Author affiliations: Palo Alto University, California (Drs Atallah and Muñoz); Schools of Nursing (Drs Cooper, Paul, and Miaskowski) and Medicine (Drs Anguera, Levine, Chen, and Melisko), University of California, San Francisco; Department of Nursing, Mount Sinai Hospital (Dr Hammer); and School of Nursing, New York University (Dr Wright), New York; School of Nursing, University of Pittsburgh, Pennsylvania (Dr Conley); and Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, California (Dr Dunn).
Cancer Nurs. 2020 Sep/Oct;43(5):402-410. doi: 10.1097/NCC.0000000000000713.
Decrements in attentional function-perceived effectiveness in everyday functioning related to cognitive dysfunction-are frequently reported by cancer patients during treatment. However, patients vary widely in their experiences of changes in attentional function.
The aim of this study was to understand differences in attentional function among cancer patients during chemotherapy.
Patients (n = 1329) undergoing chemotherapy were assessed at 6 time points during 2 rounds of chemotherapy. Latent profile analysis was used to identify subgroups of patients based on patterns in changes on the Attentional Function Index. Differences among the subgroups in demographic and clinical characteristics, psychological symptoms, and stress were evaluated.
Three latent classes (ie, high, moderate, and low attentional function) were identified. Patients in the low and moderate classes were younger, more likely to be female, and less likely to be employed compared with those in the high class. Patients in the low class had higher levels of depressive and anxiety symptoms, cancer-related distress, and perceived stress compared with those in the moderate class, who, in turn, reported higher levels of these symptoms compared with those in the high class.
Different experiences of changes in self-perceived attentional function are associated with psychological symptoms in cancer patients.
Relationships between changes in attentional function and psychological symptoms and stress suggest that clinicians should attend to the potential that patients' cognitive and psychological experiences may be closely linked and may need to be addressed as related phenomena. Clinical trials are needed that evaluate treatments for both attentional and psychological symptoms.
在治疗过程中，癌症患者经常报告注意力功能下降——与认知功能障碍相关的日常功能感知效果下降。然而，患者在注意力功能变化方面的体验差异很大。
本研究旨在了解癌症患者在化疗期间注意力功能的差异。
在两轮化疗期间的 6 个时间点对接受化疗的患者（n=1329）进行评估。采用潜在剖面分析，根据注意力功能指数变化模式对患者进行分组。评估亚组间在人口统计学和临床特征、心理症状和压力方面的差异。
确定了三个潜在类别（即高、中、低注意力功能）。与高功能组相比，低功能组和中功能组的患者更年轻，更可能是女性，更可能没有工作。与中功能组相比，低功能组的患者抑郁和焦虑症状、癌症相关痛苦和感知压力水平更高，而中功能组的患者则报告其抑郁和焦虑症状、癌症相关痛苦和感知压力水平高于高功能组。
自我感知注意力功能变化的不同体验与癌症患者的心理症状有关。
注意力功能变化与心理症状和压力之间的关系表明，临床医生应该注意到患者的认知和心理体验可能密切相关，并且可能需要将其作为相关现象来解决。需要进行临床试验，以评估针对注意力和心理症状的治疗方法。
