激素治疗前列腺癌后认知困难的性质和影响是什么？：一种解释性现象学分析。
What is the nature and impact of cognitive difficulties following hormonal treatments for prostate cancer?: An interpretative phenomenological analysis.
机构信息
Lifespan Health and Wellbeing Research Centre, Macquarie University, 2109, Sydney, NSW, Australia.
School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University & Macquarie University Hospital, 2109, Sydney, NSW, Australia.
出版信息
Support Care Cancer. 2024 Jul 22;32(8):534. doi: 10.1007/s00520-024-08749-z.
OBJECTIVE
Prostate cancer hormonal treatments (e.g. androgen deprivation therapy) yield clinical benefits. However, there is increasing evidence these treatments may adversely impact cognitive functioning. This study aimed to qualitatively characterise the nature and impact of cognitive difficulties following these treatments.
METHODS
Prostate cancer survivors (PCS) self-reporting cognitive difficulties following hormonal treatments (via an online survey) and their partners were invited to participate in semi-structured interviews. Telephone or videoconferencing interviews were conducted, then transcribed, double-coded and analysed using the Framework Method, following the principles of Interpretative Phenomenological Analysis.
RESULTS
Eleven participants (six PCS and five partners) were interviewed. PCS reported a range of cognitive difficulties, verified by their partners, including forgetfulness, "fogginess", fatigue and slowed processing speed. For some PCS, word-finding difficulties, tangential speech and memory problems were apparent during interviews. The aetiology of the reported cognitive difficulties was unclear as it was attributed to a possible combination of cancer treatments, compounding side-effects (e.g. fatigue, sleep problems, hot flashes), exacerbation of pre-existing conditions and/or age-related changes. Cognitive difficulties were reported to have led to shifts in self-perception, interpersonal dynamics and increased emotionality. Engagement in cognitively-stimulating activities and reliance on compensatory strategies were reported to be helpful in managing some cognitive difficulties. All participants endorsed the potential benefits of neuropsychological intervention.
CONCLUSIONS
There are a diverse range of cognitive difficulties following hormonal treatments for prostate cancer experienced by PCS and their partners. Understanding the impact of these difficulties is important for the development of targeted neuropsychological interventions.
目的
前列腺癌激素治疗（如雄激素剥夺疗法）可带来临床获益。然而，越来越多的证据表明，这些治疗可能对认知功能产生不利影响。本研究旨在定性描述这些治疗后认知困难的性质和影响。
方法
通过在线调查，邀请报告激素治疗后存在认知困难的前列腺癌幸存者（PCS）及其伴侣参加半结构式访谈。采用电话或视频会议进行访谈，然后转录、双编码，并使用框架方法进行分析，遵循解释现象学分析的原则。
结果
共对 11 名参与者（6 名 PCS 和 5 名伴侣）进行了访谈。PCS 报告了一系列认知困难，其伴侣也证实了这些困难，包括健忘、“模糊”、疲劳和处理速度减慢。对于一些 PCS，在访谈过程中明显存在找词困难、离题和记忆问题。报告的认知困难的病因尚不清楚，因为它可能归因于癌症治疗的综合作用、叠加的副作用（如疲劳、睡眠问题、热潮红）、原有疾病的恶化以及/或与年龄相关的变化。认知困难据报道导致了自我认知、人际关系动态和情绪增加的转变。参与认知刺激活动和依赖补偿策略被报道有助于管理一些认知困难。所有参与者都认可神经心理干预的潜在益处。
结论
前列腺癌激素治疗后，PCS 及其伴侣存在多种认知困难。了解这些困难的影响对于制定有针对性的神经心理干预措施很重要。
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