Women's experiences of cognitive changes or 'chemobrain' following treatment for breast cancer: a role for occupational therapy?
OBJECTIVE
Changes to functioning and cognition are commonly reported following chemotherapy. These changes are highly individual, and may not be fully recognised or understood. Breast cancer is the most common cancer diagnosed in women worldwide, yet little is known about the impact of cognitive changes for these women following treatment and many do not benefit from occupational therapy services. The aim was to describe changes in cognitive function experienced by women who had undergone chemotherapy, and the strategies used to overcome the associated challenges.


METHODS
This was a qualitative phenomenological study conducted with nine women, aged between 39 and 67 years, from New South Wales. Participants were breast cancer survivors who had received chemotherapy treatment, and self-reported chemobrain symptoms. Data were collected through semi-structured in-depth telephone and face-to-face interviews. Data were transcribed, coded and thematically analysed.


RESULTS
Six themes described the chemobrain experience for these women. They were: uncertainty about the origin of the chemobrain experience; persistent but inconsistent impacts on function; simple function turned complex; losing functional independence in family life; strategies to maintain function; and the need for recognition of the subjective experience of cancer treatment.


CONCLUSIONS
The experiences of cognitive and functional changes following chemotherapy for those reporting chemobrain symptoms are highly individual, and include the need for adaptive strategies. Some similarities in the types of impairments were experienced. As breast cancer survivorship rates continue to rise, there is a need for occupational therapy services to assist women in returning to daily occupations during or following their cancer treatment.
Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia.
Lucy
L
Player
Lynette
L
Mackenzie
Karen
K
Willis
Siew Yim
SY
Loh
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D003072:Cognition Disorders / Q000139:chemically induced* / Q000523:psychology*; D003221:Confusion / Q000523:psychology; D005221:Fatigue / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009517:New South Wales; D009788:Occupational Therapy; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D057566:Self Report; D016387:Women's Health
D000970:Antineoplastic Agents
breast cancer; cognition; functional activities; qualitative