman.2015.06.019. - DOI - PubMed
    1. Hess LM, Insel KC. Chemotherapy-related change in cognitive function: a conceptual model. Oncol Nurs Forum. 2007;34(5):981–994. doi:W5348N73K3603L2N. - PubMed
    1. Merriman JD, Von Ah D, Miaskowski C, Aouizerat BE. Proposed mechanisms for cancer- and treatment-related cognitive changes. Semin Oncol Nurs. 2013;29(4):260–269. doi: 10.1016/j.soncn.2013.08.006. - DOI - PMC - PubMed
    1. Bender CM, Merriman JD. Cancer- and treatment-related cognitive changes: what can we do now? What lies ahead? Oncology (Williston Park) 2014;28(9):806–808. doi:201379. - PMC - PubMed
    1. Cimprich B. Attentional fatigue following breast cancer surgery. Res Nurs Health. 1992;15(3):199–207. - PubMed