Gosselt Isabel K, Scheepers Vera P M, Spreij Lauriane A, Visser-Meily Johanna M A, Nijboer Tanja C W
Center of Excellence for Rehabilitation Medicine Utrecht, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.
Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands.
Neurooncol Pract. 2020 Nov 21;8(2):160-170. doi: 10.1093/nop/npaa078. eCollection 2021 Apr.
Cognitive deficits have been frequently assessed in brain tumor patients. However, self-reported cognitive complaints have received little attention so far. Cognitive complaints are important as they often interfere with participation in society. In this study, cognitive complaints were systematically assessed in brain tumor patients. As patients' experiences and relatives' estimations may vary, the level of agreement was investigated.
Brain tumor outpatients (n = 47) and relatives (n = 42) completed the inventory , assessing cognitive complaints across 10 daily life activities and cognitive domains (total, memory, executive, attention). Cognitive complaints scores were compared between patients with different clinical characteristics (tumor type, number of treatments, the absence/presence of epilepsy). Complaints difference scores in patient-relative pairs were calculated to explore the level of agreement using intraclass correlations (ICC). Furthermore, we explored whether the level of agreement was related to (1) the magnitude of cognitive complaints in patient-relative pairs and (2) patients' cognitive functioning (assessed with the Montreal Cognitive Assessment).
Patients and relatives reported most cognitive complaints during work/education (100%) and social contacts (88.1%). Patients with different clinical characteristics reported comparable cognitive complaints scores. Overall, the level of agreement in patient-relative pairs was moderate-good (ICC 0.73-0.86). Although in 24% of the pairs, there was a substantial disagreement. The level of agreement was not related to the magnitude of complaints in patient-relative pairs or patients' cognitive functioning.
Both the perspectives of brain tumor patients and their relatives' on cognitive complaints are important. Clinicians could encourage communication to reach mutual understanding.
脑肿瘤患者的认知缺陷已得到频繁评估。然而，迄今为止，自我报告的认知主诉很少受到关注。认知主诉很重要，因为它们常常会干扰社会参与。在本研究中，对脑肿瘤患者的认知主诉进行了系统评估。由于患者的体验和亲属的估计可能存在差异，因此对二者的一致程度进行了调查。
脑肿瘤门诊患者（n = 47）及其亲属（n = 42）完成了一份量表，该量表评估了10项日常生活活动和认知领域（总体、记忆、执行、注意力）方面的认知主诉。比较了具有不同临床特征（肿瘤类型、治疗次数、有无癫痫）的患者之间的认知主诉得分。计算患者 - 亲属对的主诉差异得分，以使用组内相关系数（ICC）来探索一致程度。此外，我们还探讨了一致程度是否与以下因素相关：（1）患者 - 亲属对中认知主诉的严重程度；（2）患者的认知功能（用蒙特利尔认知评估量表进行评估）。
患者和亲属报告在工作/学习（100%）和社交接触（88.1%）期间认知主诉最多。具有不同临床特征的患者报告的认知主诉得分相当。总体而言，患者 - 亲属对的一致程度为中等至良好（ICC 0.73 - 0.86）。尽管在24%的配对中存在较大分歧。一致程度与患者 - 亲属对中主诉的严重程度或患者的认知功能无关。
脑肿瘤患者及其亲属对认知主诉的看法都很重要。临床医生可以鼓励交流以达成相互理解。
