Development of Mobile-application based Cognitive Training Program for Cancer Survivors with Cognitive Complaints

Pok Ja Oh; Jung-Hae Youn; Ji Hyun Kim

doi:10.7475/kjan.2017.29.3.266

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Oh, Youn, and Kim: Development of Mobile-application based Cognitive Training Program for Cancer Survivors with Cognitive Complaints

Original Article

Korean J Adult Nurs 2017;29(3):266-277.

Published online: 9 June 2017

DOI: https://doi.org/10.7475/kjan.2017.29.3.266

Development of Mobile-application based Cognitive Training Program for Cancer Survivors with Cognitive Complaints

Pok Ja Oh, Ph.D., RN¹, Jung-Hae Youn, Ph.D.², Ji Hyun Kim, Ph.D Candidate, RN^1,

¹Department of Nursing, Sahmyook University, Seoul, Korea

²Clinical and Counseling Psychology, Graduate School of Medicine, CHA University, Seoul, Korea

Corresponding author: Kim, Ji Hyun Department of Nursing, Sahmyook University, 815 Kongnung-dong, Hwarang-ro, Nowon-gu, Seoul 01795, Korea. Tel: +82-2-3399-1590, Fax: +82-2-3399-1594, E-mail: kimjh@syu.ac.kr

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

Received 31 March 20172 June 2017 Accepted 23 June 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to design a mobile-application of a cognitive training program for people who have chemo-related cognitive complaints.

Methods

The program was developed based on the network- based instructional system design proposed by Jung. The program consisted of several tasks centered on four cognitive domains: learning, memory, working memory, and attention. For memory learning, a target-image and all its elements (color, position, and number) were presented on the screen that had to be recognized among a number of distractor-figures. In working memory training, the previous learned target-figure according to the level of difficulty had to be remembered among many different figures. In attention training named “ Find the same figure,” two identical symbols in a grid-pattern filled with different images were presented on the screen, and these had to be simultaneously touched. In attention training named “ Find the different figure,” a different symbol in a grid pattern filled with same figures had to be selected. This program was developed to train for a minimum of 20 min/day, four days/week for six weeks.

Results

This cognitive training revealed statistically significant improve-ment in subjective cognitive impairments (t=3.88, p=.006) at six weeks in eight cancer survivors.

Conclusion

This cognitive training program is expected to offer individualized training opportunities for improving cognitive function and further research is needed to test the effect in various settings.

Keywords: Cognitive dysfunction, Neoplasm, Mobile applications, Program development

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Figure 1.

Main page: Memory learning.

Figure 2.

Attention.

Table 1.

Description of Cognitive Training Programs for Cancer Patients

Intervention type and content	Intervention format	Intervention session
Type: Neuropsychological training
Content: Teaching coping strategies for cognitive decline
		Computer-based cognitive training:
Type: Behavioral intervention	• Group approach	• Number of sessions: 4~36 (mean: 26)
Content: meditation, exercise, walking	• Individual approach	• Time per session: 46.6~50 minutes (total 8.6 hour)
Type: Computer based cognitive training
Content: Practice the cognitive tasks to improving attention, memory and executive function

Table 2.

Description of Cognitive Tasks in the Training Program

Task name	Abilities trained	Task description	Sensory stimulation and feedback	Determinants of difficulty level
Memory:(memory learning)	• Visual memory • Learning strategies	• The participant has to observe symbols presented on the screen. • Then the first learned target-image and all its elements (color, position, number) have to be recognized amongst a number of distractor-figures.	• Introduction text at start-up • Different visual	• Varying number of target-figure to be learned (5 to 35) • Varying pattern complexity (image, color, position, and number) • Number of symbols (1~4)
Memory:(working memory)	• Maintain and process perceptions simultaneously	• Many different figures by level of difficulty are shown on screen. • Then the participant has to remember the previous learned target-figure.	stimuli (image, color, position, and number) • Feedback: • A visual scale	• Varying number of target-figure to be learned (5 to 35) • Varying pattern complexity (image, color, position, and number)
Attention I: (find the same figure)	• Focused attention • Vigilance • Response time and accuracy	• The participant has to simultaneously touch screen when presented with two identical symbols (images) in a grid-pattern filled with different.	providing information on precision (% correct) • Motivational stamp are displayed when	• Varying size of grid-pattern (2×2 to 4×4) and varying distractor-items.
Attention II:(find the different figure)	• Focused attention • Vigilance • Response time and accuracy	• The participant has to touch a different symbol (image) in a grid pattern filled with same figures.	the score is improved. • When the participant	• Varying size of grid-pattern (2×2 to 4×4) and varying distractor-items.
Memory:(delayed recall memory)	• Maintain and process perceptions simultaneously	• The participant has to remember a target-figure. • Two distraction tasks (Attention I & II) are presented before recall of the previous learned target-figure.	answered incorrectly, the learning is repeated.	• Varying number of target-figure to be learned (5 to 35) • Varying pattern complexity (image, color, position, and number)

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