ASPO Abstracts
Cancer-Related Symptoms and Cognitive Intervention Adherence Among Breast Cancer Survivors: A Mixed Methods Study
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research,
Conference Year: 2018
Abstract Body:
Purpose: To explore the relationship between selected cancer-related symptoms and adherence to the Speed of Processing in Middle Aged and Older Breast Cancer Survivors (SOAR) cognitive training intervention among breast cancer survivors (BCS) residing in Alabama by using a sequential quantitative (Quan), qualitative (Qual) mixed methods design consisting of two distinct phases. Methods: The first (Quan) phase examined the relationship between selected cancer-related symptoms and adherence to SOAR among BCS (n = 30) through self-reported questionnaire data. The second (Qual) phase explored potential facilitators and/or barriers to SOAR and identified how symptoms contributed to/explained differences in adherence by conducting semistructured interviews with 15 purposefully selected phase I participants. Data were analyzed using R Studio (Quan) and NVivo® (Qual) software. Results: Spearman’s rho correlation suggested relationships between adherence and perceived cognitive impairment, depressive symptoms, and sleep quality. Inductive thematic analysis yielded four themes that described how cancer-related symptoms are related to adherence to SOAR among BCS, differences between adherent and non-adherent participants, and cultural aspects: 1) experiences of cancer-related symptoms; 2) influences of cognitive training; 3) adherence to cognitive training; and 4) environment for cognitive training. Integration of the Quan and Qual findings revealed that response to awareness of perceived cognitive impairment is critical to cognitive training adherence and that cognitive training exacerbates depressive symptoms among some BCS. Moreover, poor sleep quality can aggravate cognition and mood and negatively influence cognitive training motivation and performance, creating a snowball effect. Yet, continued cognitive training may improve sleep, mood, and cognition among BCS. Conclusions: Experiences of and responses to cognitive training and cancer-related symptoms shape adherence to cognitive training among BCS. BCS experiencing concurrent cancer-related symptoms may be mentally and/or physically unable to attend to cognitive training. Future cognitive studies among BCS may consider applying a comprehensive approach aimed at addressing concurrent cancer-related symptoms.
Keywords: breast cancer survivors, cognitive impairment, cognitive training, adherence, cancer-related symptoms, mixed methods research