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Oh and Lee: Effect of Cancer Symptoms and Fatigue on Chemotherapy-related Cognitive Impairment and Depression in People with Gastrointestinal Cancer
Original Article

Journal of Korean Academy of Nursing 2016; 46(3): 420-430.

Published online: 30 June 2016

DOI: https://doi.org/10.4040/jkan.2016.46.3.420

Effect of Cancer Symptoms and Fatigue on Chemotherapy-related Cognitive Impairment and Depression in People with Gastrointestinal Cancer

Pok Ja Oh, Jung Ran Lee

Department of Nursing, Sahmyook University, Seoul, Korea.

Address reprint requests to: Lee, Jung Ran. Department of Nursing, Sahmyook University, 815 Kongnung-dong, Hwarang-ro, Nowon-gu, Seoul 01795, Korea. Tel: +82-2-3399-1589, Fax: +82-2-3399-1594, jrwin@naver.com

Received 22 October 2015       Revised 12 January 2016       Accepted 30 March 2016

© 2016 Korean Society of Nursing Science

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

The purpose of this study was to test a hypothetical model of chemotherapy-related cognitive impairment (CRCI) and depression in people with gastrointestinal cancer.

Methods

A purposive sample of 198 patients undergoing chemotherapy was recruited from November 2014 to July 2015. The instruments were Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module. Data were analyzed using descriptive statistics, correlation, and path analysis.

Results

CRCI was directly affected by cancer symptoms (β=.19, p=.004) and fatigue (β=.56, p<.001)(R2=47.2%). Depression was directly affected by fatigue (β=.48, p<.001) and CRCI (β=.27, p<.001). However, The impact of cancer symptoms on depression was confirmed through the mediating effect of CRCI.

Conclusion

Results indicate that in patients with gastrointestinal cancer undergoing chemotherapy along with the direct physiologic effects (fatigue, symptoms) of cancer treatment may have altered cognitive function leading to depression.

Keywords: Mild cognitive impairment, Neoplasm, Fatigue, Depression

Figures and Tables

Figure 1-A

Path diagram of the hypothetical model.

jkan-46-420-g001
Figure 1-B

Modified path diagram of the study.

jkan-46-420-g002
Table 1

Cancer Symptoms, Fatigue, Cognitive Function, and Depression according to General Characteristics of Participants (N=198)

jkan-46-420-i001

ECOG=Eastern cooperative oncology group.

Table 2

Descriptive Statistics of Cancer Symptoms, Fatigue, Objective Cognitive Function, Perceived Cognitive Decline, and Depression (N=198)

jkan-46-420-i002
Table 3

Correlations among Cancer Symptoms, Anemia, Fatigue, Objective Cognitive Function, Perceived Cognitive Decline, and Depression (N=198)

jkan-46-420-i003
Table 4

Total Effect, Direct Effect, and Indirect Effect

jkan-46-420-i004

SE=Standard error; CR=Critical ratio; SMC=Squared multiple correlations.

Notes

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2014R1A1A2053517)

CONFlCTS OF INTEREST The authors declared no conflict of interest.

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