Cognitive intervention for breast cancer patients undergoing adjuvant chemotherapy: a needs analysis

Background: Evidence suggests women with breast cancer who had received chemotherapy experienced cognitive problems. Although these are largely subtle deficits, they can negatively impact a patient's quality of life, ability to work, and subsequent employment decisions. Objective: The present study explored what healthcare information and support are available to help women understand the effects of chemotherapy on daily functioning at home and at work. It also explored what information and support they would find useful as interventions. Methods: Qualitative interviews were carried out with 31 patients attending a breast cancer clinic 4 months after treatment completion (phase 1) and with 5 oncology health professionals (phase 2). Fifteen women who took part in the interviews completed a short questionnaire on suitable interventions (phase 3). Results: Participants reported problems with fatigue, low mood, memory, and attention. Problems with remembering tasks at work were most common. Participants requested more information and support on cognitive difficulties. Oncology health professionals discussed the need for information and support for patients on managing cognitive problems. From the findings, 4 interventions and delivery modes were identified and validated. These were information and activites on cognitive strategies, help with emotional distress associated with cognitive difficulties, and advice for families and employers. Conclusion: Despite mixed evidence for cognitive problems associated with chemotherapy, there is a need for an intervention, and this may be related to managing emotional distress associated with perceived cognitive problems. Implications for Practice: Nurses should include potential cognitive problems when providing information to patients.