Development of the Cognitive Function Scale for Breast Cancer Patients

Bok Yae Chung; Eun Hee Choi; Gyung Duck Kim; Kyung Hae Kim; Hye Sun Byun

doi:10.5388/aon.2017.17.1.12

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Chung, Choi, Kim, Kim, and Byun: Development of the Cognitive Function Scale for Breast Cancer Patients

Original Article

Asian Oncology Nursing 2017; 17(1): 12-19.

Published online: 31 March 2017

DOI: https://doi.org/10.5388/aon.2017.17.1.12

Development of the Cognitive Function Scale for Breast Cancer Patients

Bok Yae Chung¹, Eun Hee Choi², Gyung Duck Kim³, Kyung Hae Kim⁴, Hye Sun Byun²

¹College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Korea.

²School of Nursing, Yeungnam University College, Daegu, Korea.

³Department of Nursing, Dongyang University, Yeongju, Korea.

⁴Department of Nursing, Gyeongbuk College of Health, Gimcheon, Korea.

Address reprint requests to: Choi, Eun Hee. School of Nursing, Yeungnam University College, Daegu 42415, Korea. Tel: +82-53-650-9388, Fax: +82-53-625-4705, eh5472@ync.ac.kr

Received 17 October 2016 Revised 26 January 2017 Accepted 15 March 2017

(open-access):

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

This is the methodological study to develop the cognitive function scale for breast cancer patients.

Methods

Study was consisted with 1st and 2nd items developing and testify for reliability and validity of them. 94 breast cancer patients in 2 university hospitals and 1 general hospitals responded to a questionnaire that assessed cognitive function scale. Collected data were analysed using the program SPSS/PC Win 21.0. Structural validity was determined factor analysis and convergent validity. This method yielded Cronbach's α value as an internal consistency for the reliability.

Results

Factor analysis resulted in six factors and 24 items accounted for 76.31% of the variance. Cronbach's α of scale developed was high as a .95.

Conclusion

The developed cognitive function scale in breast cancer patients scale has reliability and validity as linear analogue scale witch quantitatively measure the subjectivity. Over these results, providing the way on an assessment in cognitive function in effect for breast cancer patients, it is supposed to contribute the development of nursing knowledge about the cognitive function in breast cancer patients.

Keywords: Breast Neoplasms, Cognition

Figures and Tables

Table 1

Experiences of Cognitive Function Disorder after Chemotherapy in Breast Cancer

Categories	Theme clusters	Themes
Memory	Short-term memory disorder	• Forgetfulness like an amnesia
	Short-term memory disorder	• Reducing of moment memory
	Long-term memory disorder	• Delaying of past memory
	Long-term memory disorder	• Disconnecting of memories
	Working memory disorder	• Forgetting what doing
	Working memory disorder	• Forgetting what to do
	Language memory disorder	• Forgetting of words
	Language memory disorder	• Reducing of language fluency
	Visual memory disorder	• Forgetting of persons
	Visual memory disorder	• Delaying of image memory
	Recognizing of memory decrease differences	• Mild reducing of memory
	Recognizing of memory decrease differences	• Sever memory reducing over than 50%
	Reducing of memorization	• Differencing of number memory
	Reducing of memorization	• Memory differencing of access number
Perception	Reducing in sense of direction	• Confusing of place
	Reducing in sense of direction	• Getting lost
	Reducing in sense of time	• Confusing of time
	Reducing in sense of time	• Entirely forget of time
Attention & concentration	Reducing of attention	• Attention difference due to visual loss
		• Distraction
		• Not wishing to attention
	Reducing of concentration	• Not perception of danger
	Reducing of concentration	• Burning food due to not turning off the gas
Organization	Reducing of thinking power	• Spacing out
		• Thinking simply
		• Frantic like dementia
	Reducing of decision making	• Reducing of judgement
Exectutive function	Reducing of computability	• Difficulty of money account
	Reducing of computability	• Difficulty in solving of mathematics
	Delaying of response	• Delaying of response
Understanding	Reducing of learning ability	• Slowing of learning flow
	Reducing of learning ability	• Scaring of learning
	Reducing of understanding	• Misunderstanding of book or newspaper
		• Not progressing of reading
		• Difficulty of analysis
Impetus	Reducing of exercise function	• Slowing of acting
	Reducing of exercise function	• Reducing of muscle function
	Dull of hand motion	• Slowing of hand motion
	Dull of hand motion	• Difficulty of house work

Table 2

Characteristics of Subjects (N=94)

Characteristics	Categories	n (%)
Age (year)	35~40	6 (6.5)
	41~50	32 (34.8)
	51~60	37 (40.2)
	61~75	17 (18.5)
Economic state	High	1 (1.1)
	Middle	70 (79.6)
	Low	17 (19.3)
Education level	≤Middle school	29 (31.2)
	High school	41 (44.1)
	College or university	23 (24.7)
Marital status	Single/divorced/separated/widowed	17 (18.3)
Marital status	Married	76 (81.7)
Occupation	Yes	19 (21.1)
Occupation	No	71 (78.9)
Religion	Yes	78 (83.9)
Religion	No	15 (16.1)
Antiestrogen medication	Yes	26 (28.6)
Antiestrogen medication	No	65 (71.4)
Duration with antiestrogen medication (year)	< 1	8 (42.1)
	1~2	6 (31.6)
	≥2	5 (26.3)
Duration with cancer che- motherapy (year)	< 1	68 (84.0)
	1~2	10 (12.3)
	≥2	3 (3.7)

Note. Missing data is excluded.

