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Characteristics associated with inter-individual differences in the trajectories of self-reported attentional function in oncology outpatients receiving chemotherapy

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Abstract

Purpose

Between 14 and 85 % of patients report noticeable changes in cognitive function during chemotherapy (CTX). The purposes of this study were to determine which demographic, clinical, and symptom characteristics were associated with inter-individual variability in initial levels of attentional function as well as with changes in the trajectories of attentional function in a sample of oncology patients who received two cycles of CTX.

Methods

Oncology outpatients (n = 1329) were recruited from two comprehensive cancer centers, one veteran’s affairs hospital, and four community-based oncology programs. The Attentional Function Index (AFI) was used to assess perceived effectiveness in completing daily tasks that required working memory and attention. Hierarchical linear modeling (HLM) was used to evaluate for inter-individual variability in initial levels and in the trajectories of attentional function.

Results

Demographic, clinical, and symptom characteristics associated with inter-individual differences of attentional function at enrollment (i.e., intercept) were as follows: employment status, functional status, trait anxiety, depressive symptoms, sleep disturbance, evening fatigue, and morning energy. Gender was the only characteristic associated with inter-individual differences in the trajectories of attentional function. Morning fatigue was the only characteristic associated with both initial levels and the trajectories of attentional function.

Conclusions

Prior to their next dose of CTX, patients reported moderate levels of attentional function that persisted over two cycles of CTX. Many of the clinical and symptom characteristics associated with decrements in attentional function are amenable to interventions. Clinicians need to assess patients for changes in attentional function and associated characteristics and recommend evidence-based interventions.

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Acknowledgments

This study was funded by the National Cancer Institute (NCI, CA134900). Dr. Miaskowski is supported by a grant from the American Cancer Society and NCI (CA168960). Ms. Shih was supported by grants from the Graduate Division of the University of California, San Francisco (UCSF) and from Associated Students of the UCSF School of Nursing to present her thesis findings at the Oncology Nursing Society’s 41st Annual Congress.

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Authors and Affiliations

  1. School of Nursing, University of California, San Francisco, CA, USA

    Juliet Shih, Heather Leutwyler, Steven M. Paul, Bruce Cooper & Christine Miaskowski

  2. School of Medicine, University of California, San Francisco, CA, USA

    Christine Ritchie & Jon D. Levine

  3. School of Nursing, Yale University, New Haven, CT, USA

    Fay Wright

  4. School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA

    Yvette P. Conley

  5. Department of Physiological Nursing, University of California, Box 0610 - N631Y, San Francisco, CA, 94143-0610, USA

    Christine Miaskowski

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  1. Juliet Shih
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Correspondence to Christine Miaskowski.

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The study was approved by the Institutional Review Board at each of the study sites. Written informed consent was obtained from all patients.

Conflict of interest

The authors declare that they have no competing interests.

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Shih, J., Leutwyler, H., Ritchie, C. et al. Characteristics associated with inter-individual differences in the trajectories of self-reported attentional function in oncology outpatients receiving chemotherapy. Support Care Cancer 25, 783–793 (2017). https://doi.org/10.1007/s00520-016-3461-2

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  • DOI: https://doi.org/10.1007/s00520-016-3461-2

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