Impact of Cognitive Function and Cancer Coping on Quality of Life among Women with Post-chemotherapy Breast Cancer

Yoon Jung Kim; Sook Jung Kang

doi:10.4069/kjwhn.2016.22.3.182

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Kim and Kang: Impact of Cognitive Function and Cancer Coping on Quality of Life among Women with Post-chemotherapy Breast Cancer

Original Article

Korean Journal of Women Health Nursing 2016; 22(3): 182-190.

Published online: 27 September 2016

DOI: https://doi.org/10.4069/kjwhn.2016.22.3.182

Impact of Cognitive Function and Cancer Coping on Quality of Life among Women with Post-chemotherapy Breast Cancer

Yoon Jung Kim, Sook Jung Kang

College of Nursing, Ewha Womans University, Seoul, Korea.

Corresponding author: Kang, Sook Jung. College of Nursing, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea. Tel: +82-2-3277-2882, Fax: +82-2-3277-2850, sookjungkang@ewha.ac.kr

Received 21 July 2016 Revised 23 August 2016 Accepted 31 August 2016

(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 study was done to identify effects of cognitive function and cancer coping on quality of life among women with breast cancer treated with antineoplastic agents.

Methods

The study was correlational research and participants were 145 women with breast cancer who had received antineoplastic agents. Data were collected from October to November, 2015 via online replies. Cognitive function was measured with the Functional Assessment of Cancer Therapy-Cognitive Function Version-3 (FACT-Cog), cancer coping, with the Korean Cancer Coping Questionnaire (K-CCQ), and quality of life with the Functional Assessment of Cancer Therapy-Breast Version-4 (FACT-B). Data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, ANCOVA, Bonferroni test, partial correlation coefficient, and hierarchical multiple regression with SPSS 21.

Results

Cognitive functions, total individual coping, and interpersonal coping explained 42% of quality of life. Cognitive function (β=.35, p<.001) was the best predictor of quality of life, followed by total individual coping (β=.34, p<.001), and interpersonal coping (β=.26, p<.001).

Conclusion

Results indicate that cognitive function and cancer coping are meaningful factors for quality of life among breast cancer survivors. Therefore when developing intervention programs for these women, content on cognitive function and coping skills as well as coping resources should be included.

Keywords: Cognition, Breast neoplasms, Antineoplastic agents, Quality of life

Figures and Tables

Table 1

Characteristics of Women with Breast Cancer (N=145)

Characteristics	Categories	n (%) or M±SD
Age (year)		40.61±7.02
	≤39	64 (44.1)
	40~44	35 (24.1)
	45~49	34 (23.4)
	≥50	12 (8.3)
Religion	Yes	99 (68.3)
Religion	None	46 (31.7)
Educational level	≤Middle school	2 (1.4)
	High school	29 (20.0)
	≥College	114 (78.6)
Subjective economic status	High	3 (2.1)
	Middle	111 (76.6)
	Low	31 (21.4)
Length of time since diagnosis (month)		20.10±15.94
	≤12	66 (45.5)
	13~24	29 (20.0)
	>24	50 (34.5)
Stage of disease	1	31 (21.4)
	2	78 (53.8)
	3	33 (22.8)
	4	3 (2.1)
Hormone therapy	Yes	87 (60.0)
Hormone therapy	No	58 (40.0)
Number of chemotherapy		7.39±3.96
	≤4	37 (25.5)
	5~8	88 (60.7)
	≥9	20 (13.8)
Chemotherapy	Not finished	34 (23.4)
Chemotherapy	Finished	111 (76.6)
Menopause	Yes	55 (37.9)
Menopause	No	90 (62.1)

Table 2

Cognitive Function, Cancer Coping, and Quality of Life according to Characteristics of Participants (N=145)

