title: Perceived cognitive impairment in Chinese patients with breast cancer and its relationship with post-traumatic stress disorder symptoms and fatigue.
abstract: OBJECTIVE
  Clinical reports have shown that adjuvant chemotherapy has a negative impact on perceived cognitive impairment (PCI) of patients with breast cancer; however, evidence concerning the effects of psychological factors such as post-traumatic stress disorder (PTSD) symptoms on PCI is limited, especially in relation to Chinese patients with breast cancer. This research investigated the associations between psychological factors and PCI in Chinese women with breast cancer.
  
  
  METHODS
  In total, 204 women with breast cancer were assessed for PCI, PTSD symptoms, fatigue, anxiety, and depression using self-report measures. Hierarchical linear regression was conducted to investigate the associations between the variables of interest and PCI.
  
  
  RESULTS
  Two hundred and two women were included in the final analysis; two of those originally tested were excluded because of missing data. A univariate analysis showed that PCI was significantly related to education, PTSD symptoms (re-experience, avoidance, and hyperarousal), fatigue, depression, anxiety, and undergoing chemotherapy or radiotherapy. Hierarchical linear regression revealed that PTSD symptoms and fatigue (ΔR(2)  = 0.26, P < 0.001) independently accounted for PCI in Chinese women with breast cancer regardless of age, education level, chemotherapy and radiotherapy. Hyperarousal was the only contributing PTSD symptom to PCI (B = -1.24, SE = 0.33, β = -0.39, P < 0.001).
  
  
  CONCLUSIONS
  Besides chemotherapy, PTSD symptoms, especially hyperarousal, and fatigue are important risk factors for significant PCI and are therefore worthy of further investigation.
authors.affiliation: Nursing School, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong Province, 250012, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: The Second Hospital of Shandong University, Shandong University, 247 Beiyuan Road, Jinan, Shandong Province, 250033, China.
authors.forename: Lixiang
authors.initials: L
authors.lastname: Yu
authors.affiliation: Nursing School, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong Province, 250012, China.
authors.forename: Zhouting
authors.initials: Z
authors.lastname: Long
authors.affiliation: Nursing School, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong Province, 250012, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Nursing School, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong Province, 250012, China.
authors.forename: Fenglin
authors.initials: F
authors.lastname: Cao
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D001943:Breast Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D002681:China; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D010465:Perception; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D000970:Antineoplastic Agents
keywords: breast cancer; cancer; fatigue; oncology; perceived cognitive impairment; post-traumatic stress disorder