PhD Candidate, School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
Professor, Department of Psychology, National Taiwan University, Taipei, Taiwan.
Semin Oncol Nurs. 2023 Aug;39(4):151446. doi: 10.1016/j.soncn.2023.151446. Epub 2023 May 13.
To compare subjective and objective cognitive functions among patients at the following three stages of treatment for colorectal cancer (CRC): new diagnosis (Group A), ≤2 years since chemotherapy completion (Group B), and >2 years since chemotherapy completion (Group C).
A comparative cross-sectional approach was used in this study. The Functional Assessment of Cancer Therapy-Cognitive Function questionnaire and neuropsychological assessments were used to assess patients' subjective cognitive function, attention, memory, and executive functions. A total of 63 patients with stage I to III CRC were recruited from a medical center in northern Taiwan. We performed one-to-one-to-one propensity score matching to identify 36 individuals as eligible for this study. A generalized estimating equation was used to compare subjective and objective cognitive functions.
We observed no significant between-group differences in subjective cognitive function and objective performance in overall cognition and memory. Group B had significantly longer reaction time in attention and processing speed than did Group A. Adjuvant chemotherapy had significantly deleterious effects on attention and processing speed in patients with CRC. These cognitive symptoms last for approximately 2 years after the completion of chemotherapy.
The early detection of cancer-related cognitive impairment is necessary for managing symptom distress. Future studies with a large sample size and longitudinal design may elucidate the trajectory of specific cognitive functions. Developing nursing interventions aimed at improving attention and executive function in patients with CRC are needed.
比较结直肠癌（CRC）治疗后以下三个阶段的患者的主观和客观认知功能：新诊断（A 组）、化疗完成后≤2 年（B 组）和化疗完成后>2 年（C 组）。
本研究采用了一种比较性的横断面方法。使用癌症治疗功能评估-认知功能问卷和神经心理学评估来评估患者的主观认知功能、注意力、记忆和执行功能。共招募了来自台湾北部一家医疗中心的 63 名 I 期至 III 期 CRC 患者。我们进行了一对一到一对一的倾向评分匹配，以确定 36 名符合本研究条件的患者。采用广义估计方程比较主观和客观认知功能。
我们观察到，在主观认知功能和总体认知及记忆的客观表现方面，三组间无显著差异。B 组在注意力和处理速度方面的反应时间明显长于 A 组。辅助化疗对 CRC 患者的注意力和处理速度有明显的不良影响。这些认知症状在化疗完成后大约持续 2 年。
对癌症相关认知障碍的早期检测对于管理症状困扰是必要的。未来需要更大样本量和纵向设计的研究来阐明特定认知功能的轨迹。需要制定针对 CRC 患者注意力和执行功能的护理干预措施。
