Cancer Control Research
5R03CA090151-02
Ferguson, Robert J.
COGNITIVE BEHAVIORAL TREATMENT OF MEMORY PROBLEMS
Abstract
DESCRIPTION: (Applicant's Description)
Cognitive deficits associated with cancer treatment can have a dramatic effect
on patients' quality of life and have been recognized as a problem by the
President's Cancer Panel (1999) and the National Coalition for Cancer
Survivorship for those living with cancer (Ferrell Hassey & Dow, 1997).
Increasing evidence suggests that standard dose, systemic chemotherapy can
produce memory and concentration deficits in adult 5-year cancer survivors
(Ahles, 1999). While more research on the cognitive effects of chemotherapy is
needed, mounting evidence suggests strongly that development of interventions
to improve cognitive functioning following chemotherapy is important. The
present application proposes pilot testing a brief cognitive-behavioral
treatment program (4 visits with 3 phone contacts) designed to assist breast
cancer survivors in compensating for cognitive impairment associated with
systemic chemotherapy. The principal long-term objective of this work is to
examine the treatment program's feasibility to be carried out in clinical
oncology settings at this pilot-phase of treatment development and examine its
preliminary effectiveness in a small sample of cancer survivors. Results will
aid planning and carry-through of a randomized controlled trial of efficacy in
future investigation. Specific aims of the present project are:
1. To evaluate the feasibility of a brief cognitive-behavioral treatment
program designed specifically for rehabilitation of cognitive deficits
resulting from systemic chemotherapy. Breast cancer survivors will be the
target population.
2. Pilot-test the effectiveness of the brief cognitive-behavioral treatment as
a first-phase of treatment development (one-group, repeated measures design).
3. Quantify the proportion of treatment participants who achieve clinically
significant improvement using statistical methods to determine clinically
significant outcomes in behavioral research (Jacobson, Roberts, Berns, &
McGlinchey, 1999). Clinically significant change will be defined as exceeding
the reliable change index (RCI) in pre- to post-test scoring on self-report
measures of cognitive functioning and quality of life measures.
4. Evaluate participant satisfaction with treatment.
Thirty-three breast cancer survivors (5 years after disease remission) with
attention and memory deficits will enroll in the pilot treatment. A
single-group, 3 (time: pre-treatment, post-treatment, 2-month follow-up) X 1
(treatment group) repeated-measures, multivariate analysis of variance
(MANOVA) design will be used to evaluate effects of treatment on three
dependent measures: 1) standardized self-report measure of cognitive function;
2) a global neuropsychological test performance score; and 3) a self-report
measure of survivor quality of life. Participant satisfaction and adherence to
behavioral and cognitive homework tasks will also be assessed by quantifying
these variables with descriptive statistics. Implications for future study are
discussed.
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