Table 3

Inter-subscale Correlations and Reliability Coefficients of Each Scale

Factors	1	2	3	4	5	Cronbach's α
Factors	r (p)	r (p)	r (p)	r (p)	r (p)	Cronbach's α
1	1					.94
2	.53 (<.001)	1				.91
3	.58 (<.001)	.48 (<.001)	1			.93
4	.56 (<.001)	.62 (<.001)	.67 (<.001)	1		.88
5	.54 (<.001)	.54 (<.001)	.47 (<.001)	.48 (<.001)	1	.74

Table 4

Reliability of Each Subscale

Factors	No	Item	Corrected term - total correlation
Memory	1	Forgetting why I open refrigerator	.77 (<.001)
	2	Forgetting purpose of doing	.76 (<.001)
	3	Write on memo not to forget	.69 (<.001)
	4	Hard to remember where key is	.73 (<.001)
	5	Experiences for difficulty on speaking	.74 (<.001)
	6	Feeling stupid myself	.84 (<.001)
	7	Absentminded	.78 (<.001)
Executive function	12	Sloppy work	.63 (<.001)
	13	Slower in writing or cooking than before	.64 (<.001)
	14	Difficult to do more than 2 things at a time	.61 (<.001)
	15	Slower working speed than before	.66 (<.001)
	17	Forgetting of promise	.66 (<.001)
	18	Misunderstanding about time	.70 (<.001)
Attention & concentration	21	Difficult concentration on working	.72 (<.001)
	22	Difficult concentration on minor things	.70 (<.001)
	23	Difficult reading a newspaper constantly	.71 (<.001)
	24	Difficult listening carefully	.70 (<.001)
Organization skill	25	Not careful decision making	.66 (<.001)
	27	Difficult thinking carefully	.59 (<.001)
	29	Difficult decision making	.60 (<.001)
	32	Loss of direction senses	.53 (<.001)
	33	Difficult collecting the data	.70 (<.001)
Perception	41	Repeated newspaper reading	.68 (<.001)
Perception	42	Repeated asking because of misunderstanding	.65 (<.001)
Cronbach's α			.95

Table 5

Factor Loadings and Accumulative Variance in the Items (N=94)

No	Factor loading-I^a								Factor loading-II^b						Factor loading-III^c					Factor loading-IV^d
No	1	2	3	4	5	6	7	8	1	2	3	4	5	6	1	2	3	4	5	1	2	3	4	5
1	.82								.82						.84					.84
2	.82								.84						.84					.84
3	.81								.80						.83					.83
4	.81								.81						.81					.81
5	.76								.78						.79					.79
6	.69								.69						.70					.71
7	.61								.68						.68					.70
8
9
10
11	.53
12		.83								.88						.90					.90
13		.82								.82						.84					.84
14		.70								.71						.73					.73
15		.68								.69						.68					.68
16		.68
17		.63								.62						.62					.61
18		.61								.67						.70					.70
19		.59
20
21			.83								.84						.85					.86
22			.83								.82						.86					.86
23			.80								.83						.83					.83
24			.69								.69						.69					.70
25				.72								.79					.65						.64
26				.63
27				.61								.68					.77						.76
28
29				.58								.63					.59						.57
30
31
32					.79									.78					.82					.82
33					.68									.66					.66					.65
34					.61
35
36						.71
37
38
39
40
41							.77							.73			.70						.71
42							.74							.66			.73						.75
43
44
45								.60						.56
46
TVE	73.36								76.83						75.17					76.31

TVE= Total variance explained; Criteria of value of loading>.50.

^aKaiser-Meyer-Olkin (KMO)= .86, Bartlette's test of sphericity= 4,616.31, p<.001; ^bKaiser-Meyer-Olkin (KMO)= .86, Bartlette's test of sphericity= 2,418.54, p<.001; ^cKaiser-Meyer-Olkin (KMO)= .87, Bartlette's test of sphericity= 1,966.96, p<.001; ^dKaiser-Meyer-Olkin (KMO)= .86, Bartlette's test of sphericity= 1,905.17, p<.001.

Notes

This research was supported by Basic Science Program through the National Foundation of Korea (NRF) Funded by the Ministry of Education, Science and Technology (No. 2010-0011091).

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