The impact of cognitive dysfunction on the occupational performance of cancer survivors post chemotherapy
Mulhern, Jason
Mulhern, Jason
Loading...
Publication Date
2024-03-13
Type
Thesis
Downloads
Citation
Abstract
Background: Cancer rates are increasing globally. Survivorship is also rising due to advancements in early detection and treatment. Chemotherapy is a common anti-cancer treatment with adverse effects reported due to its cytotoxic nature. Of these, one is cognitive dysfunction. Cancer survivors report the behavioural repercussions of this sequela in relation to occupational performance. Objectives: This study aims to examine cognitive dysfunction post-chemotherapy and its’ effect on the occupational performance of cancer survivors. Methods: The cognitive function of ten (non-central nervous system) cancer survivors post chemotherapy was compared with eight non-cancer controls, matched for age, sex and education. The influence of cognitive dysfunction on the occupational performance of cancer survivors was examined. Cognitive dysfunction was assessed using ecologically valid neuropsychological tests with good psychometric properties. Occupational performance was measured using the COPM (Law et al., 2014) and participant-reported scales. Results: Cancer survivors demonstrated significantly poorer performance on the Visual Elevator-Timing (Robertson et al., 1994) than non-cancer controls (t(16)=2.43, p=0.03). All other group differences were non-significant (p>0.05). The Digit Span-Sequencing (Lezak et al., 2012) directly predicted occupational performance (β=0.95, p=0.03). In addition, combinations between the Digit Span-Sequencing (Lezak et al., 2012) or Modified Six Elements (Wilson et al., 1996a) and confounding factors significantly predicted variance in occupational satisfaction, IADL performance and ability to participate in social roles and activities. Conclusions: The results demonstrated that cancer survivors experience occupational performance issues related to cognitive dysfunction post-chemotherapy. Cognitive abilities which rely on an executive control element seem most affected. The impact appears greatest on higher-level tasks such as IADLs, work, driving and reading. These findings provide evidence that occupational therapists should consider the cognitive needs of cancer survivors post-chemotherapy as standard practice.
Funder
Publisher
NUI Galway