Characteristics	Categories	n	Cognitive function		Total individual scale		Interpersonal scale		Quality of life
Characteristics	Categories	n	M±SD	t or F (p) Bonferroni	M±SD	t or F (p)	M±SD	t or F (p)	M±SD	t or F (p)
Age (year)	≤39	64	92.97±23.57	2.21 (.090)	36.84±8.56	0.37 (.778)	26.22±7.38	2.59 (.055)	85.95±22.98	0.17 (.914)
	40~44	35	95.43±26.68		38.77±10.2		22.57±7.95		89.09±23.14
	45~49	34	81.88±26.21		37.44±7.94		22.59±8.23		86.06±19.15
	≥50	12	84.67±24.94		37.75±7.82		25.83±7.41		87.17±19.0
Religion	Yes	99	92.94±24.86	3.46 (.065)	38.90±7.84	-2.62 (.011)	26.03±7.64	-3.70 (<.001)	89.50±20.94	-2.20 (.029)
Religion	None	46	84.54±25.86	3.46 (.065)	34.57±9.87	-2.62 (.011)	21.07±7.29	-3.70 (<.001)	81.10±22.41	-2.20 (.029)
Educational level	≤High school	31	89.90±22.05	0.10 (.753)	35.84±8.31	-1.21 (.227)	23.39±8.89	-7.78 (.441)	88.29±19.28	0.42 (.675)
Educational level	≥College	114	90.38±26.32	0.10 (.753)	37.98±8.83	-1.21 (.227)	24.75±7.56	-7.78 (.441)	86.44±22.37	0.42 (.675)
Subjective economic status	Middle & high	114	92.29±24.98	2.57 (.111)	38.61±8.78	2.93 (.004)	25.44±7.54	2.97 (.004)	89.40±20.68	2.80 (.006)
Subjective economic status	Low	31	82.87±25.96	2.57 (.111)	33.55±7.43	2.93 (.004)	20.84±8.05	2.97 (.004)	77.39±23.08	2.80 (.006)
Length of time since diagnosis (month)	≤12^a	66	98.36±22.12	7.46 (.001) b<a	38.82±8.96	1.64 (.198)	26.09±8.00	2.79 (.065)	88.89±18.75	2.41 (.093)
	13~24^b	29	77.24±26.64		35.45±7.92		23.59±8.30		79.00±23.44
	>24^c	50	87.16±25.35		37.02±8.77		22.80±7.09		88.66±23.62
Stage of disease	01	31	90.26±18.76	0.04 (.963)	35.23±8.74	1.59 (.207)	23.03±7.24	1.04 (.355)	87.97±17.71	1.71 (.185)
	02	78	90.17±26.86		38.51±8.69		24.40±8.00		89.03±21.01
	3, 4	36	90.53±27.65		37.36±8.69		25.81±8.02		81.11±25.53
Hormonal therapy	Yes	87	88.79±24.35	0.68 (.411)	36.52±8.92	-1.71 (.089)	23.41±7.65	-1.98 (.050)	85.02±23.46	-1.29 (.199)
Hormonal therapy	No	58	92.50±26.95	0.68 (.411)	39.03±8.31	-1.71 (.089)	26.02±7.96	-1.98 (.050)	89.55±18.61	-1.29 (.199)
Number of chemotherapy	≤4	37	94.30±20.41	0.89 (.411)	36.84±7.59	0.22 (.802)	24.78±7.49	0.55 (.581)	92.92±16.51	2.38 (.096)
	5~8	88	89.14±28.67		37.91±8.79		24.70±7.82		85.63±23.08
	≥9	20	87.85±17.03		37.10±10.70		22.75±8.80		80.90±22.31
Chemotherapy	Not finished	34	97.65±21.44	3.34 (.070)	37.21±8.42	-0.24 (.809)	26.76±7.37	1.98 (.050)	85.68±21.63	-.355 (.723)
Chemotherapy	Finished	111	88.02±26.16	3.34 (.070)	37.62±8.87	-0.24 (.809)	23.75±7.89	1.98 (.050)	87.19±21.81	-.355 (.723)
Menopause	Yes	55	80.04±25.54	-11.79 (<.001)	37.91±9.11	0.41 (.680)	22.76±7.94	-2.05 (.042)	86.69±19.01	-.062 (.951)
Menopause	No	90	96.53±23.31	-11.79 (<.001)	37.29±8.54	0.41 (.680)	25.49±7.66	-2.05 (.042)	86.92±23.30	-.062 (.951)

Table 3

Influencing Factors on Quality of Life

Variables	Model 1				Model 2
Variables	B	β	t	p	B	β	t	p
Age	0.15	.05	0.50	.620	0.16	.05	0.65	.514
Religion (None=0)
Yes	8.03	.17	2.11	.037	-0.45	-.01	-0.14	.891
Subjective economic status (Low=0)
Middle & high	10.33	.20	2.73	.019	3.32	.06	0.91	.367
Menopause (Yes=0)
No	0.09	.00	0.02	.983	-4.51	-.10	-1.18	.238
Length of time since diagnosis (month)
13~24	8.32	-.15	-1.76	.081	0.26	.01	0.06	.950
>24	1.81	.04	0.45	.655	6.09	.13	1.82	.071
Cognitive function					0.34	.35	4.77	<.001
Coping - individual					0.85	.34	4.62	<.001
Coping - interpersonal					0.71	.26	3.38	<.001
	R²=.11, F=2.76, p=.014				R²=.42, ΔR²=.31, F=10.78, p<.001

Notes

This manuscript is a condensed form of the first author's master's thesis from Ewha Womans University.

Summary Statement

▪ What is already known about this topic?

A majority of breast cancer survivors, particularly those treated with antineoplastic agents, experience cognitive decline that significantly reduce quality of life.

▪ What this paper adds?

The result indicate that cognitive function and cancer coping are significant predictors for quality of life among breast cancer women who received antineoplastic agents.

▪ Implications for practice, education and/or policy

Nurses may be the best professionals to support breast cancer women with cognitive problems by providing interventions that can ultimately improve their quality of life.

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