title: Characteristics associated with inter-individual differences in the trajectories of self-reported attentional function in oncology outpatients receiving chemotherapy.
abstract: Between 14 and 85 % of patients report noticeable changes in cognitive function during chemotherapy (CTX). The purposes of this study were to determine which demographic, clinical, and symptom characteristics were associated with inter-individual variability in initial levels of attentional function as well as with changes in the trajectories of attentional function in a sample of oncology patients who received two cycles of CTX.
  
  
  
  Oncology outpatients (n = 1329) were recruited from two comprehensive cancer centers, one veteran's affairs hospital, and four community-based oncology programs. The Attentional Function Index (AFI) was used to assess perceived effectiveness in completing daily tasks that required working memory and attention. Hierarchical linear modeling (HLM) was used to evaluate for inter-individual variability in initial levels and in the trajectories of attentional function.
  
  
  
  Demographic, clinical, and symptom characteristics associated with inter-individual differences of attentional function at enrollment (i.e., intercept) were as follows: employment status, functional status, trait anxiety, depressive symptoms, sleep disturbance, evening fatigue, and morning energy. Gender was the only characteristic associated with inter-individual differences in the trajectories of attentional function. Morning fatigue was the only characteristic associated with both initial levels and the trajectories of attentional function.
  
  
  
  Prior to their next dose of CTX, patients reported moderate levels of attentional function that persisted over two cycles of CTX. Many of the clinical and symptom characteristics associated with decrements in attentional function are amenable to interventions. Clinicians need to assess patients for changes in attentional function and associated characteristics and recommend evidence-based interventions.
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Juliet
authors.initials: J
authors.lastname: Shih
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Leutwyler
authors.affiliation: School of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Ritchie
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Paul
authors.affiliation: School of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Jon D
authors.initials: JD
authors.lastname: Levine
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Cooper
authors.affiliation: School of Nursing, Yale University, New Haven, CT, USA.
authors.forename: Fay
authors.initials: F
authors.lastname: Wright
authors.affiliation: School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Yvette P
authors.initials: YP
authors.lastname: Conley
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA. chris.miaskowski@ucsf.edu.|Department of Physiological Nursing, University of California, Box 0610 - N631Y, San Francisco, CA, 94143-0610, USA. chris.miaskowski@ucsf.edu.
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
mesh_terms: D001288:Attention / Q000187:drug effects*; D003071:Cognition / Q000187:drug effects; D056344:Executive Function / Q000187:drug effects; D005260:Female; D006801:Humans; D007206:Individuality; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D010045:Outpatients; D057566:Self Report
keywords: Attentional function; Chemotherapy; Cognitive function; Executive function; Hierarchical linear modeling