Longitudinal Study Of Cognitive Impairment Development And Adaptation In Breast Cancer Patients During Treatment

Objective: To depict the trajectory of cognitive impairment development during treatment,analyze the factors influencing the course,to analyze the impact of changes in anxiety-depression dynamics on cognitive impairment.To describe how breast cancer patients adapt to cognitive impairment and their experiences and provide a reference for rehabilitation interventions for breast cancer patients.Methods: This study used a hybrid research design method to conduct nested design simultaneously.A longitudinal study investigated 213 patients in a tertiary care hospital.The FACT-Cog and HADS scales were used to assess dynamics at admission,after three courses of chemotherapy,six courses of chemotherapy,eight courses of chemotherapy,and three months after the end of chemotherapy.Latent category trajectories were used to explore the trajectories of PCI,PCA,and Qo L;linear mixed models were used to analyze the dynamic changes of anxiety and depression on PCI,PCA,and Qo L.Semistructured interviews were used to interview 10 of these patients,and descriptive qualitative studies were used to describe patients’ adaptation to cognitive impairment and their experiences.Results:1.The incidence of T1～T5 cognitive impairment was 42.7%,88.2%,90.6%,78.4%,90.6%,cognitive impairment occurs in memory,language function,attention,multitasking,and interference.2.PCI showed a two-group trajectory,accounting for 21.6% in the "high cognitive impairment group" and 78.4% in the "low cognitive impairment group." PCA was divided into 63.85% in the "low perception group" and 36.15% in the "high perception group." The Qo L trajectory was the optimal model for two groups,with 21.13% in the "low quality of life group" and 78.87% in the "high quality of life group."3.The experience and adaptation of cognitive impairment during treatment of breast cancer patients include（1）forgetfulness of daily tasks;（2）difficulty in recalling the past;（3）uncertainty about oneself;（4）slower response and poor resistance to interference.Attributions of cognitive impairment were（1）chemotherapy,（2）a history of narcotic drugs,（3）feeling tired and not willing to remember,and（4）things not essential to remember.Attitudes toward cognitive impairment were（1）acceptance;（2）not a priority concern;（3）affecting work.Coping with cognitive impairment was classified as（1）using notes;（2）trying to control;（3）relying on family support;（4）accepting the status quo and lowering expectations.Conclusion:（1）Cognitive impairment is common in breast cancer patients during treatment,with mild but persistent symptoms and a single coping style;The cognitive impairment of patients affected by anxiety and depression can be alleviated by improving anxiety and depression.（2）Cognitive impairment showed a multidimensional decline,and memory impairment was the most prominent cognitive impairment in patients’ experience,suggesting that memory function training is the focus of clinical intervention.（3）The low evaluation of cognitive ability was not consistent with the severity of cognitive impairment,which suggested that the influencing mechanism should be further studied when the individual evaluation effectiveness was emphasized.