Crouch Adele, Von Ah Diane
Author Affiliations: The University of Pennsylvania School of Nursing, NewCourtland Center for Transitions and Health, Philadelphia (Dr Crouch); and The Ohio State University College of Nursing, Columbus (Dr Von Ah).
Cancer Nurs. 2023;46(1):29-35. doi: 10.1097/NCC.0000000000001073. Epub 2022 Mar 11.
Many breast cancer survivors (BCSs) report numerous symptoms following cancer treatment, including cognitive concerns and psychological symptoms (anxiety and depression). However, the association among these symptoms is not well understood.
The objectives were to, primarily, examine the relationship between self-reported cognitive ability and psychological symptoms (anxiety and depressive symptoms) controlling for potential confounders of age, education, and time posttreatment and, secondarily, examine the relationship between self-reported cognitive domains (attention, language, visuoperception, visual memory, and verbal memory) and psychological symptoms.
This secondary data analysis pooled data from 2 theoretically and conceptually congruent, institutional review board-approved studies of BCSs. Breast cancer survivors completed the Multiple Ability Self-report Questionnaire (cognitive ability), Spielberger State Trait Anxiety Inventory-State (anxiety), and Center for Epidemiological Studies-Depression Scale (depressive symptoms). Data were analyzed using descriptive statistics, Pearson correlations, and separate linear regression.
One hundred fifty-five BCSs who were on average 54.8 (SD, 8.9) years of age, approximately 5 years (mean, 5.2 [SD, 3.8] years) posttreatment, and well-educated (mean, 15.2 [SD, 2.2] years) completed questionnaires. In bivariate correlations, higher anxiety and depressive symptoms were significantly related to cognitive abilities in all domains ( P = <.01). In the regression model, increased anxiety was associated with poorer cognitive abilities in all domains ( P < .01).
Anxiety and depressive symptoms were associated with decrements in self-reported cognitive abilities among BCSs.
With increasing numbers of BCSs, more research is needed to address psychological symptoms, which correlate with cognitive function. Findings from this analysis can inform clinical BCS survivorship care planning and future interventional research, focused on comprehensive symptom management.
许多乳腺癌幸存者（BCS）报告称在癌症治疗后出现了多种症状，包括认知问题和心理症状（焦虑和抑郁）。然而，这些症状之间的关联尚未得到充分理解。
主要目的是在控制年龄、教育程度和治疗后时间等潜在混杂因素的情况下，研究自我报告的认知能力与心理症状（焦虑和抑郁症状）之间的关系；次要目的是研究自我报告的认知领域（注意力、语言、视觉感知、视觉记忆和言语记忆）与心理症状之间的关系。
这项二次数据分析汇总了两项理论和概念上一致且经机构审查委员会批准的BCS研究数据。乳腺癌幸存者完成了多项能力自我报告问卷（认知能力）、斯皮尔伯格状态特质焦虑量表-状态（焦虑）和流行病学研究中心抑郁量表（抑郁症状）。使用描述性统计、皮尔逊相关性分析和单独的线性回归对数据进行分析。
155名平均年龄为54.8（标准差8.9）岁、治疗后约5年（平均5.2 [标准差3.8]年）且受教育程度较高（平均15.2 [标准差2.2]年）的BCS完成了问卷调查。在双变量相关性分析中，较高的焦虑和抑郁症状与所有领域的认知能力均显著相关（P = <.01）。在回归模型中，焦虑增加与所有领域的认知能力较差相关（P <.01）。
焦虑和抑郁症状与BCS自我报告的认知能力下降有关。
随着BCS数量的增加，需要更多研究来解决与认知功能相关的心理症状。该分析结果可为临床BCS生存护理计划和未来侧重于综合症状管理的干预研究提供参考。
