Symptom Management of Affective and Cognitive Disturbance With a Group of Cancer Survivors

Abstract

Cancer survivors 65 years of age and older experience treatment-induced memory impairments. However, clinicians do not intervene for these cognitive problems. This article describes the findings from a pilot study of a memory versus health training intervention and its adaptability for cancer survivors for symptom management. A convenience sample of older adults was enrolled in a longitudinal study of a memory and health training intervention and tested on five occasions for 2 years postintervention. The memory training was designed to increase cognitive performance, reduce anxiety, decrease negative attributions, promote health, and increase memory self-efficacy. In this analysis, we included change over time for the first four of the five data collection points. We calculated means and standard deviations on the memory measures for cancer survivors in the intervention (n = 8) and comparison (n = 14) groups. The analysis consisted of a mixed design analysis of variance comparing the two intervention groups across four periods for 12 months. The typical cancer survivor in the sample was a 74-year-old Caucasian female; 14% were minorities. Because of the small sample, some of the effects were not statistically significant. Moderate to large effects were revealed in everyday and verbal memory performance scores, memory self-efficacy, strategy use, and memory complaints. There were also moderate effects for group-by-time interactions on the visual memory performance measure, the memory self-efficacy measure, the depression, the trait anxiety measure, and the complaints subscale. The memory intervention group tended to improve more than the health training group, although this was not always consistent. The results suggested that the participants benefited from the memory training intervention. Clinicians are often at a loss on how to intervene with cancer survivors who are experiencing cognitive problems following chemotherapy treatment. Evidenced-based interventions for this aspect of symptom management are almost nonexistent. The Cognitive Behavioral Model of Everyday Memory (CBMEM), derived from Self-Efficacy theory provides an evidence-based intervention for symptom management.