A Pilot Study of a Cognitive-Behavioral Intervention for Breast Cancer Survivors

To test combining a group intervention to build self-efficacy for using compensatory strategies and lifestyle adjustments with brain-training practice to improve cognition.
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A quasiexperimental design.
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Texas Oncology, a community oncology practice in Austin.
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20 women aged 35-65 years, who had finished chemotherapy at least three months before the study, were within five years of completing all treatment, and had self-reported cognitive concerns. 
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Six group sessions to build self-efficacy for using compensatory strategies, along with other health behaviors that affect cognitive performance, were combined with practice on a computer-based training program. Female breast cancer survivors were recruited through flyers, mailings, and personal contacts. 
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Cognitive performance, cognitive concerns, cognitive/memory strategies, fatigue, emotional distress, sleep disorders, and quality of life.
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Participants reported that the intervention was useful in building cognitive abilities. Although scores on performance tests did not increase, ratings of cognitive concerns, fatigue, emotional distress, and sleep disturbance decreased significantly. Use of cognitive/memory strategies increased significantly. 
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This pilot study demonstrated the feasibility of combining a group intervention with brain-training practice. A larger randomized trial would afford a more rigorous test of efficacy.
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A growing body of evidence regarding potential interventions to address survivors' cognitive problems exists. Nurses should counsel breast cancer survivors about fatigue, sleep deprivation, and emotional distress, as well as the effects of cancer treatment on cognition.