考虑到癌症相关认知障碍导致的未满足需求。

Accounting for unmet needs resulting from cancer-related cognitive impairment.

作者信息

Haywood Darren, Chan Alexandre, Chan Raymond J, Dauer Evan, Dhillon Haryana M, Henneghan Ashley M, Lustberg Maryam B, O'Connor Moira, Vardy Janette L, Rossell Susan L, Hart Nicolas H

机构信息

Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, Sydney, NSW, 2030, Australia.

Department of Mental Health, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.

出版信息

J Cancer Surviv. 2025 Mar 11. doi: 10.1007/s11764-025-01769-6.

DOI:10.1007/s11764-025-01769-6

PMID:40067418

Abstract

PURPOSE

Cancer-related cognitive impairment (CRCI) causes a wide range of unmet needs for cancer survivors. It is unknown which clinical, demographic, cognitive, and psychological factors underpin and account for these various unmet needs. This study aimed to (a) identify factors associated with CRCI-related unmet needs, and (b) establish the most pertinent factors that account for CRCI-related unmet needs.

METHODS

Four hundred and fifty-six (n = 456) cancer survivors responded to a range of demographic and clinical questions, as well as measures of CRCI-related unmet needs (MASCC COG-IMPACT), perceived cognitive impairment (PROMIS-COG), and psychological distress (DASS-21). Descriptive statistics, bivariate correlations, and feed-forward multiple regression analyses were completed.

RESULTS

Cognitive impairment severity (r = 0.39 to 0.59; p < 0.01), psychological distress (r = 0.36 to 0.58; p < 0.01), and time since diagnosis (r = - 0.11 to - 0.20; p < 0.05 to p = 0.02) were significantly associated with CRCI-related unmet needs across all domains. Age (r = - 0.10 to - 0.22; p < 0.001 to p = 0.03), stage of cancer at initial diagnosis (r = 0.10 to 0.13; p < 0.001 to p = 0.04), stage of cancer at most progressed (r = 0.11 to 0.18; p < 0.001 to p = 0.03), and sex (r = 0.12; p = 0.01; females experiencing greater unmet needs than males), were significantly associated with one or more domains of unmet need. Cognitive impairment severity and psychological distress were the most pertinent factors accounting for CRCI-related unmet needs (R = 0.245, F = 48.96, p < 0.001 to R = 0.474, F = 114.81, p < 0.001), explaining 24.5% to 47.4% of the variance.

CONCLUSION

Cognitive impairment severity and psychological distress were the most key factors in accounting for CRCI-related unmet needs. Other variables, while associated with CRCI-related unmet needs, did not provide additional predictive utility.

IMPLICATIONS FOR CANCER SURVIVORS

The results may inform the choice of supportive care targets, and future strategies, to improve supportive care for people experiencing cancer-related cognitive impairment.

摘要

目的

癌症相关认知障碍（CRCI）给癌症幸存者带来了一系列未得到满足的需求。目前尚不清楚哪些临床、人口统计学、认知和心理因素是这些各种未满足需求的基础并导致了这些需求。本研究旨在（a）确定与CRCI相关未满足需求相关的因素，以及（b）确定导致CRCI相关未满足需求的最相关因素。

方法

456名癌症幸存者回答了一系列人口统计学和临床问题，以及与CRCI相关未满足需求的测量指标（MASCC COG-IMPACT）、感知认知障碍（PROMIS-COG）和心理困扰（DASS-21）。完成了描述性统计、双变量相关性分析和前馈多元回归分析。

结果

认知障碍严重程度（r = 0.39至0.59；p < 0.01）、心理困扰（r = 0.36至0.58；p < 0.01）和确诊后的时间（r = -0.11至-0.20；p < 0.05至p = 0.02）在所有领域均与CRCI相关未满足需求显著相关。年龄（r = -0.10至-0.22；p < 0.001至p = 0.03）、初次诊断时的癌症分期（r = 0.10至0.13；p < 0.001至p = 0.04）、最严重时的癌症分期（r = 0.11至0.18；p < 0.001至p = 0.03）和性别（r = 0.12；p = 0.01；女性未满足需求比男性更多）与一个或多个未满足需求领域显著相关。认知障碍严重程度和心理困扰是导致CRCI相关未满足需求的最相关因素（R = 0.245，F = 48.96，p < 0.001至R = 0.474，F = 114.81，p < 0.001），解释了24.5%至47.4%的方差。