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Chemotherapy-Related Change in Cognitive Function: A Conceptual Model

Lisa M. Hess
Kathleen C. Insel
ONF 2007, 34(5), 981-994 DOI: 10.1188/07.ONF.981-994

Purpose/Objectives: To develop a conceptual model of chemotherapy-related changes in cognitive function.

Data Sources: MEDLINE®, CINAHL®, HealthStar, and PsycINFO® databases.

Data Synthesis: Patients undergoing chemotherapy often complain of forgetfulness, absentmindedness, and an inability to focus when performing a variety of daily tasks. Changes in cognitive function have been referred to by the colloquial term "chemo-brain." The authors conducted an examination of the literature to investigate relationships among concepts and to synthesize current knowledge.

Conclusions: Cognitive function, defined as higher-order mental processes, may be altered along two distinct and interacting pathways: (a) the cancer diagnosis, which can lead to anxiety, stress, distress, and depression; and (b) the direct physiologic effects of cancer treatment. The Chemotherapy-Related Change in Cognitive Function conceptual model is informed by a review of literature that illustrates antecedents, moderators, mediators, and consequences that may be relevant to this issue.

Implications for Nursing: When a patient presents with cognitive complaints, the problems can be evaluated for intervention when an overall understanding exists of chemotherapy-related cognitive changes based on a conceptual model that continues to be informed through well-conceptualized and well-designed research.

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