Emerging From the Haze: A Pilot Study Evaluating Feasibility of a Psychoeducational Intervention to Improve Cancer-Related Cognitive Impairment in Gynecologic Cancer Survivors

J Palliat Care. 2019 Jan;34(1):32-37. doi: 10.1177/0825859718796794. Epub 2018 Aug 31.

Abstract

Purpose:: The objective of this pilot study is to evaluate the (1) applicability of a 15-hour attending-taught psychoeducational intervention in a retrospective cohort and (2) feasibility of a trainee-taught intervention in a prospective cohort of patients with gynecologic cancer to help manage cancer-related cognitive impairment (CRCI).

Methods:: Adults with any stage gynecologic cancer who completed chemotherapy and reported cognitive complaints were eligible. Additionally, the screening criteria of Functional Assessment of Cancer Therapy-Cognition (FACT-Cog) perceived cognitive impairment (PCI) subscale score <59 was used in the prospective cohort. Validated patient-reported outcomes including FACT-Cog and Patient-Reported Outcomes Measurement Information System (PROMIS) Applied Cognition Abilities and General Concerns were measured before and after the intervention.

Results:: Twelve patients underwent an attending-taught intervention between 2011 and 2014. Significant improvements in mean FACT-Cog PCI (+6.1, P < .048), quality of life (+2.4, P = .04), and total score (+9.8, P = .03) were demonstrated, while there was no significant change in mean FACT-Cog perceived cognitive abilities. Ten patients underwent a trainee-taught intervention in 2017. No significant changes in mean FACT-Cog subscale or total scores were seen. Significant improvements in PROMIS Applied Cognition Abilities (+8.2, P = .01) and PROMIS Applied Cognition General Concerns were demonstrated (-8.0, P < .01).

Conclusions:: Our psychoeducational intervention demonstrates applicability to patients with gynecologic cancer reporting CRCI and supports the feasibility of more widespread training based on improvements in validated patient-reported outcomes related to cognition.

Keywords: cancer-related cognitive impairment; chemobrain; cognitive rehabilitation; gynecologic cancer; psychoeducational intervention.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects*
  • Behavior Therapy / methods
  • Cancer Survivors / education*
  • Cancer Survivors / psychology*
  • Cognitive Dysfunction / chemically induced*
  • Cognitive Dysfunction / rehabilitation*
  • Female
  • Genital Neoplasms, Female / complications*
  • Genital Neoplasms, Female / drug therapy*
  • Humans
  • Los Angeles
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Retrospective Studies

Substances

  • Antineoplastic Agents